Crosstalk among adipose tissue,vitamin D level,and biomechanical properties of hypertrophic burn scars

PurposeThis cross-sectional study aimed to investigate whether adipose tissue loss and reduced vitamin D levels following severe burn injury are associated with pathologic scar formation and biomechanical scar properties.MethodsA total of 492 male subjects with hypertrophic burn scars were enrolled from January 2014 to July 2018 and analyzed. Body fat content was measured using dual-energy X-ray absorptiometry. Values of melanin, erythema, and trans-epidermal water loss (TEWL) and the distensibility and elasticity of hypertrophic scars were examined using pigment- and TEWL-measuring devices and a suction skin elasticity meter.ResultsBurn patients with higher fat percentage tended to have higher 25(OH) vitamin D levels (P < 0.001). As body fat percentage increased, hypertrophic scars showed higher mean value of Uf (distensibility, P < 0.001) and lower mean value of Uv/Ue (viscoelasticity or interstitial fluid shifting, P < 0.001). Burn patients with higher 25(OH) vitamin D levels tended to have higher mean values of Uf (P < 0.001) and Ua/Uf (gross elasticity, P = 0.013) and lower mean value of Uv/Ue (P = 0.008).ConclusionAdipose tissue loss and decreased 25(OH) vitamin D levels following burn injury were related to scar rigidity and slow interstitial fluid shifting in hypertrophic scars.