Identification of factors predicting scar outcome after burn in adults: A prospective case-control study

Burns. 2017 Sep;43(6):1271-1283. doi: 10.1016/j.burns.2017.03.017. Epub 2017 Apr 15.

Abstract

This study examined influences on scarring after burn in a prospective study using a defined outcome measure: scar height measured by a modified Vancouver Scar Scale (mVSS). A prospective case-control study was conducted among 616 adult subjects who sustained a burn in Western Australia. Patient factors influencing scar outcome including gender, Fitzpatrick skin type and selected co-morbidities were explored, as well as injury and clinical factors. A logistic regression model for raised scar after burn was developed which achieved an overall correct prediction rate of 81.1%; 74.8% for those with raised scar and 86.0% for those without raised scar. From this study, injury and clinical predictors for raised scar after adjustment for other variables are: increasing %TBSA, greater burn depth as indicated by level of surgical intervention, wound complications and prolonged hospital stay. Intrinsic patient predictors for raised scar in patients with comparable injuries are: young age (≤30 years), female gender and Fitzpatrick skin types 4-6. The strength of association statistics (odds ratios and 95% confidence intervals) reported will be of practical benefit for clinical decision-making and counselling of patients, and plausible biological explanations for the findings support the validity of the results.

Keywords: Adults; Burns; Hypertrophic scar; Risk factors; Wound healing.

MeSH terms

  • Adult
  • Body Surface Area
  • Burns / complications*
  • Burns / pathology
  • Case-Control Studies
  • Cicatrix, Hypertrophic / epidemiology
  • Cicatrix, Hypertrophic / etiology*
  • Cicatrix, Hypertrophic / pathology
  • Clinical Decision-Making
  • Female
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Odds Ratio
  • Prospective Studies
  • Risk Assessment
  • Sex Factors
  • Trauma Severity Indices
  • Western Australia / epidemiology
  • Young Adult