Scar quality in Burn Wounds with Various Healing Potentials:A Pilot Study

Nowadays, scar formation and quality are considered as one of the most
important outcomes in burn wounds. It is generally accepted that superficial
dermal burns with an expected wound healing of less than 14 days require no
surgical intervention, and that deep dermal or subdermal (full thickness) burns
with a healing potential of more than 21 days require surgical intervention. In
full-thickness and deep partial-thickness burns there will be scarring
regardless of intervention, however early excision and grafting is shown to be
positively correlated with scar quality.
However, clinical decision-making in burns of indeterminate depth, with a
healing potential within 14-21 days, is less straight forward. In addition,
often the depth of a burn is not either superficial dermal or deep dermal but a
mix of depths. In these cases, early excision and grafting could be
overzealously and cause scarring in areas that would have been able to
reepithelialise without surgical intervention. Conservative treatment could
give the superficial dermal areas time to reepithelialise with little or no
scarring, but postponing excision of the deep dermal areas too long will cause
more extensive (hypertrophic) scars. Hence, clinical decision-making is unclear
and evidence is missing regarding wounds with an intermediate healing potential
(14 to 21 days) and mixed wounds.

To determine long-term scar quality in patients admitted to a Dutch burn centre
with burn wound of indeterminate depth.

In a prospective cohort study we will determine scar quality > 15 months
post-burn in all patients included in a previous trial conducted at our burn
centre(s). For this trial (NL37844) patients burn wounds have been carefully
documented and depth has been determined with LDI scans. Hence, using these
data, a high quality study can be conducted with minimal efforts.

Not applicable

Burden for patients will be minimal. As the assessment of scar outcome by
Patient and Observer Scar Scale, Cutometer®, Dermaspectometer® are all
non-invasive measurements requiring limited registration time, total duration
of all measurements is estimated at 20 minutes per subject. No additional risks
are to be expected. When possible, scar quality is assessed combined with a
regular outpatient visit to the burn centre physician. In case a patient is
willing to participate but unable to visit the outpatient department, the
patient will be visited by a member of the research team.