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Updated: Sep 18, 2025
A Murine Model of a Burn Wound Reconstructed with an Allogeneic Skin Graft
Published on: August 8, 2020
Skin grafting as a preventive strategy against infections in children with deep burns
Enrico Cocchi1, Luca Montemurro2, Francesco Pio Bettoni2
1Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum - University of Bologna, Bologna, Italy; AUSL Romagna, Neonatal and Pediatric Intensive Care Unit, Bufalini Hospital, Cesena, Italy; Division of Precision Medicine and Genomics, Department of Medicine, Columbia University, New York, NY, United States.
Insights
Autologous skin grafting significantly reduces infectious complications and systemic inflammatory response syndrome (SIRS) in pediatric burn patients. Early grafting is crucial for preventing infection and improving outcomes in children with deep burns.
Area of Science:
- Pediatric Burn Care
- Infectious Complications
- Wound Healing
Background:
- Infectious complications are a major cause of morbidity and mortality in pediatric burn patients.
- The role of autologous skin grafting in reducing infection and antibiotic use in this population requires further elucidation.
Purpose of the Study:
- To evaluate the impact of skin grafting on infectious complications, SIRS development, and antibiotic treatment needs in pediatric burn patients.
- To assess the effectiveness of autologous split thickness skin grafting in managing deep burn wounds in children.
Main Methods:
- Retrospective cohort study of 123 pediatric burn patients (2018-2024).
- Utilized Inverse Probability of Treatment Weighting (IPTW) for covariate balancing.
- Applied Cox proportional hazards models and sensitivity analyses to determine the influence of grafting.
Main Results:
- Skin grafting significantly reduced the risk of wound infectious complications (HR=0.12) and SIRS development (HR=0.14).
- A non-significant trend towards reduced antibiotic treatment was observed.
- Sensitivity analyses confirmed the robustness of these findings.
Conclusions:
- Autologous split thickness skin grafting is critical in preventing infectious complications in pediatric burn patients.
- Early skin grafting may be a pivotal component of treatment protocols for deep burns in children.
- Further multi-center studies are recommended to confirm these findings.
Background:
Infectious complications are a significant cause of morbidity and mortality in patients with deep burns, especially pediatric patients. While autologous split thickness skin grafting is commonly used after escharectomy to promote wound healing, its effect on reducing infection rates and the need for antibiotics in this population is not well understood.
Objective:
This study aimed to evaluate the impact of skin grafting on the incidence of wound infectious complications, systemic inflammatory response syndrome (SIRS) development, and the need for antibiotic treatment, in pediatric patients.
Methods:
A retrospective cohort of 123 pediatric burn patients treated at Bufalini Hospital, Cesena, Italy, between 2018 and 2024 was analyzed. Inverse probability of treatment weighting (IPTW) was used to balance covariates. Cox proportional hazards models were applied to assess the influence of grafting on the time to wound infectious complications, subsequent SIRS development, and need for antibiotic treatment. Sensitivity analysis using both time-insensitive logistic models and leave-one-out approach were performed to assess robustness of findings.
Results:
Skin grafting significantly reduced the risk of wound infectious complications (hazard ratio = 0.12, 95 % CI: 0.02-0.58, p < 0.01) and SIRS development (hazard ratio = 0.14, 95 % CI: 0.03-0.73, p = 0.02). A non-significant trend was also identified in the need for antibiotic treatment. Sensitivity analysis confirmed the robustness of the results.
Conclusion:
Autologous split thickness grafting plays a critical role in preventing infectious complications in pediatric burn patients. In children with deep burns, early skin grafting may play a pivotal role as part of the treatment protocol, pending confirmation from larger multi-center studies.
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