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Pediatric Burns: Biological and Tissue Engineered Skin Substitutes-A Systematic Review.

Pietro Susini¹, Martina Certini², Gianluca Marcaccini¹

¹Plastic Surgery Unit, Department of Medicine, Surgery and Neuroscience, University of Siena, 53100 Siena, Italy.

Journal of Clinical Medicine

|November 27, 2025

Summary

Biological Skin Substitutes (BSS) and Tissue Engineered Skin Substitutes (TESS) show promise for pediatric burn reconstruction when autografting is not feasible. While safe and effective, more high-quality evidence is needed to establish standardized treatment protocols.

Keywords:

allograft and pediatric burn fish dermis and pediatric burn integra and pediatric burn plastic surgery and pediatric burn regenerative medicine and pediatric burn

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Area of Science:

Regenerative Medicine
Pediatric Surgery
Burn Care

Background:

Skin autografting is standard for pediatric burns but often unfeasible.
Limited donor sites or poor graft conditions necessitate alternative treatments.
Biological Skin Substitutes (BSS) and Tissue Engineered Skin Substitutes (TESS) are emerging options.

Purpose of the Study:

To review current literature on BSS and TESS for pediatric burn reconstruction.
To assess the efficacy and safety of these alternative treatments.
To inform improved medical and surgical management strategies.

Main Methods:

Systematic review following PRISMA 2020 guidelines.
PubMed (MEDLINE) search from 2000-2024.
Quality assessment using Joanna Briggs Institute (JBI) checklists.

Main Results:

Included 29 articles covering 2676 pediatric burn patients.
Methodological quality was generally moderate (observational studies, case series).
BSS and TESS demonstrated safety and effectiveness in reconstructive applications.

Conclusions:

BSS and TESS are viable reconstructive options for pediatric burns.
The current evidence level is low to moderate.
Further prospective trials are required to standardize treatment algorithms.