Early paediatric scald surgery-A cost effective dermal preserving surgical protocol for all childhood scalds

摘要

Despite advances in prevention and better access to first-aid, childhood scalds remain a common presentation. Different protocols have been described to manage varying depths of paediatric scalds [1,2], including application of biological dressings, cultured cells and early split-thickness skin grafting (STSG). It is established that early wound healing reduces hyper-trophic scars [3], and we believe any scald protocol should aim for early wound closure, in addition to being cost-effective. Dermal preservation is important to optimise scar quality [2], while early debridement of mid-dermal burns with application of ReCell and Biobrane may improve scar outcomes and reduce dressing and analgesic costs [4]. ReCell non-cultured autologous skin cells utilise a small skin biopsy and have a comparable yield to cultured cells following enzymatic processing [5]. We utlilise a new algorithm that is dynamic, with early dermal preserving surgery, optimised wound healing and cost savings.