RECONSTRUCTIVE STRATEGIES IN PEDIATRIC EXTENSIVE BURNS: A RETROSPECTIVE COHORT ANALYSIS emilianomerazmb@gmail.com

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RECONSTRUCTIVE STRATEGIES IN PEDIATRIC EXTENSIVE BURNS: A RETROSPECTIVE COHORT ANALYSIS

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Mexico

Oral or Poster

Pediatric extensive burns remain a major cause of morbidity worldwide, often requiring complex reconstructive strategies. The impact of different reconstructive techniques on early postoperative complications remains unclear, particularly in resource-variable settings.

We conducted a retrospective cohort study of pediatric patients with extensive burns undergoing surgical reconstruction at a tertiary burn center between March 2024 and June 2025. Demographics, total body surface area (TBSA), reconstructive techniques, and early postoperative complications were analyzed. A standardized subgroup of patients with deep second-degree burns (10–59% TBSA) treated with split-thickness skin grafts was evaluated to compare temporary coverage strategies (dermal substitutes vs cadaveric skin). Statistical analysis included Fisher’s exact test and odds ratios (OR) with 95% confidence intervals (CI).

Sixty seven patients underwent 128 reconstructive procedures. The most frequent techniques were debridement (100%), split-thickness skin grafting (38.8%), dermal substitutes (28.3%), and cadaveric skin grafts (17.9%). Complications occurred in 12.5% of procedures (n=16), totaling 25 events, predominantly infections (60%). In the standardized subgroup (n=26), complication rates were comparable between dermal substitutes (14.3%) and cadaveric skin (16.7%), with no significant association (OR≈1.2; 95% CI crossing unity; p=1.000).

Postoperative complications in pediatric burns appear to be driven primarily by clinical severity rather than the reconstructive technique employed. No clinically meaningful differences were observed between dermal substitutes and cadaveric skin as temporary coverage prior to autologous grafting. Given its wide availability, rapid application, and effectiveness as a biological dressing, cadaveric skin remains a valuable and pragmatic option, particularly in resource-limited settings, supporting a flexible and context-adapted reconstructive approach.