M.KazmierskiP.MankowskiA.JankowskiComparison of the results of operative and conservative treatment of deep dermal partial-thickness scalds in childrenEur J Pediatr Surg17/52007 (October)354361

Abstract

Deep dermal partial-thickness scalds remain one of the most common types of injuries in childhood. Local treatment of these wounds alternatively described as grade IIb is still very controversial. Some authors advise conservative treatment of such wounds, pointing to their ability to self-reepithelialize, which is possible but significantly prolonged. Other investigators recommend operative treatment, that is, tangential necrotectomy and split-thickness autologous skin grafting which may shorten the time of wound healing. Arguments call for contra-arguments, and the problem still seems to be unresolved. There is indeed a lack of acceptable standardization of local treatment for deep dermal partial thickness scalds in the pediatric population. The results of 114 both conservatively and operatively treated children, aged between 3 months and 17 years, are presented. The treatment of 5 groups of patients according to the extent of their wounds was evaluated. The patients were treated by tangential necrectomy and skin grafting, mechanical dermabrasion, Granuflex (Convatec) hydrocolloid dressings, Iruxol Mono (Knoll) enzymatic dressings, or Aquagel Ag (Convatec) hydrofiber dressings with silver ions. A number of parameters of wound healing were analyzed. The results encouraged the authors to present and discuss a proposition for standardization of local treatment of deep dermal partial-thickness scalds in children, according to the extent of the injury.