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A Journal on Forensic Medicine
Minerva Medicolegale 2001 March;121(1): 1-14
Damage in sequelae to burns. Problems concerning medicolegal evaluation
Magliacani G., Bollero D., Cortellini M., Iorio M.
Burns represent one of the most dramatic pathologies in the field of medicine and surgery. They are characterised by an acute phase endangering survival, calling for particularly challenging treatment, and cicatricial sequelae that frequently lead to disabling results in which a major subjective component of a psychological nature is combined with objective clinical problems. The overall analysis of the patient with burn sequelae for medicolegal purposes, whether for compensation purposes or insurance, cannot reflect the real severity of the psychosomatic and physical deficiencies following the injury, owing to the lack of instruments for evaluation that are uniformly applicable to such a variegated reality that is also so difficult to catalogue. It is also worth underlining the difficulty of making a final evaluation of the damage linked to the interval between the injury and the time of the medicolegal assessment, given that the patient can present very different clinical and psychological symptoms depending on the moment the tests are carried out. In view of the need to establish a basis on which to standardise medicolegal opinion of the outcome of burns, we aimed to carry out a project to evaluate this type of damage by combining the knowledge of two apparently distinct structures. This aim is hampered by difficulties linked to the extreme variability of the resulting scars deriving from the. severity and extent of burns, age, scarring disorders and the individual psychological impact of bums. We hope that we can achieve a result that, even if not conclusive, represents a scientifically solid basis on which to continue to work and to correct the current evaluations that are known to be unrealistic.