Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Jan 19:5:3.
doi: 10.1186/s41038-016-0068-2. eCollection 2017.

A prospective study of time to healing and hypertrophic scarring in paediatric burns: every day counts

Elizabeth Chipp  1 , Lisa Charles  1 , Clare Thomas  1 , Kate Whiting  1 , Naiem Moiemen  1 , Yvonne Wilson  1
Affiliations

A prospective study of time to healing and hypertrophic scarring in paediatric burns: every day counts

Elizabeth Chipp et al. Burns Trauma. .

Abstract

Background: It is commonly accepted that burns taking longer than 3 weeks to heal have a much higher rate of hypertrophic scarring than those which heal more quickly. However, some of our patients develop hypertrophic scars despite healing within this 3-week period.

Methods: We performed a prospective study of 383 paediatric burns treated non-operatively at a regional burns centre over a 2-year period from May 2011 to April 2013. Scar assessment was performed by a senior burns therapist using the Vancouver Scar Scale.

Results: Overall rates of hypertrophic scarring were 17.2%. Time to healing was the strongest predictor of developing hypertrophic scarring, and the earliest hypertrophic scar developed in a patient who was healed after 8 days. The risk of hypertrophic scarring was multiplied by 1.138 for every additional day taken for the burn wound to heal. There was a trend towards higher rates of hypertrophic scarring in non-white skin types but this did not reach statistical significance.

Conclusions: The risk of hypertrophic scarring increases with every day and, therefore, every effort should be made to get the wound healed as quickly as possible, even within the traditional 3-week period usually allowed for healing. We believe that the traditional dogma of aiming for healing within 3 weeks is overly simplistic and should be abandoned: in paediatric burns, every day counts.

Trial registration: Not applicable.

Keywords: Burn; Hypertrophic; Paediatric; Scar; Skin type; Time to healing.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Rate of HTS by skin type and time to healing
Fig. 2
Fig. 2
Predicted risk of HTS versus time to healing
See this image and copyright information in PMC

References

    1. Bock O, Schmid-Ott G, Malewski P, Mrowietz U. Quality of life of patients with keloid and hypertrophic scarring. Arch Dermatol Res. 2006;297:433–438. doi: 10.1007/s00403-006-0651-7. - DOI - PubMed
    1. Lawrence JW, Mason ST, Schomer K, Klein MB. Epidemiology and impact of scarring after burn injury: a systematic review of the literature. J Burn Care Res. 2012;33(1):136–146. doi: 10.1097/BCR.0b013e3182374452. - DOI - PubMed
    1. Bae SH, Bae YC. Analysis of frequency of use of different scar assessment scales based on the scar condition and treatment method. Arch Plast Surg. 2014;41(2):111–115. doi: 10.5999/aps.2014.41.2.111. - DOI - PMC - PubMed
    1. Deitch EA, Wheelahan TM, Rose MP, Clothier J, Cotter J. Hypertrophic burn scars: analysis of variables. J Trauma. 1983;23(10):895–898. doi: 10.1097/00005373-198310000-00009. - DOI - PubMed
    1. Cubison TC, Pape SA, Parkhouse N. Evidence for the link between healing time and the development of hypertrophic scars (HTS) in paediatric burns due to scald injury. Burns. 2006;32(8):992–999. doi: 10.1016/j.burns.2006.02.007. - DOI - PubMed