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Even Better Than The Real Thing? Comparison Of Xenograft To Autograft For The Treatment Of Pediatric Scald Injuries: Review Of Outcomes And Costs At A Single, Accredited Burn Center, From 2004-2013
Paul Diegidio, MD, Shiara Ortiz-Pujols, MD, Samuel W. Jones, MD, Bruce A. Cairns, MD, Charles S. Hultman, MD, MBA.
University of North Carolina, Chapel Hill, NC, USA.

Purpose: Scald injuries are the most common burn in children, but best practices continue to evolve. Depending on depth, area, and mechanism of injury, management can include wound care, xenografting, or autografting. We examined our 10-year experience with pediatric scald burns, comparing xenografting to autografting.
Methods: Using prospectively collected data submitted to the National Burn Repository, we identified all patients less than 18 years of age, admitted to a single burn center, who sustained a scald burn, over the past 10 years. Patients were divided into three cohorts, based on wound closure method: Nonoperative, Xenografting, or Autografting. Statistical significance was assigned to p values < 0.05, using t-test and chi-square.
Results: 1792 children with scald burns were admitted from 2004-2013. Compared to autografting, patients who underwent xenografting had a similar TBSA, but were younger and had a shorter length of stay, shorter ICU stay, and less expensive hospitalization (all p values <0.05) (Table).
Conclusions: Xenografting appears to be a more cost-effective method of wound closure, compared to autografting, for children with scald burns. While non-operative management may be appropriate for small/superficial burns, and autografting may be required for large/deep burns, xenografting provides rapid wound closure, permitting early discharge from the hospital. Future research will focus on determining if xenografting confers a long-term advantage, in terms of reducing incidence of hypertrophic scars or need for reconstruction.
Comparison of Xenograft to Autograft in Pediatric Patients with Scald Injury
Scald Burn
N
Age
Years
TBSA
%
LOS
Days
ICU
Days
Hospital
Charges
\0/td>
Xenograft4763.428.125.271.1425,623
Autograft3225.7612.5922.957.3483,413
p value
(xeno v auto)
<0.001<0.0010.065<0.001<0.001<0.001
Non-operative9944.155.755.090.7217,571
All patients17924.348.139.632.4936,450


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