Factors influencing surgical care and outcome of pediatric burn injuries and the use of synthetic skin substitutes

Burn trauma is one of the most common causes of inpatient treatment in children and is associated with severe physical and psychological consequences. Synthetic skin substitutes are designed to reduce the risk of infection, minimize wound pain, and reduce the frequency of dressing changes. However, data regarding premature detachment of these materials is scarce. The aim of this study was to identify factors associated with early detachment and subsequent consequences for surgical treatment. A retrospective analysis of 392 children with superficial and deep partial thickness burns undergoing inpatient treatment with application of a skin substitute (Suprathel®) was performed. Patient age, wound localization and progression as well as burned total body surface area (TBSA %) were investigated as possible risk factors for early detachment of wound dressings and surgical intervention. Premature material detachement was significantly associated with burn localization (p < 0.001) and correlated with burn depth progression (r = 0.23, < 0.001) and patient age (r = 0.22, < 0.001). Surgical revision after material detachment were required in 13 % of patients. Patient age and burn localization seem to increase the risk of premature material detachement. In addition, we observed increased premature detachment of Suprathel®in areas which elicited higher wound progression rates. Identifying these areas might prove pivotal in the improvement of pediatric burn trauma management.