Plantar burns in children: Epidemiology and sequelae

Pediatric plantar burns present with significant and unique characteristics. The treatment of choice remains controversial, and any alteration of the anatomy will lead to alteration in gait. To study the outcome of conservative treatment of plantar burns and determine risk factors, 40 pediatric patients affected with isolated plantar burns were studied. All burns were treated with silver sulfadiazine and early ambulation, and those that did not heal within 3 weeks were autografted. Twenty-eight patients (70%) had partial-thickness burns and 12 patients (30%) full-thickness burns. Complications during the acute period included 1 episode of cellulitis and 1 patient with prolonged difficulties with ambulation. Three patients required excision and autografting, and none of them developed late sequelae. Five patients presented with late sequelae, and all had in common complete healing with conservative treatment, young age, and a longer healing time (24.4 days). We conclude that conservative treatment of pediatric plantar burns has a negligible complication rate. Burns that do not heal within 3 weeks are best managed with excision and autografting, which had a 0% incidence of complication rate in this series.