Itch in Burn Areas After Skin Transplantation: Patient Characteristics, Influencing Factors and Therapy

Abstract

Pruritus is a frequently encountered symptom following burns. Higher intensity of itching has been associated with depth of the wounds and specific body locations but these differences are not well understood. Our aim was to investigate the intensity of post burn pruritus in grafted and non-grafted burns across anatomic areas and to report on itch-inducing factors and applied treatments. The study included 226 patients prospectively followed for 18 months. Results showed that grafted patients and non-grafted patients reported similar overall itch intensity in-hospital. At 3 months post burn, grafted patients had higher overall itch scores, a difference that was found robust across the study period. Grafted wounds were found to produce higher mean itch intensity at 3 months post burn but this difference disappeared at 12 months post burn. Differences in itch prevalence rates were found across anatomic areas, but only in non-grafted burns. The differences in itch intensity on patient level versus wound level suggest that on the longer run, peripheral mechanism do not explain the higher itch scores in grafted patients.

Biotechnological Management of Skin Burn Injuries: Challenges and Perspectives in Wound Healing and Sensory Recovery

“…Furthermore, itching is generally more intense during the first 3 months post-burn and its severity significantly decreases between the 3 rd and 12 th month post-burn, a timeframe consistent with the improvement of the scar quality (148,151,152). Sometimes, however, it delays the healing is stronger as the number of itchy body surface areas is high (151,154). This apparent discrepancy between the two studies likely stems from the fact that the post-burn time was around few years in the first one and only around few months in the second one.…”

“…Overall, itching appears to be related to the severity of the burn injury since other data highlighted its positive association to the time required for wound healing and to the number of surgical interventions (150,155). Moreover, grafted burn scars are itchier than non-grafted scars, especially in the first months (151). This findings support previous outcomes showing more substance P-immunoreactive fibers in grafted skin in the first years post-burn, although the number of the total nerve fibers was decreased (132).…”

“…Contrary to the face and the neck, legs are typically affected, especially in the first months (150,151). Furthermore, itching is generally more intense during the first 3 months post-burn and its severity significantly decreases between the 3 rd and 12 th month post-burn, a timeframe consistent with the improvement of the scar quality (148,151,152). Sometimes, however, it delays the healing is stronger as the number of itchy body surface areas is high (151,154).…”

Course and Predictors of Pruritus Following Burns: A Multilevel Analysis

“…Female sex and younger age are associated with the presence and severity of itch (1,5,7,8). The most consistent injury characteristic associated with higher itch scores is the percentage total body surface area (TBSA) burned (1,5,9,10). Furthermore, some studies have shown that an increase in TBSA burned is associated with a higher itch severity (1,2,(5)(6)(7)11).…”

Pain and itch outcome trajectories differ among European American and African American survivors of major thermal burn injury

“…First, our sample size (n=96) was small and included 39 African Americans, 43 European Americans at the 6 months follow-up. However, unlike many prior studies of this difficult to recruit population, our follow-up rates were excellent, increasing internal validity [32; 38]. Additionally, no studies have examined ethnic differences in pain/itch outcomes among MThBI survivors.…”