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Outcomes of Minimally Invasive Excision with Epidermal Autografting in Pediatric Partial Thickness Burns
Mallory Wampler, MD
Julia Maxey, DO
Djoni Elkady, BS
Kelly Williamson, PharmD
Richard Lou, MD
Anjay Khandelwal, MD
Summa Health
2024-01-15
Presenter: Mallory Wampler, MD
Affidavit:
Ananth Murthy, MD
Director Name: Ananth Murthy, MD
Author Category: Fellow Plastic Surgery
Presentation Category: Clinical
Abstract Category: General Reconstruction
Introduction:
The traditional approach to pediatric deep partial thickness burns has been to "watch and wait". However, there is significant morbidity with delayed healing, increased pain, dressing changes, hospital stays, added cost and hypertrophic scarring. Dermabrasion is a minimally invasive excisional technique that may preserve viable dermis while epidermal autografting can facilitate wound healing. The authors evaluated the outcomes of dermabrasion with epidermal autografting in the pediatric population.
Methods:
A retrospective review of pediatric patients who underwent dermabrasion with epidermal autografting between January 2022 and July 2023 was performed. Patient information collected included: demographics, burn depth, burn mechanism, %TBSA, time to OR, length of stay (LOS), narcotic use, postoperative complications, need for autografting, and dressing changes requiring sedation. This was compared to previously conservatively managed patients and historical data.
Results:
A total of 46 patients [mean age: 4.95 years (0.04-18)] were examined with an average %TBSA of 7.45 (0.3-19.75). The majority sustained a scald injury (74%). Most patients (66%) had involvement of critical areas (hands, face, feet or genitalia. The average time to OR was 2.7 days (0-8). Average LOS/%TBSA was 0.45 days. The number of dressing changes requiring sedation was 1.6 (0-7). Almost all patients (96%) had wounds that were >90% re-epithelialized by postoperative day 10. When compared to historical data, time to epithelialization, grafting rate, LOS, and opiate usage was decreased, and infection rate was reduced to zero.
Conclusions:
Within the pediatric population, minimally invasive excision with epidermal autografting may be superior to conservative management.
