Outcomes of split-thickness skin grafting with and without skin cell suspension autografting in pediatric burn care.

BACKGROUND

Skin cell suspension autografting (SCSA) creates a cell suspension from patient skin that is applied to burn wounds, often in conjunction with meshed split-thickness skin grafts (STSG). Application over STSG is thought to promote graft integration, decrease pain, and improve cosmetic appearance. This study compares outcomes of STSG + SCSA versus STSG alone in pediatric burn patients.

METHODS

A retrospective cohort study was performed of pediatric burn patients (<16 years) who underwent STSG at a children's hospital (05/2021-05/2024). Demographics, injury characteristics, surgical details, and post-operative care were abstracted. Patients were categorized into STSG or STSG + SCSA. Univariate analysis was performed.

RESULTS

In total, 47 patients were included (median age 6 years (IQR 2-10); 62 % male). Burns were caused by hot liquid (47 %), fire/explosion (30 %), or hot surface contact (11 %), with a median total body surface area of 7 % (IQR 4-12). The median grafted area was 150 cm2 (IQR 48-425). STSG + SCSA was used in 16 (34 %) patients, while 31 (66 %) received STSG. A meshing ratio of 1:1.5 was used in 55 % of STSG and 12.5 % STSG + SCSA. 2:1 or 3:1 was used in 69 % of STSG + SCSA. In the STSG + SCSA group, 81 % also received autografting to the donor site or other superficial burns, with a median of 50 cm2 (IQR 12-253) additional autograft treatment. Two patients in the STSG group had graft failure; none in STSG + SCSA. The median time to healed was 16 days (1QR 13-28), similar between groups (p = 0.37).

CONCLUSION

STSG + SCSA provided opportunity for wider meshing ratios, decreasing the size of the donor site, without increasing healing time and with zero graft failures.

LEVEL OF EVIDENCE: Level III.