Isolated Deep Thermal Burns of the Dorsal Foot Treated by Excision and Split-Thickness Skin Grafting at the Burn Centre of Lille: Characteristics, Surgical Management and Healing Delay

Foot burns involve a small total body surface area but may cause significant functional impairment. Deep thermal foot burns often require surgical excision and split-thickness skin grafting, yet the optimal timing of grafting remains debated. Our objective is to describe patient characteristics, surgical management and healing outcomes of isolated deep thermal dorsal foot burns treated at a single burn centre. We conducted a retrospective cohort study including all patients surgically treated for partial- or full-thickness dorsal thermal foot burns at the Burn Centre of the University Hospital of Lille between 2021 and 2023. Two surgical strategies were used: excision followed by delayed grafting and single-stage excision with immediate grafting. Healing times were analyzed per burned foot. Sixty-three patients (75 feet) were included. Patients treated with delayed grafting were older and more frequently had bilateral foot burns. Burn severity was comparable between groups. Post-operative healing time was significantly shorter after single-stage excision and grafting, whereas total healing time from burn injury did not differ significantly. Dermal matrix use was not associated with differences in healing time. In this real-life retrospective cohort, single-stage excision and immediate grafting were associated with faster post-operative healing, while overall healing time remained similar between surgical strategies. Differences between groups reflect clinical decision-making based on patient and wound characteristics rather than a protocol-driven approach.