Early Enzyme-Alginogel Treatment Improves Healing and Reduces Complications, Scarring, and Healthcare Burden in Children with Mild-to-Moderate Burns: A Retrospective Real-World Study

Background/Objectives: Pediatric mild-to-moderate burns require careful management in the early phase, yet evidence guiding optimal initial dressing selection remains limited. Although topical medications and specialized dressings are routinely used, a universally accepted standard of care is lacking. Methods: We conducted a 1-year, real-world, retrospective, comparative, single-center study evaluating whether treatment with enzyme alginogel (Flaminal®) or NaOCl 0.05% antiseptic in the first 24 h led to different outcomes in terms of healing time, lesion progression, complication occurrence, scar quality, and burden of care. Medical records of 80 children with mild-to-moderate burns (Total Body Surface Area < 15%) treated between January and December 2024 were analyzed. Results: Despite a higher proportion of deep burns, early treatment with enzyme alginogel was associated with a 6.17-day [95% Confidence Interval: 4.71–7.63 days] shorter healing time (p < 0.001), with no observed lesion worsening or need for early surgery. The complication rate was 14% in the enzyme alginogel group, while all patients receiving antiseptic dressing had at least one complication (p < 0.001). Patients treated with enzyme alginogel also showed better Vancouver Scar Score [2.95 points, 95% Confidence Interval: 2.33–3.23, p < 0.001] and fewer follow-up visits, supporting a direct relationship between healing time and scar outcomes, and suggesting a potential reduction in the burden of care. Conclusions: Early management with alginogel favored healing, reduced complications, improved scar outcomes, and reduced burden of care in comparison to the initial treatment with NaOCl-based antiseptic dressings followed by treatment change when clinically indicated. Prospective, comparative, randomized studies are needed to confirm these findings.