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Hypertrophic Scarring of Split-thickness Autograft Donor Sites at a Pediatric Burn Hospital
Rotatori RM, Starr B, Fowler L, James L, Nelson J, Dale EL
University of Cincinnati
2017-02-15
Presenter: Max Rotatori
Affidavit:
This student was responsible for a significant portion of the conception, design, data collection, analysis of data, and abstract drafting for this project. This study has not been previously presented.
Director Name: Dr. David A Billmire
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: General Reconstruction
Introduction: The split-thickness autograft (STAG) remains a fundamental treatment for burn injuries. In concept, the donor site wound is superficial and heals with minimal morbidity. However, STAG donor sites may remain hypersensitive, hyperemic, less pliable, and develop hypertrophic scarring (HTS). To date, few reports have assessed long-term scarring of donor sites after pediatric burns.
Methods: A retrospective review of pediatric burn patients at a single institution (2010-2016) was performed. Primary outcomes were incidence of donor site HTS and risk factor assessment (ethnicity, total body surface area (TBSA) and full-thickness area burned, depth of STAG harvest, burn cause, and donor site size and location).
Results: 182 pediatric burn patients were identified. Mean age at burn 7.3yo; mean TBSA 20.9% with 13% being full-thickness; mean follow-up 2.3yrs. HTS was observed in 99 (54.4%) patients with 61 (33.5%) patients having persistent HTS through long-term follow up. Risk factors for HTS were total donor site wound size at date of surgery (p=0.0109), depth of STAG (p=0.0240), and buttocks donor site (p=0.396) with TBSA associated with long-term HTS (p=0.0081). Scalp, anterior torso, and lower leg donor sites were less likely to observe HTS (p=0.0044, 0.0311, 0.0001, respectively) with lower leg donor sites being less likely to have long-term HTS (p=0.0022).
Conclusions: Hypertrophic scarring is a prominent burden in donor site wounds of pediatric burn patients. Primary risk factor for long-term hypertrophic scarring was TBSA.
