Case report on 4 year old with unhealed burn wound

July 7, 2025

Dr. Mohammed Ali AJAM , consultant plastic surgeon. | Dr Shadi Naasan HAJALI , resident in plastic surgery
Department of Plastic and Burn Surgery, Alkindi Teeching Hospital, Aleppo University, Aleppo, Syria.

A 4 year old girl presented to Alkindi hospital with unhealed burn wound of lateral aspect of left thigh and part of scalp, the patient sustained burn at home 45 days ago by hot vegetable oil, and she was treated at private hospital.

The patient had a past medical history of nephrotic syndrome about 3 months ago and was treated by predlon (oral corticosteroid) 5mg three times daily, she was still on until the day of admission.

On examination

Full thickness burn in the lateral aspect of left thigh and part of scalp with fragile unhealthy granulation tissue without pus or eschar.

Diagnosis

Delay in burn healing due to corticosteroid (predlon), hypoalbuminemia (caused by nephrotic syndrome), and mismanagement of the wound.

Treatment

The patient was admitted to burn and plastic surgery unit in Alkindi hospital and:

Gradual ceasing of oral predlon with monitoring 24 hours urine proteins.
Vitamin A orally
Albumin supply according to blood albumin level.
Regarding to local treatment of wound, two different ways were applied: First on the scalp (traditional treatment, cleansing by betadin and application of flamazine, furacillin, and fucidin ointment and cotton gauze)

Second on the thigh in this manner

First day:

Cleansing the wound by normal saline, drying, applying Citrugel and Eclypse every 8 hours.

Second and third days:

Cleansing the wound by normal serum, drying, applying Activon tube and Eclypse every 8 hours.

After the third day:
Cleansing the wound by normal serum, drying, applying Algivon and Eclypse every 2- 4 days.

Results

On the 14th day:

The thigh wound is nearly healed. The scalp wound has not healed and needs skin grafting.

Conclusion

Although the result of our case study showed promising outcome, we believe the result warrants further investigation into the beneficial effect of the treatment.