Oral commissure burns in children

Pediatric oral commissure burns present a therapeutic and reconstructive challenge. Although these injuries are fairly common in young children, there exists some controversy on the appropriate timing and nature of the repair that should be performed. Some authors advocate early surgical intervention, whereas others advocate a far more conservative approach that uses prolonged splinting techniques in the hope of avoiding the need for reconstructive surgery. In the event that reconstructive surgery becomes necessary, there exists a wide range of reconstructive techniques that are described in the literature, from simple excision and skin grafting to complex local flap reconstruction using adjacent or distant tissue. In this article, we present an overview of the nature of pediatric oral commissure burns, identify special concerns in pediatric burn patient, discuss the potential role for oral commissure splinting, and finally review a number of different surgical reconstructive techniques that have been proposed in the literature.