Patient‐reported scar quality of adults after burn injuries: A five‐year multicenter follow‐up study

Abstract

Scar formation is an important adverse consequence of burns. How patients appraise their scar quality is often studied shortly after sustaining the injury, but information in the long‐term is scarce. Our aim was, therefore, to evaluate long‐term patient‐reported quality of burn scars. Adults with a burn center admission of ≥1 day between August 2011 and September 2012 were invited to complete a questionnaire on long‐term consequences of burns. We enriched this sample with patients with severe burns (>20% total body surface area [TBSA] burned or TBSA full thickness >5%) treated between January 2010 and March 2013. Self‐reported scar quality was assessed with the Patient Scale of the Patient and Observer Scar Assessment Scale (POSAS). Patients completed this scale for their—in their opinion—most severe scar ≥5 years after burns. This study included 251 patients with a mean %TBSA burned of 10%. The vast majority (91.4%) reported at least minor differences with normal skin (POSAS item score ≥2) on one or more scar characteristics and 78.9% of the patients’ overall opinion was that their scar deviated from normal skin. Patients with severe burns had higher POSAS scores, representing worse scar quality, than patients with mild/intermediate burns, except for color, which was high in both groups. A longer hospital stay predicted reduced scar quality (both mean POSAS and mean overall opinion of the scar) in multivariate analyses. In addition, female gender was also associated with a poorer overall opinion of the scar. In conclusion, this study provides new insights in long‐term scar quality. Scars differed from normal skin in a large part of the burn population more than 5 years after burns, especially in those with severe burns. Female gender is associated with a poorer patients’ overall opinion of their scar, which may be an indication of gender differences in perception of scar quality after burns.

Course of scar quality of donor sites following split skin graft harvesting: Comparison between patients and observers

“…Studies that investigated patient-and observer-reported scar quality of burn wounds also found that items on color were rated worse than other items. 7,21 The severe scores and reduction over time that we found for patientreported itching are also in accordance with previous studies regarding burn and linear scars. 7,12,13 The items pliability, thickness, and relief seem of less importance in our study population than to populations with burn scars or linear scars.…”

Recovery of health-related quality of life after burn injuries: An individual participant data meta-analysis

“…And a changed appearance might have a greater impact on a females life [46]. Studies focusing on other outcomes in burns found that female burn patients had higher levels of fatigue, a worse opinion about their scars, more difficulties with social participation, and mortality rates are higher than in male patients [46][47][48][49]. With respect to longer LOS, many studies have shown that patients with a prolonged hospital stay have a diminished HRQL, both shortly and longer after burns [10,41].…”

Studying the healing and long-term outcomes of two partial thickness wound models using different wound dressings

“…As reported in the result section, we found that female sex was the only factor that seemed to negatively influence the self-reported total POSAS scar scores. Two recent studies, from 2018 and 2019 [120,126], supported this finding, showing that women rated their overall scar score significantly higher than men. Another study from 2014, showed that women least preferred donor sites on the thigh, compared with all other locations [127].…”