Longitudinal burn scar quantification |
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| Institution: | 1. School of Physical and Occupational Therapy, McGill University, Canada;2. Centre de recherche du Centre Hospitalier de l’Université de Montréal (CHUM), Canada;3. Hôpital de réadaptation Villa Medica, Canada;4. Department of Mathematics and Statistics, McGill University, Montreal, Quebec, Canada;1. Queen Victoria Hospital, Holtye Road, East Grinstead, UK;2. Eykona Medical Ltd., Oxford, UK;1. Centre for Children''s Burns and Trauma Research, Child Health Research Centre, Level 4, Foundation Building, Royal Children''s Hospital, Herston Rd, Herston, Brisbane, Queensland 4006, Australia;2. Central Queensland Hospital and Health Service, East St, Rockhampton, Queensland 4700, Australia;3. School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Brisbane, Queensland 4067, Australia;4. Department of Occupational Therapy, Lady Cilento Children''s Hospital, 501 Stanley St, South Brisbane, Queensland 4101, Australia;5. Department of Paediatric Surgery, Urology, Neonatal Surgery, Burns and Trauma, Lady Cilento Children''s Hospital, Brisbane, Queensland 4101, Australia;6. School of Medicine, The University of Queensland, St Lucia, Brisbane, Queensland 4067, Australia;7. Physiotherapy Department, Royal Brisbane and Women''s Hospital, Butterfield St, Herston, Brisbane, Queensland 4006, Australia;8. Occupational Therapy Department, Royal Brisbane and Women''s Hospital, Butterfield St, Herston, Brisbane, Queensland 4006, Australia;1. Centre for Children''s Health Research, Faculty of Health, School of Biomedical Sciences, Queensland University of Technology, Brisbane, QLD, Australia;2. Burn Injury Research Unit, School of Biomedical Sciences, The University of Western Australia, Perth, WA, Australia;3. Burns Service of Western Australia, Perth Children''s Hospital and Fiona Stanley Hospital, Perth, WA, Australia;4. Centre for Children''s Burns and Trauma Research, The University of Queensland, South Brisbane, QLD, Australia;5. Queensland Children''s Hospital, South Brisbane, QLD, Australia;6. The Children''s Hospital Burns Research Institute, The Children''s Hospital at Westmead, The University of Sydney, NSW, Westmead, Australia;1. Burn Injury Research Unit, School of Surgery, The University of Western Australia, Australia;2. Department of Dermatology, Bispebjerg University Hospital, Denmark;3. Burn Outcomes Centre, Royal Perth Hospital, Australia |
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| Abstract: | Quantitative studies of the clinical recovery of burn scars are currently lacking. Previous reports validate the objective, precise, diagnostic capabilities of high-frequency ultrasound to measure thickness, the Cutometer® to measure pliability and the Mexameter® to measure erythema and pigmentation of scars. Thus, we prospectively quantified clinical characteristics of patient-matched, after burn hypertrophic scar (HSc), donor site scar (D) and normal skin (N) using these instruments. One investigator measured 3 sites (HSc, D, N) in 46 burn survivors at 3, 6, and 12 months after-burn. A mixed model regression analysis, adjusting p-values for multiplicity of testing, was used to compare means among sites and time points. Participants were 41.2 ± 13.5 years old, 87% males, predominantly Caucasian, with an average of 19.5% body surface area burned. HSc thickness decreased significantly between 3 and 6, 6 and 12, and 3 and 12 months (all p < 0.0001), but remained thicker than D and N skin (all p < 0.0001). Pliability differed significantly between HSc, D and N sites at all time points (all p < 0.0001), with HSc and D increasing between 3 and 12 months (p < 0.05) but not reaching normal. HSc and D sites were significantly more erythematous than normal skin (p < 0.05) at 3 and 6 months but D sites approached normal by 12 months. The only time points at which pigmentation significantly differed were the HSc and D sites at 6 months. Thickness, pliability, erythema and pigmentation of N skin remained similar over the 12 months. We found that post-burn HSc thickness, pliability and erythema differed significantly from D and N skin at 3, 6, and 12 months and does not return to normal by 12 months after-injury; however, significant improvements towards normal can be expected. Donor sites are redder than normal skin at 3 and 6 months but can be expected to return to normal by 12 months. Although the color of HSc and D sites change markedly with time these color changes are primarily due to changes in redness of the site, not melanin in this primarily Caucasian population. |
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| Keywords: | Hypertrophic scar Burns Skin injuries Cutometer Mexameter High-frequency ultrasound scanning |
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