ArticleBMC pediatrics2026
Outcomes of modern conservative burn care in children treated outside a burn center: a four-year retrospective analysis of 520 patients.
Article in BMC pediatrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundBurn injuries are a major cause of morbidity and mortality in children, particularly in low- and middle-income countries where access to specialized burn centers is limited. Advances in modern dressings have facilitated conservative management, but evidence from non-burn centers remains scarce.
methodsWe retrospectively analyzed 520 pediatric patients with burn injuries involving ≤ 20% total body surface area (TBSA) treated between January 2021 and February 2025 in a tertiary hospital without a dedicated burn unit. All children were managed using a standardized conservative protocol incorporating silver-based, hyaluronic acid–based, alginogel, hydrogel, Tulle Gras, and hemoglobin spray dressings. Demographic features, etiology, TBSA, hospitalization, graft requirement, early complications, microbiologically confirmed infections, and mortality were evaluated. Long-term cosmetic and functional outcomes could not be systematically assessed and were therefore not primary endpoints of this study.
resultsThe median age was 4.2 years, and 65% of patients were aged 0–6 years. Scald burns accounted for 76.2% of injuries, and 65.0% of children had TBSA 1–10%. Overall, 98% of patients achieved acute wound closure without grafting, while 2% required split-thickness skin grafts, predominantly in burns > 15% TBSA or flame/electrical injuries. Keloid formation was documented in 5.0% and contractures in 0.4% of patients during early follow-up, but these rates likely underestimate true long-term scar prevalence due to incomplete late follow-up. Microbiologically confirmed infection occurred in 12.8% of hospitalized children, and no sepsis, invasive infections or mortality was observed.
conclusionIn pediatric patients with burns involving ≤20% TBSA, a structured conservative wound-care protocol can achieve high rates of acute wound closure with a very low need for grafting and no observed in-hospital mortality, even in a hospital without a dedicated burn center. These findings relate to acute outcomes; definitive long-term cosmetic and functional results could not be determined and warrant prospective studies with standardized long-term follow-up.
trial registrationNot applicable. This was a retrospective observational study that did not involve any prospective intervention or randomization.
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