Early excision and sequelae of facial and cervical burns: A matched-cohort study of 110 patients

Early surgical excision of deep burns is a life-saving strategy, but its impact on long-term sequelae, particularly in the cephalic region, remains insufficiently studied. This is a critical concern, as facial and cervical burns often carry significant functional, aesthetic, and psychosocial consequences.

We conducted a matched observational cohort study comparing adults with deep facial and/or cervical burns who underwent early excision (<10 days post-injury) versus those treated later (≥10 days). A total of 243 patients were screened, and 55 matched pairs were included based on age, sex, burn depth, and total body surface area burned. A sensitivity analysis was performed using a 7-day threshold.

Sequelae occurred in 36.4 % of patients in the early excision group versus 33.4 % in the delayed group. The difference was not statistically significant (p = 0.69). The relative risk (RR) of sequelae with early excision was 1.11 (95 % CI: 0.66-1.86). Sensitivity analysis using a 7-day threshold yielded a similar RR of 0.98 (0.56-1.70), indicating no increased risk associated with earlier intervention.

Our findings suggest that early excision (<10 days) of deep facial and cervical burns in adults does not increase the risk of long-term sequelae. Larger prospective studies are needed to validate these results and further guide clinical practice.