Is there any place for spontaneous healing in deep palmar burn of the child?

Area of Science:

• Pediatric Surgery
• Burn Management
• Rehabilitation Medicine

Background:

• Child palm burns are often deep and pose unique challenges due to growth and potential for scar contractures.
• Current standard treatment involves early excision and skin grafting to prevent sequelae.
• The long-term functional outcomes of different treatment approaches require further evaluation.

Purpose of the Study:

• To compare spontaneous healing with rehabilitation versus early skin grafting and rehabilitation for pediatric palmar burns.
• To assess the incidence of sequelae, including reconstructive surgery needs and splinting duration.
• To determine the optimal management strategy for minimizing long-term complications.

Main Methods:

• A retrospective study was conducted across two burn centers and one rehabilitation hospital (1995-2010).
• Eighty-seven pediatric hands with palmar burns were analyzed, divided into spontaneous healing and early skin grafting groups.
• Both groups received specific rehabilitation protocols; outcomes were evaluated based on splint wear duration and reconstructive surgeries.

Main Results:

• The median follow-up was approximately four years, with comparable groups.
• Children in the early skin grafting group required splint wearing for one-third longer duration.
• Half of the grafted hands needed reconstructive surgery, compared to one-fifth of hands treated with spontaneous healing.

Conclusions:

• Spontaneous healing, when combined with a dedicated and intensive rehabilitation protocol, demonstrates significant advantages for pediatric palmar burns.
• This approach may reduce the need for subsequent reconstructive surgeries and prolonged immobilization.
• Further research should focus on optimizing rehabilitation strategies for spontaneous healing in pediatric burn care.