The relationship between transepidermal water loss (TEWL) and scar activity.

Tanja Klotz¹, Brad Schmitt¹, Guy Maddern², Marcus Wagstaff¹, Yugesh Caplash¹,
¹Royal Adelaide Hospital, Adelaide, South Australia, Australia
²University of Adelaide , Adelaide, South Australia, Australia
³The Queen Elizabeth Hospital, Woodville, South Australia, Australia

Abstract

Scars, including keloid and hypertrophic scars, are common and unpleasant and can cause functional side effects post burn injury, trauma, or surgery. In a clinical setting, assessors judge the elasticity and colour of scars to indicate their activity and guide decisions on scar management. TEWL is a measure that has been shown to remain elevated after wound healing and throughout scar formation, but eventually normalises. Understanding TEWL and how scars progress may allow for more accurate refinements in scar management techniques.
The objective of this research was to measure TEWL of active scars and investigate any potential correlations with other objective measurements of scar activity, including elasticity and colour, over different time points. An area of ‘normal’ unburned skin in a similar location was used as a comparator.
Participants were recruited from the pool of current outpatients receiving scar management services at the Burn Unit of the Royal Adelaide Hospital. The treating clinicians conducted a subjective scar assessment (POSAS) after identifying a suitable scar and site matched ‘normal’ skin site. Objectively, TEWL was measured using two different devices (Dermalab® and Vapometer®). Colour and elasticity were also measured with the Dermalab®.
Results of this study, including a comparison of scars resulting from skin grafts and those forming from wounds that heal by secondary intention, will be presented. An early review of the data indicates that TEWL is significantly higher in scars from wounds that heal by secondary intention compared to scars from skin-grafted wounds.

Biography

Tanja has been working as a Burns OT for the past 20 years. After completing a Master of Clinical Science, which included conducting a systematic review on the impact of moisturizers on scars, she discovered that the available evidence was insufficient to guide clinicians dealing with burn scars. Consequently, she is currently pursuing a PhD to shed light on the effects of basic and commonly recommended moisturizers on burn scars. Alongside her academic endeavors, Tanja remains committed to her work on the burn unit at Royal Adelaide Hospital.