Mrs Stephanie Ball2, Ms Stephanie Wicks1, Mrs Rhianydd Thomas1,2, Mrs Claire Toose1, Dr Kelly Gray2, Associate Professor Verity Pacey2
1The Children’s Hospital At Westmead, Sydney, Australia, 2Macquarie University, Sydney, Australia
Abstract:
Hypertrophic scarring is a significant complication post burn injury, especially for children healing after 3 weeks. However there remains a risk for children healing prior to 3 weeks to also develop hypertrophic scarring. A retrospective chart audit reviewed 326 burn patients (median age 2 years) treated at a tertiary hospital from 2014–2019 who did not receive skin grafting, healed >14 days and received prophylactic conservative scar interventions. Scar assessment was conducted by experienced burn therapists using modified Vancouver Scar Scale. A scar was deemed hypertrophic if >1mm in height. To identify early and persistent hypertrophic scar prevalence the time periods 3–6 and 12–18 months post burn was used. Median days to re-epithelisation was 18 (range 14–77). Prevalence of hypertrophic scarring for the cohort at 3–6 months was 56.1% and 16.3% at 12–18 months. At 3–6 months, 56.8% healed within 14–21 days. Similarly, at 12–18 months 56.6% healed within 14–21 days. A burn crossing a joint occurred in 113 children, no child developed subsequent joint contracture. Medical intervention for scar modulation was received by 17 (5.2%) children. Early signs of hypertrophic scarring were seen in just over half the patients presenting to physiotherapy and despite scar intervention, persistent hypertrophic scarring was seen in 16.3%. At both time points, just over half of the children presenting healed between 14–21 days. This study reaffirms that children have the potential to progress to hypertrophic scarring when healing prior to 21 days.
Biography:
Stephanie Ball is a paediatric Physiotherapist who previously worked within The Children’s Hospital at Westmead Burn Unit and completed her Master of Research at Macquarie University investigating scar outcomes for children.