Acetic acid dressings converted skin graft donor sites into full thickness wounds in a burned infant, a case report

•Acetic acid has been appreciated for the past 6000 years as a topical agent to treat burn wounds colonised with Pseudomonas aeruginosa.•The topical application of 2.5% acetic acid dressing in infected donor sites used in an infant proved to be detrimental.•Low concentration of topical acetic acid seems to be reasonable and effective to use in infants. Colonisation with Pseudomonas aeruginosa considerably increases the mortality rate in burns, due to its common resistance to antibiotic treatment. Simple dressings consisting of gauze soaked in acetic acid have been proven as effective in eradicating pseudomonas however few studies have demonstrated the optimum concentration or treatment regime. We report a burned infant who developed iatrogenic chemical injuries to her donor sites as a complication of topical acetic acid treatment. Possible contributing factors and strategies to improve safety are discussed.