790 A Single Institution’s Surgical Model for Pediatric Burns with ≤ 10% Body Surface Area Involvement
Bibliographic record
Abstract
Abstract Introduction Burn injuries continue to be prevalent in the pediatric population and are the fifth most common cause of non-fatal injury according to the World Health Organization. Unlike the adult population, most pediatric burns in the United States are small in size and are often the result of scalds. Despite the high incidence of small burns, a standardized treatment algorithm does not currently exist, and care is often influenced by clinical judgement and resource availability. As a result, various techniques to close the burn wound and promote further healing are currently utilized. This study explores the utility of a multi-stage grafting technique, involving allograft and autograft, for treating small burns (≤ 10% total body surface area (TBSA)) in pediatric patients. Methods A retrospective review of patients aged 0-18 years who had a burn that was ≤ 10% TBSA and underwent a multi-stage grafting procedure involving the use of allograft and autograft between 09-01-2018 and 09-01-2022 was conducted. Demographic information including data pertaining to the burn injury was collected for all patients. The primary outcome measure for this study was the percentage of graft take at the graft dressing takedown procedure. All variables were summarized using descriptive statistics. P values < 0.05 indicated statistical significance. Results One hundred and sixty-eight patients met the inclusion criteria for this study. The mean time from presentation to allograft surgery was 10.8 days (SD 5.6) followed by autograft surgery approximately one week later. Most patients were discharged within 24 hours following allograft surgery (88.1%) and autograft surgery (80.9%). Mean autograft take was 97.7% (SD 11.1%) with only four patients experiencing significant graft loss requiring subsequent re-grafting. The main causes of graft loss were infection and inadequate excision of the wound bed. Conclusions This analysis revealed that patients who underwent a multi-stage grafting procedure involving the use of allograft and autograft experienced minimal graft loss. These positive outcomes demonstrate that the multi-stage grafting technique, which has traditionally been employed for larger burn injuries, can be successfully adapted for smaller burns in children. Moreover, the findings from this study help to address the significant knowledge gap regarding the optimal approach to treating small burn wounds. Further research in this area is warranted to learn more about cosmetic outcomes following multi-stage grafting and determine how it compares to other techniques for treating small burns. Applicability of Research to Practice The findings from this study will allow us to begin benchmarking our treatment of small burn wounds with other centers resulting in improvements in patient care and outcomes.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.013 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".