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Published on: December 30, 2025
A ten-year experience with pediatric face grafts
David G Greenhalgh1, Katharine Hinchcliff, Soman Sen
1From the Shriners Hospitals for Children-Northern California, Sacramento; Firefighters Regional Burn Center at University of California, Davis; and Department of Surgery, University of California, Davis.
Facial autografting for pediatric burns is effective, especially the "wrap-around" technique for cosmetic results. Allograft or Integra serve as viable temporary options when autograft is limited, though Integra doesn't reduce reconstructive needs.
Area of Science:
- Plastic Surgery
- Pediatric Burn Care
- Regenerative Medicine
Background:
- Facial burns in children present unique challenges for reconstruction.
- Aesthetic outcomes and the need for subsequent reconstructive surgery are key concerns.
Purpose of the Study:
- To review a decade of experience with facial grafting in pediatric burn patients.
- To compare different grafting methods regarding aesthetic results and reconstructive needs.
- To evaluate the efficacy of allograft skin and Integra as temporary burn covers.
Main Methods:
- Retrospective review of 160 pediatric patients with facial burns treated between 2000 and 2010.
- Analysis of initial grafting procedures (autograft, allograft, Integra) and staged procedures.
- Evaluation of outcomes including length of stay, mortality, regrafting rates, and reconstructive surgery requirements.
Main Results:
- Autografting as an initial, one-stage procedure yielded good results, with the "wrap-around" technique showing excellent cosmetic outcomes.
- Allograft and Integra were utilized for massive burns, associated with high mortality (39%) and significant regrafting needs (43% for Integra).
- No significant difference in reconstructive surgery rates was observed between Integra and autografting groups.
Conclusions:
- Initial one-stage facial autografting is a successful approach for pediatric burns.
- "Wrap-around" autografts offer superior cosmetic results.
- Allograft and Integra are useful temporary measures for extensive burns but do not eliminate the need for future reconstructive surgery.
