Longitudinal burn scar quantification

作者：Nedelec Bernadette^*; Correa Jose A; de Oliveira Ana; LaSalle Leo; Perrault Isabelle

来源：Burns, 2014, 40(8): 1504-1512.

DOI：10.1016/j.burns.2014.03.002

• Hypertrophic scar
• Burns
• Skin injuries
• Cutometer
• Mexameter
• High-frequency ultrasound scanning

Quantitative studies of the clinical recovery of burn scars are currently lacking. Previous reports validate the objective, precise, diagnostic capabilities of high-frequency ultrasound to measure thickness, the Cutometer (R) to measure pliability and the Mexameter (R) to measure erythema and pigmentation of scars. Thus, we prospectively quantified clinical characteristics of patient-matched, after burn hypertrophic scar (HSc), donor site scar (D) and normal skin (N) using these instruments. One investigator measured 3 sites (HSc, D, N) in 46 burn survivors at 3, 6, and 12 months after-burn. A mixed model regression analysis, adjusting p-values for multiplicity of testing, was used to compare means among sites and time points. Participants were 41.2 +/- 13.5 years old, 87% males, predominantly Caucasian, with an average of 19.5% body surface area burned. HSc thickness decreased significantly between 3 and 6, 6 and 12, and 3 and 12 months (all p < 0.0001), but remained thicker than D and N skin (all p < 0.0001). Pliability differed significantly between HSc, D and N sites at all time points (all p < 0.0001), with HSc and D increasing between 3 and 12 months (p < 0.05) but not reaching normal. HSc and D sites were significantly more erythematous than normal skin (p < 0.05) at 3 and 6 months but D sites approached normal by 12 months. The only time points at which pigmentation significantly differed were the HSc and D sites at 6 months. Thickness, pliability, erythema and pigmentation of N skin remained similar over the 12 months. We found that post-burn HSc thickness, pliability and erythema differed significantly from D and N skin at 3, 6, and 12 months and does not return to normal by 12 months after-injury; however, significant improvements towards normal can be expected. Donor sites are redder than normal skin at 3 and 6 months but can be expected to return to normal by 12 months. Although the color of HSc and D sites change markedly with time these color changes are primarily due to changes in redness of the site, not melanin in this primarily Caucasian population.

• 出版日期2014-12
• 单位McGill