IntroductionAn evidence-based national policy for the management of paediatric burns is lacking. This has resulted in great variations in the management and outcome of such injuries. This study aimed to look at variations in management of paediatric burns ? 3%TBSA in our burns unit and to investigate further whether care pathways and outcomes are linked.MethodsA retrospective review of international Burn Injury Database (iBID) was performed over a period from 2014 to 2017 to obtain data for children treated in our burns unit with burns ? 3% TBSA. Demographics, burns details and management, clinical course and outcomes were collected from patient records and analysed. Outcome measures included length of stay (LOS), incidence of infection, readmission rates and requirement for further surgery.ResultsA total of 106 patients were identified of which 100 patients were included. 50% of the cases were 1-2 years old.61% were males. 95% of burns were due to scalding injury. 36% of cases represented 3-4.9%TBSA burns, 47% 5-9.9%TBSA and 17% ? 10%-15% TBSA. Overall, 77% of patients were managed conservatively at initial presentation. A combination of Mepitel and Acticoat dressings was the most common choice of dressings (71%). In the surgically-managed group, 74% of the cases underwent debridement and Biobrane application, 13% were debrided and grafted while another 13% underwent debridement and dressings in theatre.When comparing conservative to surgical management, there was no significant difference in LOS at initial presentation (mean 3.8 days for conservative management vs 3.5 for surgical management). However, 49% of patients who were initially treated conservatively developed fever requiring antibiotics use as opposed to 17% in the group who were surgically managed. Readmission rates were higher in the conservatively-managed cohort (32% as opposed to 13% for surgical management). Furthermore, 17% of patients who were initially managed conservatively required surgical management in the form of debridement and grafting as opposed to 9% of those managed surgically.