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12-Year Institutional Experience with Pediatric Lower Extremity Burns
Hilary Y. Liu, BS; Christopher J. Fedor, MS; Mare G. Kaulakis, BS; Alexis Henderson, MPH; José Antonio Arellano, MD; Garth Elias, MD; Alain C. Corcos, MD, FACS; Jenny A. Ziembicki, MD; Francesco M. Egro, MD, MSc, MRCS
University of Pittsburgh Medical Center
2025-01-09
Presenter: Hilary Y Liu, BS
Affidavit:
I agree
Director Name: Vu T Nguyen
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: General Reconstruction
Introduction: Lower extremity burns can lead to significant morbidity and long-term functional impairment, especially in pediatric patients, whose management and outcomes are not well understood. This study explores the management and outcomes of pediatric lower extremity burns.
Methods: A retrospective cohort study was conducted on patients under the age of 18 years who presented to a single burn center from 2012-2023 with lower extremity burns. Demographics, burn characteristics, treatment strategies, and outcomes were analyzed.
Results: 121 patients (mean age 5.6±5.1 years) were included. The most common burn etiologies were scald (n=62; 51.7%), flame (n=34; 28.3%), and contact (n=16; 13.3%). The mean total body surface area (TBSA) affected was 8.6±11.7%, with a lower extremity BSA of 4.2±4.7%. Burns were superficial partial-thickness (n=51; 43.2%), deep partial-thickness (n=37; 31.4%), or full-thickness (n=24; 20.3%). Commonly burned areas included the thigh (n=68; 56.2%), foot (n=50; 41.3%), and lower leg (n=45; 37.2%).
Most patients (n=82; 68.3%) received conservative treatment. Surgical intervention was needed for 38 patients (31.7%), with common procedures being burn wound excision and autografting (n=19; 50.0%) or a two-stage operation with cadaver graft (n=13; 34.2%). The mean time from injury to the first operation was 5.1±5.1 days, with an average of 1.3±1.3 operations until closure. Ten patients (26.3%) required re-intervention due to partial graft loss (n=1; 2.6%), total graft loss (n=1; 2.6%), and soft tissue infection (n=8; 21.1%).
Conclusion: Despite the prevalence of large, deep burns in pediatric patients, most receive conservative treatment. Effective infection control is an important consideration in this population.
