The Scalp as a Donor Site in Pediatric Burns: Systematic Review and Management Algorithm Proposal

May 2026 in “ European Burn Journal ”

Carlotta Paola Maria Canonica, Irene Paraboschi, Eleonora Durante, Francesca Izzo, Anna Mandelli, Sara Costanzo, Elvira Conti, Glória Pelizzo, Anne Le Touze

scalp split-thickness skin grafts folliculitis alopecia hypertrophic scarring epithelialization

Studysummary This systematic review concluded that the scalp can be a safe and effective donor site for split-thickness skin grafts in pediatric burn patients, with evidence indicating good scar quality and manageable complications, though a rigorous technique is essential to minimize risks.

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The systematic review concludes that the scalp is a safe and effective donor site for split-thickness skin grafts in pediatric burn patients, supported by evidence from 4 studies involving 417 children. The scalp's high density of hair follicles and rich vascular network enable rapid healing, with epithelialization occurring between 7 and 25 days. Early complications like folliculitis are more common in children with tightly curled hair, while late complications such as alopecia and hypertrophic scarring are rare. A management algorithm is proposed to optimize safety and standardize care, emphasizing the need for rigorous harvesting techniques. Despite promising outcomes, the review notes the need for larger, more diverse studies to strengthen the findings.

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