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Updated: Jun 6, 2025
A Murine Model of a Burn Wound Reconstructed with an Allogeneic Skin Graft
Published on: August 8, 2020
Pros and Cons of Early and Late Skin Grafting in Children with Burns-Evaluation of Common Concepts
Islam Abdelrahman1, Ingrid Steinvall1, Folke Sjöberg1,2
1Department of Hand Surgery, Plastic Surgery and Burns and Department of Biomedical and Clinical Sciences, Linköping University, 58183 Linköping, Sweden.
Insights
Early surgery for pediatric deep dermal burns (<20% body surface area) led to faster wound healing but required more operations. Delayed surgery resulted in longer healing times for children.
Area of Science:
- Pediatric surgery
- Burn management
- Wound healing
Background:
- Consensus on surgical timing for small pediatric burns is lacking.
- Delayed surgery risks infection and prolonged wound healing.
- Early surgery may lead to unnecessary tissue removal.
Purpose of the Study:
- To evaluate the impact of surgical timing on operative site size and wound healing time.
- Investigate outcomes for early versus delayed split-thickness skin grafting in pediatric burns.
Main Methods:
- Retrospective analysis of pediatric patients (<18 years) with burns <20% body surface area (BSA%).
- Patients were grouped into early (≤14 days) and delayed (>14 days) surgical intervention groups.
- Data collected on burn size, depth, operative area, and healing time.
Main Results:
- Early surgery group showed a significantly shorter healing time (7 days faster).
- No significant difference in initial burn size or depth between groups.
- Early surgery group had a higher rate of secondary operations (p=0.03).
Conclusions:
- Early surgical intervention in pediatric burns (<20% BSA) accelerates wound healing.
- Delayed surgery is associated with prolonged healing times.
- Early surgery may necessitate more procedures and larger excisions.
Background:
There is no consensus regarding the timing of surgery in children with smaller burn size, specifically in deep dermal burns. Delayed surgery has risks in terms of infection and delayed wound healing. Early surgery also risks the removal of potentially viable tissue. Our aim was to investigate the effect of the timing of surgical intervention on the size of the area operated on and the time to wound healing.
Methods:
A retrospective analysis for all children (<18 years) with burn size <20% body surface area (BSA%) during 2009-2020 who were operated on with a split-thickness skin graft. The patients were grouped by the timing of the first skin graft operation: early = operated on within 14 days of injury; delayed = operated on more than two weeks after injury.
Results:
A total of 84 patients were included in the study, 43 who had an early operation and 41 who had a delayed operation. There were no differences between the groups regarding burn size, or whether the burns were superficial or deep. The mean duration of healing time was seven days longer in the group with delayed operation (p = 0.001). The area operated on was somewhat larger (not significantly so) in the group who had early operation. Nine children had two skin graft operations, eight in the early group and one in the delayed group (p = 0.03).
Conclusion:
The patients who were operated on early had the advantage of a shorter healing time, but there was a higher rate of complementary operations and a tendency towards a larger burn excision.
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