Research Mentor Name
Elika Ridelman
Research Mentor Email Address
eridelma@dmc.org
Institution / Department
Wayne State University School of Medicine, Department of Pediatric Surgery
Document Type
Research Abstract
Research Type
clinicalresearch
Graduate Level Research
no
Abstract
Hot Spots: Zonal Cutaneous Functional Unit Analysis of High-Risk Regions in Pediatric Shoulder/Hip Scald Burns
Authors - Christian Hudson-Bradford, MD, Alexander J. Kallabat, BS, Candace R. Marquette, MS, Elika Ridelman, PhD, Beth Angst, OTR/L, Sarah Hackert, DPT, PT, Justin Klein, MD, and Christina Shanti, MD
Introduction
Pediatric scald burns present significant healing challenges. This study utilizes a novel zonal classification of cutaneous functional units (CFUs) of the shoulder and hip to identify anatomical risk factors and patient characteristics associated with poor outcomes, specifically delayed healing (>14 days) and the need for scar management (SM).
Methods
A retrospective review was performed on a cohort of 967 pediatric scald burnpatients (0-18 years) admitted to a regional burn center from 2015–2024. An expert panel mapped burn photographs to a six-zone anatomical classification of the shoulders and hips using standardized diagrams. Chi-square tests, ANOVA, and t-tests were used to analyze links between patient demographics, burn characteristics, specific zones, and outcomes. Outcomes were defined as time to complete healing (TTH, in days) and the need for SM, defined as treatment requiring at least silicone tape, compression garments, steroid injections, or laser therapy.
Results
Among 736 patients with complete healing data, delayed healing strongly predicted need for SM (41.6% of TTH >28 days required SM vs 2.9% of ≤14 days, p< .001). Factors predicting prolonged TTH included hot oil/grease etiology (p=.018), need for an index graft (p< .001), and ICU admission (p< .001). Bilateral shoulder (p=.027) and hip (p=.005) involvement were also significantly associated with prolonged healing. Zone-level analysis revealed distinct anatomic risk patterns: posterior-inferior hip zone 6 healed slowest (median 31 days) with the highest SM rates (32%, p< .05 vs multiple other hip zones). Hip zone 5 (median 21.5 days, 17% SM) and hip zone 3 (median 22 days, 17.4% SM) also demonstrated delayed healing compared to anterior zones. Shoulder zone 1 (anterior) consistently healed faster (median 15 days) than zones 2–5 (p≤.05), while zones 3 and 5 carried the greatest scar burden (>18% SM). The need for SM was also significantly higher in patients with an index graft (83.3% vs 11.3%, p< .001), post-burn complications (64.0% vs 11.3%, p< .001), and burn-related readmissions (61.3% vs 10.8%, p< .001). Surprisingly, Fitzpatrick score did not show any association with SM need.
Conclusions
This zonal CFU analysis identifies posterior-inferior hip zone 6 as the most vulnerable region, with healing delays exceeding 30 days and severe scarring in up to one-third of patients. Additional high-risk zones include hip zones 3 and 5 and shoulder zones 3 and 5, which consistently demonstrated worse outcomes. Conversely, shoulder zone 1 healed significantly faster with no added scar risk.
Disciplines
Analytical, Diagnostic and Therapeutic Techniques and Equipment | Medicine and Health Sciences
Recommended Citation
Hudson-Bradford, Christian MD; Kallabat, Alexander J. BS; Marquette, Candace R. MS; Ridelman, Elika PhD; Angst, Beth OTR/L; Hackert, Sarah DPT, PT; Klein, Justin MD; and Shanti, Christina MD, "Hot Spots: Zonal Cutaneous Functional Unit Analysis of High-Risk Regions in Pediatric Shoulder/Hip Scald Burns" (2026). Medical Student Research Symposium. 517.
https://digitalcommons.wayne.edu/som_srs/517