Epidemiology and Risk Factors for Pathologic Scarring After Burn Wounds

Abstract

To describe the clinical characteristics of postburn scars and determine the independent risk factors specific to these patients. While burns may generate widespread and disfiguring scars and have a dramatic influence on patient quality of life, the prevalence of postburn pathologic scarring is not well documented, and the impact of certain risk factors is poorly understood. Methods: A retrospective analysis was conducted of the clinical records of 703 patients (2440 anatomic burn sites) treated at the Turin Burn Outpatient Clinic between January 1994 and May 15, 2006. Prevalence and evolution time of postburn pathologic scarring were analyzed with univariate and multivariate risk factor analysis by sex, age, burn surface and full-thickness area, cause of the burn, wound healing time, type of burn treatment, number of surgical procedures, type of surgery, type of skin graft, and excision and graft timing. Results: Pathologic scarring was diagnosed in 540 patients (77%): 310 had hypertrophic scars (44%); 34, contractures (5%); and 196, hypertrophic-contracted scars (28%). The hypertrophic induction was assessed at a median of 23 days after reepithelialization and lasted 15 months (median). A nomogram, based on the multivariate regression model, showed that female sex, young age, burn sites on the neck and/or upper limbs, multiple surgical procedures, and meshed skin grafts were independent risk factors for postburn pathologic scarring (Dxy 0.30). Conclusion: The identification of the principal risk factors for postburn pathologic scarring not only would be a valuable aid in early risk stratification but also might help in assessing outcomes adjusted for patient risk.

Resolution of post burn hypo pigmentation and scar by homeopathic medicines

“…Among different studies on post burn scarring, the risk factors included dark skin, female sex, young age, burn site on neck and/or upper limbs, multiple surgical procedures, meshed skin graph, time to healing, and burn severity [31,32]. In this study female sex, young age, burn site on neck and/or upper limbs were also found more in the enrolled patients under this study.…”

Full thickness facial burns: Outcomes following orofacial rehabilitation

“…It is well accepted that scar maturation can take between 18 months and 3 years to fully establish, particularly in the presence of contracture release or reconstruction, so it not unreasonable that contracture management would also require a similar period of time to achieve functional goals [30][31][32]. Additionally, individual characteristics including age, gender, skin pigmentation, burn depth and presence of comorbidities are known to affect burn wound healing time [33][34][35]. Therefore the risk of developing circumoral scar tissue and subsequent contractures with restricted mouth opening is very specific to each individual.…”

“…The 2 patients who failed to meet the set functional criteria both possessed a number of characteristics known to be predictive of poorer outcome [33][34][35]. These features were female gender, widespread facial and neck grafting, graft failure and subsequent need for repeat grafting, in addition to dark skin pigmentation.…”

One World, One Standard for Burn Care: Nursing's Role in Global Health

“…Burn treatment professionals agree that devastating aesthetic and functional problems result from scarring due to burn injuries. After burn wounds and grafts have healed, burn survivors are frequently disfigured, disabled, stigmatized, and shunned because of their scars (Gangemi et al, 2008). Studies suggest that in 32 to 67 percent of burn injuries, hypertrophic scarring is prevalent (Bombaro et al, 2003;Deovic, Koupilavia, & Brychta, 1999;Druecke et al, 2004;Spurr & Shakespeare, 1990).…”