Pressure injuries are a costly and complex global issue in all health-care settings. Morbidity and mortality are significant for persons who develop facility-acquired pressure injuries and they often fail to proceed through normal wound healing, stalling in the inflammatory phase of healing and remaining in a chronic inflammatory state. Prevention and treatment require multiple approaches and multidisciplinary team involvement for success. Prevention includes attention to risk assessment, daily skin assessment, tissue load management with offloading and support surfaces, mobility and activity interventions, nutrition assessment, and incontinence management. Treatment follows the TIMERS acronym: Tissue management including debridement and cleansing, Infection and inflammation control including management of bacterial biofilms, Moisture balance with use of moisture-retentive dressings, Epithelial edge advancement or frequent and consistent reassessment of healing, Repair and regeneration with use of advanced wound healing and adjunct therapies, and Social factors and those related to the individual.

In the emergency room, a 70-year-old morbidly obese woman reports she has an ingrown hair on the right vulva. In the past day, it has grown dramatically in size. It is quite painful at rest and exquisitely painful with touch. She denies fever, nausea, or vomiting. Denies sexual activity in the past 10 years. Denies vaginal bleeding, discharge, and itching. Her past medical history is significant for diabetes for the past 40 years, hypertension, and urinary incontinence for which she wears pads. She states her blood sugar was in poor control in the past day or so. She does not smoke or have any other pertinent social history. Her medications include insulin and blood pressure medication. She denies a significant surgical history and had two term vaginal deliveries.

It is highly likely that a field hospital will need to provide wound care. The very presence of a field hospital indicates that a situation exists where normal healthcare is challenged. It is important that staff understand the situation as it directly impacts on the type of care that should be delivered. The wrong type of care will not just yield suboptimal results for the patients, but will adversely affect workload, impact on resources, and compromise the effectiveness of the facility. Achieving good outcomes in wound care is dependent on ensuring the patient’s general well-being is optimised. The core requirement for wound care is initial wound surgery, which fully evaluates the wound as well as performing debridement and essential immediate interventions. Wounds associated with conflict and disaster should not be primarily closed. Healing is achieved by delayed primary closure or later complex reconstruction.

This chapter, reviews burns management in children.The authors discuss the various types of burns in children and the impact on management. The authors review burn classification, penetration and assessment of body surface area affected as it relates to children. Discussion of the anesthetic considerations related to patients with severe burns is presented including, carbon monoxide and cyanide toxicities, fluid and temperature management, airway considerations and analgesic options