Outcome of scalp donor sites in 450 consecutive pediatric burn patients

Juan P. Barret, Peter Dziewulski, Steven Wolf, Manubhai H. Desai, David Herndon

Research output: Contribution to journalArticle

46 Citations (Scopus)

Abstract

The scalp is a useful and reliable donor site in pediatric burn patients that can be multiply harvested with minimal morbidity. Healing complications, however, may include alopecia and chronic folliculitis. To investigate scalp donor-site morbidity, a consecutive series of 2478 pediatric burn patients treated over a 10-year period were reviewed. A total of 450 of these patients had scalp donor sites for wound closure. Percent of total body surface area burned was 46 ± 23 percent (mean ± standard deviation), and the mean number of sequential scalp donor-site harvests was 2.2 ± 2 (range, 1 to 10) with mean intervals between harvesting of 6 ± 0.6 days. Ten patients (2.2 percent) had related complications. Eight patients developed scalp folliculitis, with Staphylococcus sp as the predominant organism (80 percent). Two patients were managed successfully with wound care alone; the other six patients required surgical debridement and split-thickness skin grafting to achieve wound healing. These eight patients developed varying degrees of alopecia. Two patients developed alopecia without previous folliculitis. Six patients required reconstructive surgery, which consisted of primary closure (3), staged excision (1), and tissue expansion (2). A number of variables were examined to determine any differences in the group that had complications compared with the group of patients that did not. No differences in age, sex, race, burn type, burn size, septic episodes, time to wound closure, or number of times the scalp was harvested were detected. Healed second-degree burns to the scalp that were subsequently taken as donor sites seemed to be a risk factor (p < 0.05) for folliculitis and alopecia. Our study confirms that scalp donor sites are reliable with low morbidity. Complications include alopecia and chronic folliculitis that can be avoided by meticulous technique and avoidance of previously burned areas.

Original languageEnglish (US)
Pages (from-to)1139-1142
Number of pages4
JournalPlastic and Reconstructive Surgery
Volume103
Issue number4
StatePublished - Apr 1999
Externally publishedYes

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Scalp
Tissue Donors
Pediatrics
Folliculitis
Alopecia
Morbidity
Reconstructive Surgical Procedures
Wounds and Injuries
Tissue Expansion
Skin Transplantation
Body Surface Area
Debridement
Burns
Staphylococcus
Wound Healing

ASJC Scopus subject areas

  • Surgery

Cite this

Outcome of scalp donor sites in 450 consecutive pediatric burn patients. / Barret, Juan P.; Dziewulski, Peter; Wolf, Steven; Desai, Manubhai H.; Herndon, David.

In: Plastic and Reconstructive Surgery, Vol. 103, No. 4, 04.1999, p. 1139-1142.

Research output: Contribution to journalArticle

Barret, Juan P. ; Dziewulski, Peter ; Wolf, Steven ; Desai, Manubhai H. ; Herndon, David. / Outcome of scalp donor sites in 450 consecutive pediatric burn patients. In: Plastic and Reconstructive Surgery. 1999 ; Vol. 103, No. 4. pp. 1139-1142.
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