Much progress has been made toward the development of artificial skin replacement products. Continued research promises to bring more products to the marketplace, and each new product seems to develop a niche in the field of skin replacement. However, although each skin replacement product has unique properties and advantages, nothing works as well as a patient's own skin. Clinicians can only hope for an off-the-shelf skin replacement product that can be applied to a wound and yield a permanent, dependable dermis and epidermal skin replacement for all patients.

Pain control is a major issue concerning children admitted for burns. Pain and anxiety associated with twice daily wound cleansing and dressing changes are difficult to control, especially if there is no intravenous access. We explored the effectiveness of intranasal midazolam (INM) combined with intravenous and/or oral pain medications prior to painful treatments. Charts of all patients admitted from October 1995 to November 1996 under the age of 9 were reviewed for use of INM. Twelve patients had INM used at some point during their hospitalization. Our study covers this group, with each child acting as his/her own control. Pain and response to medication during wound cleansing was assessed by the nursing staff as documented in the patient's nursing assessment. Nursing documentation indicated that patient response was positive regarding the use of INM with intravenous and/or oral pain medication.