Evidence for the link between healing time and development of hypertrophic scars in paediatric burns due to scald

What was this article about?

A retrospective notes review of all paediatric scald injuries admitted to two burns centres in England, with the intent to identify if there is a link between healing timeframes and severity of hypertrophic scarring.

The outcome was as follows;

Timeframe for healing	Overall chance of hypertrophic scarring (%)	Chance of scarring in those conservatively managed (%)	Chance of scarring in those surgically managed (%)
0-9 days	0
10-14 days	8	2	33
15-21 days	20	20	19
22-25 days	40	28	54
26-30 days	68	75	64
31+ days	92	94	88

 

Were there limitations in this study?

Method of measuring scarring was via Vancouver scar scale and study data came from retrospective notes review so inter- and intra-rater reliability would be limited in the assessment of burn wound and subsequent scarring.

How does this knowledge apply to my practice?

While a therapist has limited influence on wound healing, understanding the relationship between healing timeframes and the risk of hypertrophic scarring enables the treating therapist to 'red flag' patients at risk. This informs early scar management interventions which can commence during the later stages of wound healing which can, in turn, positively influence the longer-term scar outcome. This information supports and justifies any costs associated with intervention.