Two-year follow-up of outcomes related to scarring and distress in children with severe burns

Abstract

Purpose We assessed the perception of scarring and distress by pediatric burn survivors with burns covering more than one-third of total body surface area (TBSA) for up to 2 years post-burn. Methods Children with severe burns were admitted to our hospital between 2004 and 2012, and consented to this IRB-approved-study. Subjects completed at least one Scars Problems and/or Distress questionnaire between discharge and 24 months post burn. Outcomes were modeled with generalized estimating equations or using mixed linear models. Significance was accepted at p<0.01. Results Responses of 167 children with a mean age of 7±5 years and burns covering an average 54±14% of TBSA were analyzed. Significant improvements over the 2-year period were seen in reduction of pain, itching, sleeping disturbance, tightness, range of motion, and strength (p<0.01). There was a significantly increased persistent desire to hide the scarred body areas over time (p<0.01). The perception of mouth scarring, inability to portray accurate facial expressions, and skin coloration did not improve over the follow-up period. Conclusions According to self-assessment questionnaires, severely burned children exhibit significant improvements in their overall perception of scarring and distress. However, these patients remain self-conscious with respect to their body image even 2 years after burn injury.

Hypertrophic scarring: the greatest unmet challenge after burn injury

“…The Boston Outcomes Questionnaire, 66 the Visual Analog Scale, 64 the 5-D itch scale, 64 the Scars Problems Questionnaire, 67 and the Brisbane Burn Scar Impact Profile 68 are used to determine the long-term impact of post-burn scarring on life quality and to elucidate the relationships between variables underlying scarring. 64 Although parameters such as pain, itch, limited range of motion, and sleep disturbances decrease between the time of burn and two years post-injury, persistence in wanting to hide scarred areas, dissatisfaction with the ability to accurately portray facial expressions, and unhappiness with skin discoloration endure.…”

“…64 Although parameters such as pain, itch, limited range of motion, and sleep disturbances decrease between the time of burn and two years post-injury, persistence in wanting to hide scarred areas, dissatisfaction with the ability to accurately portray facial expressions, and unhappiness with skin discoloration endure. 67 …”

Reduced Postburn Hypertrophic Scarring and Improved Physical Recovery With Yearlong Administration of Oxandrolone and Propranolol

“…33 These scars continue to be a source of pain and discomfort and negatively impact quality of life for up to 2 years postburn. 34 Therapies such as laser or surgical revision can decrease the severity of burn scar. 33 However, there is a dearth of pharmacologic approaches that successfully reduce the effects of burn scars on function and quality of life after massive burns.…”

The P50 Research Center in Perioperative Sciences

“…Quality of life in burn survivors may be compromised due to the physical appearance of scars, reduced function of scarred joints, or by persistent itch and pain emanating from scars (90). Lessening the impact of the extensive scarring that affects 70–90% of severely burned patients has become a research priority, prompting the development of reliable animal models to study post-burn wound healing and hypertrophic scarring (15, 18, 91, 92) to parallel studies of the patients themselves.…”