Data-Driven Decision Making in Pediatric Burn Management Without a Burn Center: A Four-Year Retrospective Analysis of 520 Patients

Background Pediatric burn injuries remain a major global health concern, particularly in low- and middle-income countries. Recent advances in wound care technologies have allowed non-surgical (conservative) management to become an increasingly effective option for partial-thickness burns, even in hospitals without specialized burn centers. Methods This retrospective clinical study included 520 pediatric patients (aged 0–18 years) treated between January 2021 and February 2025 at Ordu University Training and Research Hospital, Türkiye. Patients were categorized according to age, burn etiology, and total body surface area (TBSA). Standardized conservative wound care protocols were applied using advanced dressings such as silver-based materials, hyaluronic acid preparations, enzymatic alginogel, antiseptic Tulle Gras, hydrogel sheets, and hemoglobin spray. Clinical outcomes—including healing rate, graft requirement, hospitalization duration, and complication rates—were analyzed statistically. Results The median age was 4.2 years (IQR 2.0–8.1), with 65% of patients aged 0–6 years. Scald burns were the predominant cause (76.2%). TBSA was ≤ 10% in 65% and 11–20% in 35% of cases. The mean hospital stay was 8.5 ± 2.5 days, which was significantly longer in patients with TBSA > 10% (p < 0.001). Conservative management achieved complete healing in 98% of patients, with only 2% requiring grafting. The rates of keloid and contracture formation were 5% and 0.4%, respectively. No mortality was observed. Conclusions Modern conservative burn care yielded excellent outcomes for pediatric patients with TBSA ≤ 20%, with minimal complications and no mortality. These findings highlight the efficacy, safety, and cost-effectiveness of non-surgical burn management and support its wider use in resource-limited settings through standardized care protocols and improved prevention strategies. Trial registration Not applicable. This was a retrospective observational study that did not involve any prospective intervention or randomization.