The prevalence and predictors of reconstructive surgery in pediatric burn care

Burns. 2024 Dec;50(9):107213. doi: 10.1016/j.burns.2024.07.017. Epub 2024 Jul 17.

Abstract

Objective: This study aimed to examine the prevalence and predictors of reconstructive surgery among pediatric burn patients in the Netherlands.

Methods: Pediatric burn patients were identified through the Dutch Burn Repository R3. Eligibility criteria included a burn requiring hospital admission or surgical treatment at one of the Dutch burn centers in 2009-2019. First, patient, burn, and treatment characteristics were summarized using descriptive statistics. Second, time to the first reconstructive surgery was modelled using Kaplan Meier curves. Third, a prediction model was developed using univariate and multivariate logistic regression. The model's performance was assessed using calibration, discrimination, and explained variance. Fourth, internal validation was performed using bootstrapping.

Results: Approximately three percent (n = 84) of pediatric patients (n = 3072) required reconstructive surgery between the initial burn-related hospital admission and September 2021. Median time to the first reconstructive surgery was 1.2 (0.7-1.6) years. Most surgeries were performed on the face, arm, neck, hand, or anterior trunk, owing to contractures or hypertrophic scarring. Predictors of reconstruction included the etiology, anatomical site, extent of full-thickness burn, surgical treatment in the acute phase, and length of hospital stay.

Conclusion: Our study provided an overview of the prevalence and independent predictors of reconstructive surgery in the pediatric burn population.

Keywords: Burn; Epidemiology; Pediatric; Reconstructive surgery.

MeSH terms

  • Adolescent
  • Burn Units
  • Burns* / epidemiology
  • Burns* / surgery
  • Child
  • Child, Preschool
  • Cicatrix, Hypertrophic* / epidemiology
  • Cicatrix, Hypertrophic* / surgery
  • Cohort Studies
  • Contracture* / epidemiology
  • Contracture* / surgery
  • Female
  • Humans
  • Infant
  • Kaplan-Meier Estimate
  • Male
  • Netherlands / epidemiology
  • Plastic Surgery Procedures* / methods
  • Plastic Surgery Procedures* / statistics & numerical data
  • Prevalence
  • Time-to-Treatment