{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T02:01:58Z","timestamp":1788400918383,"version":"build-2803163510"},"reference-count":35,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T00:00:00Z","timestamp":1771545600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Purified hemoglobin spray had emerged as a potential adjunctive therapy to accelerate wound healing in pediatric patients with burns. This retrospective study aimed to compare the healing process and post-treatment outcomes of children with second-degree burns treated with or without purified hemoglobin spray in a tertiary burn unit between December 1, 2023, and December 1, 2024. Data including demographics, burn characteristics (source, percentage, depth), number of dressings, length of hospital stay, and the day of complete epithelialization were recorded. Follow-up assessments at 3 and 6 months post-discharge evaluated the presence of pruritus and epithelialization defects, including hypertrophic scarring, pigmentation changes, or contractures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data were collected from pediatric patients with second-degree burns treated in a tertiary burn unit between December 1, 2023, and December 1, 2024. Variables included demographics, burn characteristics (source, percent TBSA, depth), number of dressings, length of hospital stay, and day of complete epithelialization. Patients were grouped by receipt of 99.9% purified hemoglobin spray versus no spray. Follow-up assessments at 3 and 6 months post-discharge evaluated pruritus and epithelialization defects, including hypertrophic scarring, pigmentation changes, or contractures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Patients treated with 99.9% purified hemoglobin spray had significantly shorter hospital stays and epithelialization times (\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.001). Post-discharge pruritus was also significantly less common in this group (\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.001). The risk of developing pigmentation defects and epithelialization defects at the third month after discharge was reduced by 94.0% and 90.9%, respectively, while at the sixth month the risk of pigmentation defects was reduced by 90.9% and the risk of hypertrophic scar development during the 6-month follow-up period was reduced by 93.3%.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>These findings suggested that purified hemoglobin spray might enhance wound healing, reduce the need for frequent dressing changes, and minimize long-term complications in pediatric burn care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fped.2026.1744372","type":"journal-article","created":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T06:41:26Z","timestamp":1771569686000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["The effect of purified hemoglobin spray on the treatment of pediatric patients with second-degree burns"],"prefix":"10.3389","volume":"14","author":[{"given":"Erol Can","family":"Kulice","sequence":"first","affiliation":[{"name":"Department of Pediatric Surgery, Antalya Training and Research Hospital","place":["Antalya, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,2,20]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1168","DOI":"10.1016\/S0140-6736(13)61093-4","article-title":"Burns in children: standard and new treatments","volume":"383","author":"Jeschke","year":"2014","journal-title":"Lancet"},{"key":"B2","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1038\/s41572-020-0145-5","article-title":"Burn injury","volume":"6","author":"Jeschke","year":"2020","journal-title":"Nat Rev Dis Primers"},{"key":"B3","doi-asserted-by":"publisher","first-page":"75","DOI":"10.1016\/s0300-483x(03)00154-9","article-title":"Free radicals and lipid peroxidation mediated injury in burn trauma: the role of antioxidant therapy","volume":"189","author":"Horton","year":"2003","journal-title":"Toxicology"},{"key":"B4","doi-asserted-by":"publisher","first-page":"2050312118784313","DOI":"10.1177\/2050312118784313","article-title":"Hemoglobin spray as adjunct therapy in complex wounds: meta-analysis versus standard care alone in pooled data by wound type across three retrospective cohort controlled evaluations","volume":"6","author":"Elg","year":"2018","journal-title":"SAGE Open Med"},{"key":"B5","doi-asserted-by":"crossref","first-page":"40","DOI":"10.5152\/ced.2012.10","article-title":"Bir pediatrik yanik \u00dcnitesinde epidemiyoloji ve enfeksiyonlar: \u00fc\u00e7 yillik deneyimimiz\/epidemiology and infections in a pediatric burn unit: experience of three years","volume":"6","author":"Diler","year":"2012","journal-title":"\u00c7ocuk Enfeksiyon Dergisi"},{"key":"B6","first-page":"56","article-title":"Bir yan\u0131k \u00fcnitesinin 5 y\u0131ll\u0131k deneyimi: 667 yan\u0131k olgusunun incelenmesi","volume":"27","author":"\u00c7inal","year":"2020","journal-title":"Van Medicine Journal"},{"key":"B7","doi-asserted-by":"publisher","first-page":"1565","DOI":"10.1016\/j.burns.2020.04.021","article-title":"A predictive model for prolonged hospital length of stay in surgical burn patients","volume":"46","author":"Frugoni","year":"2020","journal-title":"Burns"},{"key":"B8","doi-asserted-by":"publisher","first-page":"590","DOI":"10.31128\/AJGP-04-19-4919","article-title":"Assessment and management of minor burns in children","volume":"48","author":"Tran","year":"2019","journal-title":"Aust J Gen Pract"},{"key":"B9","doi-asserted-by":"publisher","first-page":"1029","DOI":"10.1093\/jbcr\/iraa115","article-title":"Small pediatric burns can be safely managed on an outpatient basis","volume":"41","author":"Grote","year":"2020","journal-title":"J Burn Care Res"},{"key":"B10","doi-asserted-by":"publisher","first-page":"546","DOI":"10.1111\/pan.14652","article-title":"Safety of pediatric sedation and analgesia during burn dressing changes by pediatric residents","volume":"33","author":"Hubara","year":"2023","journal-title":"Paediatr Anaesth"},{"key":"B11","doi-asserted-by":"publisher","first-page":"13","DOI":"10.2147\/PHMT.S288154","article-title":"Clinical profile of pediatric burn patients in burn care unit of halibet hospital in 2018: Asmara, Eritrea","volume":"12","author":"Mohammed","year":"2021","journal-title":"Pediatric Health Med Ther"},{"key":"B12","doi-asserted-by":"publisher","first-page":"88","DOI":"10.1177\/1534734620910318","article-title":"Granulox-the use of topical hemoglobin to aid wound healing: a literature review and case series from Singapore","volume":"20","author":"Loh","year":"2021","journal-title":"Int J Low Extrem Wounds"},{"key":"B13","doi-asserted-by":"publisher","first-page":"277","DOI":"10.1016\/j.hcl.2016.12.004","article-title":"Biological principles of scar and contracture","volume":"33","author":"Kwan","year":"2017","journal-title":"Hand Clin"},{"key":"B14","doi-asserted-by":"publisher","first-page":"301","DOI":"10.1016\/j.pmr.2011.02.002","article-title":"Hypertrophic scar","volume":"22","author":"Gabriel","year":"2011","journal-title":"Phys Med Rehabil Clin N Am"},{"key":"B15","doi-asserted-by":"publisher","first-page":"64","DOI":"10.1038\/s41572-023-00474-x","article-title":"Scars","volume":"9","author":"Jeschke","year":"2023","journal-title":"Nat Rev Dis Primers"},{"key":"B16","first-page":"264","article-title":"The presence of oxygen in wound healing","volume":"28","author":"Kimmel","year":"2016","journal-title":"Wounds"},{"key":"B17","doi-asserted-by":"publisher","first-page":"3880","DOI":"10.3390\/ijms21113880","article-title":"Post-burn pruritus","volume":"21","author":"Chung","year":"2020","journal-title":"Int J Mol Sci."},{"key":"B18","doi-asserted-by":"publisher","first-page":"151","DOI":"10.1097\/BCR.0000000000000145","article-title":"Pruritus in pediatric burn survivors: defining the clinical course","volume":"36","author":"Schneider","year":"2015","journal-title":"J Burn Care Res"},{"key":"B19","doi-asserted-by":"publisher","first-page":"419","DOI":"10.1097\/BCR.0b013e3182372bfa","article-title":"Itch assessment scale for the pediatric burn survivor","volume":"33","author":"Morris","year":"2012","journal-title":"J Burn Care Res"},{"key":"B20","first-page":"E118","article-title":"Postburn itch: a review of the literature","volume":"30","author":"Nedelec","year":"2018","journal-title":"Wounds"},{"key":"B21","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1007\/978-3-030-44766-3_60","article-title":"Burn hypertrophic scar in pediatric patients: clinical case","volume-title":"Textbook on Scar Management: State of the Art Management and Emerging Technologies","author":"Vinaik","year":"2020"},{"key":"B22","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1186\/s41038-016-0068-2","article-title":"A prospective study of time to healing and hypertrophic scarring in paediatric burns: every day counts","volume":"5","author":"Chipp","year":"2017","journal-title":"Burns Trauma"},{"key":"B23","doi-asserted-by":"publisher","first-page":"1151","DOI":"10.1016\/j.burns.2018.02.022","article-title":"Post burn pruritus in pediatric burn patients","volume":"44","author":"Nieuwendijk","year":"2018","journal-title":"Burns"},{"key":"B24","doi-asserted-by":"publisher","first-page":"33101","DOI":"10.3402\/dfa.v7.33101","article-title":"Clinical effectiveness of hemoglobin spray (granulox\u00ae) as adjunctive therapy in the treatment of chronic diabetic foot ulcers","volume":"7","author":"Hunt","year":"2016","journal-title":"Diabet Foot Ankle"},{"key":"B25","doi-asserted-by":"publisher","first-page":"e579","DOI":"10.1097\/BCR.0000000000000362","article-title":"Pediatric burns: a single institution retrospective review of incidence, etiology, and outcomes in 2273 burn patients (1995\u20132013)","volume":"37","author":"Lee","year":"2016","journal-title":"J Burn Care Res"},{"key":"B26","first-page":"584","article-title":"Retrospective epidemiological study of burn injuries in 1717 pediatric patients: 10 years analysis of hospital data in Iran","volume":"47","author":"Kazemzadeh","year":"2018","journal-title":"Iran J Public Health"},{"key":"B27","doi-asserted-by":"publisher","first-page":"616","DOI":"10.1016\/j.burns.2019.09.007","article-title":"TBSA and length of stay impact quality of life following burn injury","volume":"46","author":"Kishawi","year":"2020","journal-title":"Burns"},{"key":"B28","doi-asserted-by":"publisher","first-page":"329","DOI":"10.1093\/jbcr\/irac055","article-title":"Parent traumatic stress after minor pediatric burn injury","volume":"44","author":"Townsend","year":"2023","journal-title":"J Burn Care Res"},{"key":"B29","doi-asserted-by":"publisher","first-page":"930","DOI":"10.1093\/jbcr\/irz125","article-title":"Predictors and correlates of pediatric postburn pruritus in preschool children of ages 0 to 4","volume":"40","author":"Stewart","year":"2019","journal-title":"J Burn Care Res"},{"key":"B30","doi-asserted-by":"publisher","first-page":"e14959","DOI":"10.1111\/iwj.14959","article-title":"Scar outcomes for conservatively managed children post burn injury: a retrospective study","volume":"21","author":"Ball","year":"2024","journal-title":"Int Wound J"},{"key":"B31","doi-asserted-by":"publisher","first-page":"1017","DOI":"10.1016\/j.bjps.2014.04.011","article-title":"Updated scar management practical guidelines: non-invasive and invasive measures","volume":"67","author":"Monstrey","year":"2014","journal-title":"J Plast Reconstr Aesthet Surg"},{"key":"B32","doi-asserted-by":"publisher","first-page":"1427","DOI":"10.1016\/S0140-6736(16)31406-4","article-title":"Hypertrophic scarring: the greatest unmet challenge after burn injury","volume":"388","author":"Finnerty","year":"2016","journal-title":"Lancet"},{"key":"B33","doi-asserted-by":"publisher","first-page":"101961","DOI":"10.1016\/j.foot.2023.101961","article-title":"Adjunctive topical oxygen therapy in the management of complex diabetes-related wounds: a South African case study series","volume":"57","author":"Njokweni","year":"2023","journal-title":"Foot (Edinb)"},{"key":"B34","doi-asserted-by":"publisher","first-page":"353","DOI":"10.1097\/BCR.0000000000000599","article-title":"A pediatric burn outpatient short stay program decreases patient length of stay with equivalent burn outcomes","volume":"39","author":"Zens","year":"2018","journal-title":"J Burn Care Res"},{"key":"B35","doi-asserted-by":"publisher","first-page":"774","DOI":"10.1016\/j.surg.2022.07.044","article-title":"Factors associated with an extended length of stay in the pediatric burn patient","volume":"173","author":"Coughlin","year":"2023","journal-title":"Surgery"}],"container-title":["Frontiers in Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2026.1744372\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T15:05:27Z","timestamp":1778598327000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2026.1744372\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,20]]},"references-count":35,"alternative-id":["10.3389\/fped.2026.1744372"],"URL":"https:\/\/doi.org\/10.3389\/fped.2026.1744372","relation":{},"ISSN":["2296-2360"],"issn-type":[{"value":"2296-2360","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,20]]},"article-number":"1744372"}}