title: Influence of body mass index on skin grafting in pediatric burns.
abstract: BACKGROUND
  There is heterogeneous literature on the association of obese and underweight body habitus on burn outcomes in adult and pediatric literature. We examine the effect of standardized pediatric body mass index (BMI) categories skin graft utilisation.
  
  
  METHODS
  A retrospective chart review was performed on children who underwent burn treatment from January 1995 to November 2011. BMI was categorized by standard definitions: underweight (<5%), normal (5-85%), overweight (85-95%), obese (>95%).
  
  
  RESULTS
  There were 1164 patients: 77 underweight, 604 normal, 215 overweight, and 268 obese patients. No differences existed between group demographics. Grafts were performed in 39% of underweight, 27% of normal, 22% of overweight, and 27% of obese patients. Underweight children had nearly a 2 fold increase in their risk of full thickness burns and were 1.8 times more likely to undergo skin grafting than normal BMI children. Overweight children had a significant decrease in the incidence skin grafting by 23% then compared to normal weight children. There were no differences in percent TBSA burned or percent TBSA grafted using ANOVA.
  
  
  CONCLUSIONS
  Underweight pediatric burn victims have an increased risk for skin grafting while mildly overweight children are slightly protected from skin grafting.
authors.affiliation: The Children's Mercy Hospital, Kansas City, MO, USA.
authors.forename: Nicole E
authors.initials: NE
authors.lastname: Sharp
authors.affiliation: The Children's Mercy Hospital, Kansas City, MO, USA.
authors.forename: Priscilla G
authors.initials: PG
authors.lastname: Thomas
authors.affiliation: The Children's Mercy Hospital, Kansas City, MO, USA.
authors.forename: Ashley K
authors.initials: AK
authors.lastname: Sherman
authors.affiliation: The Children's Mercy Hospital, Kansas City, MO, USA.
authors.forename: Shawn D
authors.initials: SD
authors.lastname: St Peter
authors.affiliation: The Children's Mercy Hospital, Kansas City, MO, USA. Electronic address: djuang@cmh.edu.
authors.forename: David
authors.initials: D
authors.lastname: Juang
mesh_terms: D000293:Adolescent; D000704:Analysis of Variance; D015992:Body Mass Index; D002056:Burns / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D050177:Overweight; D012189:Retrospective Studies; D012307:Risk Factors; D016038:Skin Transplantation / Q000706:statistics & numerical data*; D013851:Thinness
keywords: BMI; Body mass index; Burn; Children; Skin graft