Application of one-step transplantation of acellular allogeneic dermis combined with autologous split-thickness skin graft in repairing deep burn wounds in functional areas of children.

Abstract

To investigate the clinical efficacy of one-stage transplantation with acellular allogeneic dermis combined with autologous thin split-thickness skin grafts in repairing deep burns at functional sites in children. Methods A retrospective clinical analysis was conducted on 52 pediatric patients with functional site burns treated at our hospital from June 2019 to December 2024. Patients were divided into two groups based on wound repair protocols: the observation group (26 cases) received acellular allogeneic dermis combined with autologous thin split-thickness skin grafts, while the control group (26 cases) underwent autologous intermediate-thickness skin grafting alone. Systematic comparisons were made between the two groups regarding wound healing time, number of surgical procedures, hospitalization duration, medical costs, skin graft survival rate, postoperative scar hyperplasia severity, Vancouver Scar Scale (VSS) scores (at 1, 3, and 6 months postoperatively), Activities of Daily Living (ADL) scores, and patient satisfaction ratings. The observation group demonstrated statistically significant advantages over the control group in skin graft survival rate (P < 0.05), shorter wound healing time (P < 0.05), fewer surgical procedures (P < 0.05), and lower graft necrosis rate (P < 0.05). At 3 and 6 months postoperatively, the observation group showed significantly lower VSS scores, ADL scores, and total scores compared to the control group (P < 0.05). Patient satisfaction rates were higher in the observation group (92.3 %) than in the control group (73.1 %). One-stage transplantation with acellular allogeneic dermis combined with autologous thin split-thickness skin grafts demonstrates superior outcomes in repairing deep burns at functional sites, significantly shortening wound healing time, accelerating functional recovery, reducing scar hyperplasia risk, and markedly improving patients' quality of life.