Blue-Light Photobiomodulation in Pediatric Burns: Inflammation, Healing, and Early Scar Outcomes in a Retrospective Historical Cohort

Background: Blue-light photobiomodulation (PBM) may support burn wound repair through modulation of early inflammatory responses, but comparative evidence in children remains limited. We examined associations between adjunctive PBM, early local inflammation, wound healing, and early scar quality in pediatric burns. Methods: This single-center retrospective historical cohort study included 84 children treated in 2024: 50 historical controls receiving standard care and 34 patients receiving standard care plus blue-light PBM after its introduction into routine practice. The primary outcome was the exploratory composite inflammation score at 72 h, adjusted for the pre-exposure 24 h score and clinical covariates. Secondary outcomes included time to complete re-epithelialization, Vancouver Scar Scale (VSS) score approximately three months after complete re-epithelialization, unplanned dressing changes, and autologous skin grafting. Documented PBM-related adverse events were also reviewed. Results: PBM was associated with a lower adjusted 72 h inflammation score (mean difference −2.70 points, 95% CI −3.71 to −1.68), shorter healing time (−5.98 days, 95% CI −8.68 to −3.28), and lower VSS scores (−1.46 points, 95% CI −2.46 to −0.47). The adjusted odds of unplanned dressing changes were lower with PBM (OR 0.25, 95% CI 0.07–0.79), whereas the association with skin grafting was not statistically significant (OR 0.63, 95% CI 0.17–2.16). No PBM-attributable adverse events were documented. Conclusions: These hypothesis-generating associations require prospective confirmation and do not establish a causal treatment effect. The sample size and retrospective recording limit conclusions about safety.