The infant siblings badly burned in a Gisborne car fire are likely to face dozens more operations and many weeks in hospital as they recover.
A plastic and reconstructive surgeon at Middlemore Hospital, where the children remain in a critical condition, said the first two weeks were the most critical for patients with serious injuries.
Amber Moazzam, who specialises in burns at the hospital's National Burn Centre, said he couldn't comment on specific patients but victims with such injuries typically faced more than 25 operations and at least two months in hospital as medical staff work round the clock to ensure their injuries heal without infection.
Manaia Namana-Rowe, 3, and her brother, 22-month-old Rious Namana-Rowe, suffered burns to 40 per cent of their bodies when their mother's car, which they had been left alone in, caught fire last Thursday.
They were stable yesterday in Middlemore's intensive care ward but Mr Moazzam warned that critically ill burns victims faced a long recovery.
"In the first week to 10 days' time we like to take the burned skin off as soon as possible. On the other hand, if they've had a major burn they may not be able to undergo a big operation [immediately] so sometimes we have to stagger the operations," he said.
"The first two weeks they'll be going under major surgery. After that you come into a plateau area and then you start reconstructing them again."
Surgeons will use as much of the children's own skin as possible to graft over areas that have been burned off.
They will also use grafts from organ donors, skin which eventually is rejected by the recipient's body but lasts long enough for new skin to grow to be used for fresh grafts.
Mr Moazzam said grafted skin was susceptible to infection and needed constant redressing between operations.
"If they are very young ... they are more susceptible to infection. Once they're 3 or 4 years of age their bodies start being quite adaptable and quite strong actually," Mr Moazzam said.
"In some cases they prove to be very strong and resilient. Once they go past 2, 3 years of age they do tend to surprise us."
Mr Moazzam said he had treated patients who had survived more than 80 per cent burns, but the chances of recovery were significantly less for young children whose immune systems were still developing.
He said days spent in hospital wards would take their toll on the families of badly burned patients.
"We keep them involved and keep them informed with what is happening regarding their operation, regarding their prognosis and what difficulties they face," he said.
"They're obviously very distraught people, very much in shock. We obviously give them support, as much as they require, and also ask them to look after themselves.
"We say 'we're looking after your kid, you need to look after yourself'."
Mr Moazzam said young burns victims often faced years of rehabilitation.
If you're dealing with a serious burn:
* Stop the burning.
* Remove clothing or jewellery from around the burn area.
* Cool the burn under cool running water for 20 minutes (this is best immediately but can still be useful up to three hours later).
* Prevent hypothermia by cooling the burn but keeping the patient warm.
* Using anything other than cool running water on the burn, such as butter, can do more harm than good.
Source: National Burn Centre