546 Obesity’s Impact on Pediatric Scald Burns: How Much Weight Does It Carry?

TL;DR

This study examines whether obesity affects wound healing in children with scald burns and finds no significant impact on healing time or complications.

Contribution

The study is one of the first to investigate obesity's impact on wound healing outcomes in pediatric scald burn patients.

Findings

No significant differences in healing time were found between BMI or WFL categories.

Obesity was not significantly associated with scar management or late grafting needs.

A moderate relationship between higher BMI and grafting was observed in older children, but not statistically significant.

Abstract

Childhood obesity is a growing public health concern in the United States, affecting about 14.7 million children and adolescents (CDC). There is increasing evidence that obesity affects morbidity and mortality in adults, but less is known about its impact on pediatric patients, particularly those with burn injuries. This study investigates the relationship between obesity and wound-healing outcomes in this population.

A retrospective chart review was conducted on 389 pediatric patients (1 month - 18 years) admitted to a regional burn center with ≥ 5% TBSA scald burns between July 2015 and January 2024. Patients with staph scalded skin or who received follow-up treatment elsewhere were excluded. Patients were categorized into WFL or BMI groups using the WHO/CDC-adapted growth charts for children < 2 years old (WFL Group) and the 2000 CDC growth charts for children 2-20 years old (BMI Group). The primary outcome was time to complete wound healing. Secondary outcomes included scar management, late grafting (delayed grafting due to poor wound healing), outpatient therapies, and hospitalization. ANOVA tests were utilized to compare healing times between weight groups, and chi-square tests for categorical data.

ANOVA tests revealed no significant differences in healing time between BMI categories in both the 5-group (underweight, healthy weight, overweight, obese, severely obese) and 3-group (underweight, healthy weight, overweight/obese/severely obese combined) analyses, nor within the 3-group WFL categories (underweight, healthy weight, overweight). Chi-square tests for patients < 2 and patients ≥2 revealed no significant associations between WFL/BMI categories and the need for Level 1 (p = 0.1727; p = 0.6422), Level 2 (p = 0.4816; p = 0.7282), or Level 3 (p = 0.6238; p = 0.7932) Scar Management, as well as Late Grafting (p = 0.2236; p = 0.7646). No significant relationship was found between WFL/BMI categories and the need for Grafting During the Index Admission for patients < 2 (p = 0.1807) or ≥2 (p = 0.1477). However, in the combined ≥2 group, a moderate relationship (p = 0.0463) suggests a potential association between higher BMI and grafting in older children.

While childhood obesity is a growing concern, this study suggests it may not significantly affect wound healing time or other outcomes in pediatric scald burn patients. Our findings suggest that obesity may not be a significant independent risk factor for wound-healing complications in this population. However, further investigation is warranted to explore other potential impacts of obesity and other burn types, such as flame burns.

This research could inform clinical practice by potentially alleviating concerns about delayed healing or complications in obese children with scald burns. These findings enhance our understanding of obesity’s impact on pediatric burn injuries, aiding treatment decisions and improving patient outcomes.

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