Abstract
BACKGROUND: Larger pediatric partial-thickness (PT) burns are typically managed with debridement and a skin substitute. Epiprotect® has shown comparable acute surgical outcomes and lower infection rates than Biobrane®, but data on long-term outcomes remain limited. PURPOSE: To compare long-term patient-reported outcomes between Biobrane® and Epiprotect® in pediatric PT burns using the Brisbane Burn Scar Impact Profile (BBSIP). METHODS: We included all pediatric patients (<18 years) treated with Biobrane® or Epiprotect® for PT burns at our center between February 2018 and July 2023 who completed the BBSIP survey >12 months after injury. Total BBSIP scores were analyzed using Wilcoxon rank-sum tests and a negative binomial regression, adjusting for total body surface area (TBSA) and burn depth. RESULTS: Forty-eight patients were included (Biobrane® n = 32; Epiprotect® n = 16). Median age was 21 months (8 months-13 years); mean TBSA was 6 % (2-15 %). Total BBSIP scores were significantly better in the Epiprotect® group (median = 7.74) compared to Biobrane® (median = 8.06; P = 0.0145). In the multivariable analysis, Epiprotect® was associated with lower total BBSIP scores compared with Biobrane® (β = -0.22, P = 0.04) adjusting for TBSA (β = 0.059, P < 0.001) and burn depth (β = -0.26, P = 0.006). CONCLUSIONS: Epiprotect® was associated with improved long-term outcomes compared to Biobrane®, particularly in larger or deeper burns. These findings support its use when long-term function and well-being are prioritized.