Citation

Spronk I, Polinder S, Haagsma JA, Nieuwenhuis MK, Pijpe A, van der Vlies CH, Middelkoop E, van Baar ME. Wound Repair Regen. 2019; 27(4): 406-414.

Affiliation

Erasmus MC, University Medical Center Rotterdam, Department of Public Health, Rotterdam, the Netherlands.

Copyright

(Copyright © 2019, Wiley-Blackwell)

DOI

10.1111/wrr.12709

PMID

30793408

Abstract

Scar formation is an important adverse consequence of burns. How patients appraise their scar quality is often studied shortly after sustaining the injury, but information in the long-term is scarce. Our aim was therefore to evaluate long-term patient-reported quality of burn scars. Adults with a burn center admission of ≥1 day between 08/2011 and 09/2012 were invited to complete a questionnaire on long-term consequences of burns. We enriched this sample with patients with severe burns (>20% total body surface area (TBSA) burned or TBSA full thickness>5%) treated between 01/2010 and 03/2013. Self-reported scar quality was assessed with the Patient Scale of the Patient and Observer Scar Assessment Scale (POSAS). Patients completed this scale for their -in their opinion- most severe scar ≥5 years after burns. This study included 251 patients with a mean %TBSA burned of 10%. The vast majority (91.4%) reported at least minor differences with normal skin (POSAS item score ≥2) on one or more scar characteristics and 78.9% of the patients' overall opinion was that their scar deviated from normal skin. Patients with severe burns had higher POSAS scores, representing worse scar quality, than patients with mild/intermediate burns, except for color, which was high in both groups. A longer hospital stay predicted reduced scar quality (both mean POSAS and mean overall opinion of the scar) in multivariate analyses. In addition, female gender was also associated with a poorer overall opinion of the scar. In conclusion, this study provides new insights in long-term scar quality. Scars differed from normal skin in a large part of the burn population more than five years after burns, especially in those with severe burns. Female gender is associated with a poorer patients' overall opinion of their scar, which may be an indication of gender differences in perception of scar quality after burns. This article is protected by copyright. All rights reserved.

This article is protected by copyright. All rights reserved.

Language: en

Keywords

Scar quality, Burns, long-term outcomes, predictors, POSAS