Comparison of complications during rehabilitation between conservative and early surgical management in thermal burns involving the feet of children and adolescents

To evaluate the long-term sequelae of early surgical management compared with conservative therapy, a retrospective review from January 1976 to December 1984 was undertaken. Through inspection of burn diagrams, 395 patients were identified with burns involving the foot. From 1976 through 1980,109 patients were managed in a conservative fashion with topical antimicrobial therapy and delayed debridement and grafting; 36 of these patients with severe burns were managed with skeletal suspension. Between 1981 and 1984,136 patients were treated with earlier surgical debridement and grafting; during this period, skeletal suspension was rarely used. No statistical difference was found in mortality, amputations, incidence of open wounds, development of contractures, or number of patients requiring reconstructive procedures between conservative and early excision therapy except in those children treated with skeletal suspension. Thus in burns involving the feet in children, early excision and grafting does not alter the resultant morbidity compared with conservative burn management.