{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T18:22:24Z","timestamp":1785435744905,"version":"3.56.0"},"reference-count":47,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T00:00:00Z","timestamp":1778198400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100012352","name":"University of Milan","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100012352","id-type":"DOI","asserted-by":"crossref"}]},{"id":[{"id":"https:\/\/ror.org\/00wjc7c48","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["EBJ"],"abstract":"<jats:p>Background: Deep burns in pediatric population often require split-thickness skin grafts (STSGs) and the identification of an optimal donor site is crucial to minimize morbidity, accelerate healing and reduce short- and long-term complications. The scalp appears to be increasingly used in clinical practice, but evidence remains limited, despite the promise of novel bioengineering and regenerative approaches. Methods: A systematic review about the use of scalp for STSG in pediatrics was conducted across PubMed, Scopus, and Cochrane (2005\u20132025). Clinical outcomes considered were donor-site healing time, early and late complications, perioperative practices, and quality of scars. Results: Four studies met the inclusion criteria (n = 417, mean age 2.9\u20137.3 years) with follow-up periods up to 27 years. Epithelialization occurred between 7 and 25 days. Early complications included folliculitis (up to 44% in certain hair types) and delayed healing (n = 13; 52%). A rigorous harvesting technique is needed to avoid preventable complications. Late sequelae included alopecia (1.6% to 33%\u2014the latter largely unperceived by patients) and hypertrophic scarring (1.6\u20134%). Scar quality was rated good in &gt;80% of cases. Conclusions: Evidence supports the scalp as a safe, efficient, and cosmetically favorable donor site for pediatric STSG. Based on evidence and clinical experience, we propose the first structured scalp-donor management algorithm to optimize safety, reduce complications, and standardize perioperative care in the management of pediatric burns.<\/jats:p>","DOI":"10.3390\/ebj7020024","type":"journal-article","created":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T19:35:43Z","timestamp":1778528143000},"page":"24","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Scalp as a Donor Site in Pediatric Burns: Systematic Review of the Literature and Proposal of a Management Algorithm"],"prefix":"10.3390","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-9119-3492","authenticated-orcid":false,"given":"Carlotta Paola Maria","family":"Canonica","sequence":"first","affiliation":[{"name":"Pediatric Surgery Department, Buzzi Children\u2019s Hospital, 20154 Milan, Italy"},{"name":"Pediatric, Urologic, Plastic Surgery and Pediatric Burn Unit, Clocheville Hospital, Centre Hospitalier R\u00e9gional Universitaire (CHRU Tours), 37000 Tours, France"},{"name":"Medicine and Surgery Faculty, University of Milan, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene","family":"Paraboschi","sequence":"additional","affiliation":[{"name":"Pediatric Surgery Department, Buzzi Children\u2019s Hospital, 20154 Milan, Italy"},{"name":"Department of Biomedical and Clinical Science, University of Milan, 20157 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eleonora","family":"Durante","sequence":"additional","affiliation":[{"name":"Pediatric Surgery Department, Buzzi Children\u2019s Hospital, 20154 Milan, Italy"},{"name":"Pediatric, Urologic, Plastic Surgery and Pediatric Burn Unit, Clocheville Hospital, Centre Hospitalier R\u00e9gional Universitaire (CHRU Tours), 37000 Tours, France"},{"name":"Medicine and Surgery Faculty, University of Milan, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2924-6904","authenticated-orcid":false,"given":"Francesca","family":"Izzo","sequence":"additional","affiliation":[{"name":"Anaesthesia and Intensive Care, Buzzi Children\u2019s Hospital, 20154 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Mandelli","sequence":"additional","affiliation":[{"name":"Anaesthesia and Intensive Care, Buzzi Children\u2019s Hospital, 20154 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4367-7607","authenticated-orcid":false,"given":"Sara","family":"Costanzo","sequence":"additional","affiliation":[{"name":"Pediatric Surgery Department, Buzzi Children\u2019s Hospital, 20154 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elvira","family":"Conti","sequence":"additional","affiliation":[{"name":"Plastic and Reconstructive Surgery, Armand-Trousseau Hospital, Assistance Publique H\u00f4pitaux de Paris (APHP), 75012 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gloria","family":"Pelizzo","sequence":"additional","affiliation":[{"name":"Pediatric Surgery Department, Buzzi Children\u2019s Hospital, 20154 Milan, Italy"},{"name":"Department of Biomedical and Clinical Science, University of Milan, 20157 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Le Touze","sequence":"additional","affiliation":[{"name":"Pediatric, Urologic, Plastic Surgery and Pediatric Burn Unit, Clocheville Hospital, Centre Hospitalier R\u00e9gional Universitaire (CHRU Tours), 37000 Tours, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"326","DOI":"10.1016\/j.burns.2017.07.012","article-title":"Trauma Mechanisms and Injury Patterns in Pediatric Burn Patients","volume":"44","author":"Moehrlen","year":"2018","journal-title":"Burns"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1016\/j.cps.2024.02.008","article-title":"Pediatric Burns: From Acute Care Through Reconstruction in 2024","volume":"51","author":"Fisher","year":"2024","journal-title":"Clin. 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