A single institution’s surgical care model for pediatric burns with ≤ 10% body surface area involvement

Small burn injuries are extremely prevalent in the pediatric population and continue to pose a challenge for clinicians. Despite their high incidence, a standardized algorithm for treating small burns does not currently exist, and care is often influenced by clinical judgement and resource availability. The aim of this study was to explore the utility of a two-stage grafting technique, involving allograft and autograft, for treating small burns (≤ 10% total body surface area) in pediatric patients. A retrospective review of patients aged 0-18 years who had a small burn and underwent a two-stage grafting procedure between 09-01-2018 and 09-01-2022 was conducted. One hundred and seventy-five patients with 220 wounds met the inclusion criteria for this study. The mean time from presentation to allograft surgery was 11.4 days (SD 5.2) followed by autograft surgery approximately one week later. Most patients were discharged within 24 hours following allograft surgery (87.4%) and autograft surgery (81.1%). Mean autograft take was 97.7% (SD 11.8) with only four patients experiencing significant graft loss requiring subsequent re-grafting. These positive outcomes demonstrate that the two-stage technique can be successfully utilized for treating smaller pediatric burns. Moreover, these findings help to address the significant knowledge gap regarding the optimal approach to treating small burn wounds. Further research is warranted to learn more about cosmetic outcomes following two-stage grafting and determine how it compares to other techniques for treating small burns.