Hypertrophic Burn Scars Research Articles

Recovery in patients undergoing ablative fractional carbon dioxide laser for adult hypertrophic burn scars: a longitudinal cohort study

IntroductionAblative fractional carbon dioxide laser (AFCO2L) is widely used as a treatment for hypertrophic burn scars. This study aimed to evaluate clinician and patient-reported outcomes after AFCO2L treatment, safety, and identify factors influencing outcomes. MethodsThis longitudinal study recruited adult patients with hypertrophic burn scars treated with AFCO2L at a single Australian burn unit. Patients received up to four AFCO2L treatments over approximately 12 months. Outcomes were ultrasound scar thickness, the Patient and Observer Scar Assessment Scale (POSAS), and the Brisbane Burn Scar Impact Scale (BBSIP), measured at baseline and 3, 6, and 12-months post first AFCO2L treatment. Analysis used mixed effects linear models. Results47 patients were included with median age 32 years (IQR:24,53) and median burn TBSA of 35% (IQR:7.5%,48%). Statistically significant improvements between baseline and 12-month follow-up occurred in scar thickness, all POSAS and BBSIP subscores. Most improvements remained when accounting for TBSA, Fitzpatrick skin type, scar maturity, and body area treated. Patients reported transient symptoms after 61 of 89 (69%) AFCO2L treatments, but infection or delayed wound healing occurred after only 4 of 89 (4%) treatments. ConclusionThis study supports safety and improved clinician and patient-reported outcomes in patients undergoing AFCO2L for hypertrophic burn scars.

Potential therapeutic effects of topical recombinant human erythropoietin on burn wound healing: A preliminary randomized double-blind controlled clinical trial

BackgroundBurn injuries can cause significant mortality and morbidity. This study aimed to evaluate the efficiency of topical recombinant human erythropoietin (rhEPO) on enhancing burn wound healing. MethodsIn this randomized double-blind controlled clinical trial, we enrolled 40 participants aged 18 years and older who were referred to a burn center during the first 24 h of burning. The participants with no concurrent comorbidities had superficial and deep second-degree burns, no respiratory burns, no face and perineum burns, no keloid formation, or a healed, fully epithelialized, hypertrophic burn scar. Topical rhEPO or nitrofurazone/Vitamin A was administered every other day, and the patients were scheduled for follow-up visits to receive wound cleansing, debridement, and dressing changes. Burn wound healing response to treatment was measured as the study main outcome. ResultsAt the second follow-up visit, all parameters were significantly lower in the rhEPO group compared with the control group except for itchiness. The results of the next two follow-up sessions were also the same. The total value of the modified Vancouver Scar Scale (VSS) at days 5, 7, and 14 was significantly lower in the rhEPO group compared with the routine of care group.Trial Registry Date: 2022–03-02, Trial Registry number: IRCT20190810044500N23 ConclusionsThe results of the present study suggested that topical rhEPO is a potential option in burn wounds and patient satisfaction, without causing intolerable side effects.

Prophylactic Antibiotics are Unnecessary for Routine CO2 Laser Burn Scar Treatment.

CO2 ablative fractional laser (CO2 AFL) therapy is a safe and effective procedure when used in the treatment of hypertrophic scars for burn patients. It has a high patient satisfaction rate and a minimal side effect profile, typically consisting of postoperative pain, irritation, surgical site inflammation, and, in rare cases, infection. Although prophylactic antibiotics have historically been recommended, there is a paucity of literature on the topic and recent studies indicate that they may be unnecessary in routine cases. In this retrospective, single center descriptive study, 230 cases in patients with hypertrophic burn scars treated with CO2 AFL therapy were compared. 28 cases were with the use of prophylactic antibiotics and 201 cases were without the use of prophylactic antibiotics. We found that there was no significant association between the use of antibiotics and the prevention of topical skin infection in cases treated with CO2 AFL therapy (p=1). Therefore, we conclude that the omission of prophylactic antibiotics is not associated with an increased risk of infection and recommend that prophylactic antibiotics should not be indicated in the setting of routine CO2 AFL therapy for patients with hypertrophic burn scars.

Utility of a Multidisciplinary Burn OT Clinic in Early Identification of Hypertrophic Burn Scars

Abstract Date Presented 03/23/24 OTs will gain professional knowledge of the specialized evaluation process in a multidisciplinary burn clinic, identification of scar appearance, and benefits of early intervention scar management techniques. Primary Author and Speaker: Nicole Victoria Avena Contributing Authors: Emily R. Ulloa

Addressing Burn Hypertrophic Scar Symptoms Earlier: Laser Scar Revision May Begin as Early as 3-6 Months After Injury.

Fractional ablative CO2 laser (FLSR) is used to treat hypertrophic scars (HTSs) resulting from burn injuries,which are characterized by factors, such as erythema, contracture, thickness, and symptoms of pain and itch. Traditionally, waiting a year after injury for scar maturation before starting laser treatment has been recommended;however, the potential benefits of earlier intervention have gained popularity. Still, the optimal timing for beginning laser intervention in patients with HTSs remains uncertain. This study aims to evaluate the ideal timing for the initiation of FLSR for HTSs using several qualitative and quantitative assessment measures. It was hypothesized that early intervention would lead to similar improvement trends as later intervention, however, would be more ideal due to the shortened time without symptom relief for patients. Patients who received three or more laser treatment sessions and completed both pre- and posttreatment evaluations were included in this analysis (n = 69). FLSR treatment was administered at 4-8-week intervals. Patients starting treatment before 6 months after injury were classified as the early-stage intervention group and those beginning treatment at 6-12 months after injury were classified as the late-stage intervention group. Demographic data, including the age of patients at the time of first treatment, age of scars at the time of first treatment, biological sex, ethnicity, Fitzpatrick skin type, and use of laser-assisted drug delivery, were collected by retrospective chart review. Patients were evaluated on six subjective scales and objectively for scar stiffness with durometry. For all scales, higher scores indicate worse scars. A two-way ANOVA, Student's t-test, and Mann-Whitney U-test were used to compare scores from the pre- to posttreatment evaluations. There were no significant differences between the groups for any of the demographic or scar-specific variables; thus, differences in outcome can be attributed to the timing of intervention. Both groups demonstrated an improvement in scars with treatment over time (p < 0.05). Both early- and middle-stage initiation showed scar symptom improvement in five out of six scales. In the late-stage intervention, the Patient and Observer Scar Assessment Scale-Patientaverage score did not show improvement. In the early-stage intervention, the Vancouver Scar Scaletotal did not show improvement. Quantitative evaluation of scar stiffness by durometry did not show symptom improvement in either group. The Scar Comparison Scaledemonstrated the greatest improvement across groups. Laser treatment led to scar improvement in at least one scale at each stage of initiation. Both intervention timelines resulted in equivalent outcomes, and early intervention should be considered when initiating FLSR treatment in burn scars to alleviate symptoms earlier.

Efficacy of Fractional Micro-plasma Radio Frequency Technology in Treating Hypertrophic Burn Scars in Asian Patients Under General Anesthesia: A Retrospective Study of 104 Cases.

Laser and other energy devices have been widely used in the minimally invasive treatment of scars. Among various technologies, Fractional Micro-Plasma Radio Frequency Technology (FMRT) has gained extensive consensus in the treatment of various types of scars and skin disorders, such as wrinkles, skin laxity, and pigmentation. This study is a retrospective clinical trial aimed at assessing the effectiveness and safety of FMRT for hypertrophic burn scars treatment in the Asian population under different anesthesia methods. A total of 104 patients with hypertrophic burn scars treated in our department from May 2018 to May 2022 were selected. Scar assessment scales were applied to observe changes in scars before and after FMRT treatment. A prospective study of 104 patients found that female patients were more likely to undergo laser treatment under general anesthesia (P < 0.05). Postoperative VSS total score, VSS total score difference, and immediate postoperative pain score were all better with general anesthesia compared to local anesthesia (P < 0.05). There were more significant improvements in scar color, vascular distribution, and flexibility (P < 0.05). When comparing the treatment outcomes between females and males, it was found that general anesthesia patients were superior to local anesthesia patients in terms of color score, vascular distribution score, flexibility score, and postoperative VSS total score 6 months after the final treatment. General anesthesia patients had a shorter hospital stay. Overall treatment evaluation was better for female general anesthesia patients than male patients. General anesthesia combined with FMRT is an effective, safe, and more acceptable treatment method for hypertrophic burn scars in the Asian population. In the Asian population, the combined use of general anesthesia and Fractional Micro-Plasma Radio Frequency Technology (FMRT) is an effective, safe, and accepted method for treating skin scars. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

81 Effectiveness of Simultaneous Intense Pulsed Light and Fractional CO2 Laser Therapy in Hypertrophic Burn Scars

81 Effectiveness of Simultaneous Intense Pulsed Light and Fractional CO2 Laser Therapy in Hypertrophic Burn Scars

527 Combination Treatment for Hypertrophic Burn Scars Utilizing Fractional Ablative and Continuous Wave CO2 Laser

527 Combination Treatment for Hypertrophic Burn Scars Utilizing Fractional Ablative and Continuous Wave CO2 Laser

Global Surgery: Burn Outreach by Shriners Children's Texas.

Global surgery describes a rapidly developing field that seeks to improve surgical treatment internationally, specifically in those specialized treatments that are not readily accessible, considered complex and expensive. Burns cause 300,000 deaths annually, 90% of which occur in low- and middle-income countries (LMICs). Burns are a public health problem since they can cause disability and death. Shriners Children's Texas is a unique model of global surgery for an important number of countries in Central and South Americas and Mexico, providing specialized acute burn care with low mortality for burned children. Survivors of severe burns may face devastating sequelae due to burn scar contractures and hypertrophic burn scars that may limit the social reintegration. Burn reconstruction is not easily accessible to patients in LMICs. After discharge from acute burn treatment at our hospital, patients may return every 6 months for in-person follow-up to assess any surgical, psychological, or rehabilitative needs. Telemedicine allows for monitoring of postoperative results and evaluation for new surgical procedures. Follow-up clinic visits called outreach clinics held in international hospitals or international Shriners Temples allow for evaluation of follow-up patients and new patients with reconstructive needs that may benefit from a treatment in Shriners Children's Texas in Galveston, Texas.

Impact of laser treatment on hypertrophic burn scars in pediatric burn patients

Paediatric patients with hypertrophic burn scars benefit from laser treatment, but this treatment’s effectiveness on burn wounds stratified by specific body region and prior burn wound therapy has not been fully evaluated. We performed a single center retrospective study of pediatric burn patients, treated with fractional CO2, with or without pulse dye, laser between 2018–2022. We identified 99 patients treated with 332 laser sessions. Median age at the time of burn injury was 4.0 years (IQR 1.7, 10.0) and 7.1 years (IQR 3.6, 12.2) at the time of first laser treatment. In the acute setting, 55.2 % were treated with dermal substrate followed by autografting, 29.6 % were treated with dermal substrate alone, and 9.1 % underwent autografting alone. Most body regions showed improvement in modified Vancouver Scar Scale (mVSS) score with laser treatment. mVSS scores improved significantly with treatment to the anterior trunk (−1.18, p = 0.01), arms (−1.14, p = 0.003), and legs (−1.17, p = 0.015). Averaging all body regions, the mVSS components of pigmentation (−0.34, p < 0.001) and vascularity (−0.47, p < 0.001), as well as total score (−0.81, p < 0.001) improved significantly. Knowing the variable effectiveness of laser treatment in pediatric burn scars is useful in counseling patients and families pre-treatment.

Treatment of hypopigmented burn hypertrophic scars with short-term topical tacrolimus does not lead to repigmentation.

Dyschromia is an understudied aspect of hypertrophic scar (HTS). The use of topical tacrolimus has successfully shown repigmentation in vitiligo patients through promotion of melanogenesis and melanocyte proliferation. It was hypothesized that HTSs treated with topical tacrolimus would have increased repigmentation compared to controls. Full-thickness burns in red Duroc pigs were either treated with excision and meshed split-thickness skin grafting or excision and no grafting, and these wounds formed hypopigmented HTSs (n = 8). Half of the scars had 0.1% tacrolimus ointment applied to the scar twice a day for 21 days, while controls had no treatment. Further, each scar was bisected with half incurring fractional ablative CO2 laser treatment before topical tacrolimus application to induce laser-assisted drug delivery (LADD). Pigmentation was evaluated using a noninvasive probe to measure melanin index (MI) at Days 0 (pretreatment), 7, 14, and 21. At each timepoint, punch biopsies were obtained and fixed in formalin or were incubated in dispase. The formalin-fixed biopsies were used to evaluate melanin levels by H&E staining. The biopsies incubated in dispase were used to obtain epidermal sheets. The ESs were then flash frozen and RNA was isolated from them and used in quantitative reverse transcription polymerase chain reaction for melanogenesis-related genes: Tyrosinase (TYR), TYR-related protein-1 (TYRP1), and dopachrome tautomerase (DCT). Analysis of variance test with Šídák's multiple comparisons test was used to compare groups. Over time, within the grafted HTS and the NS group, there were no significant changes in MI, except for Week 3 in the -Tacro group. (+Tacro HTS= pre = 685.1 ± 42.0, w1 = 741.0 ± 54.16, w2 = 750.8 ± 59.0, w3 = 760.9 ± 49.8) (-Tacro HTS= pre = 700.4 ± 54.3, w1 = 722.3 ± 50.7, w2 = 739.6 ± 53.2, w3 = 722.7 ± 50.5). Over time, within the ungrafted HTS and the NS group, there were no significant changes in MI. (+Tacro HTS= pre = 644.9 ± 6.9, w1 = 661.6 ± 3.3, w2 = 650.3 ± 6.2, w3 = 636.3 ± 7.4) (-Tacro HTS= pre = 696.8 ± 8.0, w1 = 695.8 ± 12.3, w2 = 678.9 ± 14.0, w3 = 731.2 ± 50.3). LADD did not lead to any differential change in pigmentation compared to the non-LADD group. There was no evidence of increased melanogenesis within the tissue punch biopsies at any timepoint. There were no changes in TYR, TYRP1, or DCT gene expression after treatment. Hypopigmented HTSs treated with 0.1% tacrolimus ointment with or without LADD did not show significantly increased repigmentation. This study was limited by a shorter treatment interval than what is known to be required in vitiligo patients for repigmentation. The use of noninvasive, topical treatments to promote repigmentation are an appealing strategy to relieve morbidity associated with dyschromic burn scars and requires further investigation.

Efficacy of low energy fractional carbon dioxide laser therapy in management of post-surgical hypertrophic scars

Background: aberrant &amp; accelerated wound-healing process that results in hypertrophic scarring causes extracellular matrix &amp; collagen to deposit abnormally in the dermis. After tissue damage occurs, a defensive reaction called tissue repair occurs. Aim; in this review; we aimed to present the effectiveness of low-energy fractional carbon dioxide laser therapy in treating hypertrophic scars following surgery. Summary: A safe &amp; effective approach for treating hypertrophic burn scars is fractional ablative CO2 laser therapy. Even though more treatment sessions have been necessary for satisfying outcomes, a big improvement can be seen after just one round of therapy. Combination therapy with other modalities can decrease the need for repetition of therapy as efficacy increases. Though, in some studies, combination therapy may shorten the duration of studied case downtime &amp; in others, combination therapy may increase side effects. essential for laser energy setting needs to be adjusted for each hypertrophic scar condition. larger research population &amp; longer follow-up period are recommended.

Influence of scar age, laser type and laser treatment intervals on adult burn scars: A systematic review and meta-analysis.

The study aims to identify whether factors such as time to initiation of laser therapy following scar formation, type of laser used, laser treatment interval and presence of complications influence burn scar outcomes in adults, by meta-analysis of previous studies. A literature search was conducted in May 2022 in seven databases to select studies on the effects of laser therapy in adult hypertrophic burn scars. The study protocol was registered with PROSPERO (CRD42022347836). Eleven studies were included in the meta-analysis, with a total of 491 patients. Laser therapy significantly improved overall VSS/POSAS, vascularity, pliability, pigmentation and scar height of burn scars. Vascularity improvement was greater when laser therapy was performed >12 months (-1.50 [95%CI = -2.58;-0.42], p = 0.01) compared to <12 months after injury (-0.39 [95%CI = -0.68; -0.10], p = 0.01), the same was true for scar height ((-1.36 [95%CI = -2.07; -0.66], p<0.001) vs (-0.56 [95%CI = -0.70; -0.42], p<0.001)). Pulse dye laser (-4.35 [95%CI = -6.83; -1.86], p<0.001) gave a greater reduction in VSS/POSAS scores compared to non-ablative (-1.52 [95%CI = -2.24; -0.83], p<0.001) and ablative lasers (-0.95 [95%CI = -1.31; -0.59], p<0.001). Efficacy of laser therapy is influenced by the time lapse after injury, the type of laser used and the interval between laser treatments. Significant heterogeneity was observed among studies, suggesting the need to explore other factors that may affect scar outcomes.

Rete ridges are decreased in dyschromic burn hypertrophic scar: A histological study

Dyschromic hypertrophic scar (HTS) is a common sequelae of burn injury, however, its mechanism has not been elucidated. This work is a histological study of these scars with a focus on rete ridges. Rete ridges are important for normal skin physiology, and their absence or presence may hold mechanistic significance in post-burn HTS dyschromia. It was posited that hyper-, and hypo-pigmented areas of scars have different numbers of rete ridges. Subjects with dyschromic burn hypertrophic scar were prospectively enrolled (n = 44). Punch biopsies of hyper-, hypo-, and normally pigmented scar and skin were collected. Biopsies were paraffin embedded, sectioned, stained with H&E, and imaged. The number of rete ridges were investigated. Burn hypertrophic scars that healed without autografts were first investigated. The number of rete ridges was higher in normal skin compared to HTS that was either hypo- (p < 0.01) or hyper-pigmented (p < 0.001). This difference was similar despite scar pigmentation phenotype (p = 0.8687). Autografted hyper-pigmented scars had higher rete ridge ratio compared to non-autografted hyper-pigmented HTS (p < 0.0001). Burn hypertrophihc scars have fewer rete ridges than normal skin. This finding may explain the decreased epidermal adherence to underlying dermis associated with hypertrophic scars. Though, contrary to our hypothesis, no direct link between the extent of dyschromia and rete ridge quantity was observed, the differences in normal skin and hypertrophic scar may lead to further understanding of dyschromic scars.

Efficacy of Massage Techniques for Hypertrophic Burn Scars - A Systematic Review of Literature.

Despite advancements in burn care, evidence estimates that pathological scarring occurs in 32%-75% of cutaneous burns. Scar massage therapy is an under researched method of management for hypertrophic burn scars which has scope to be a low-cost treatment alternative. The aim of this systematic review was to determine the efficacy of scar massage techniques for common hypertrophic burn scar symptoms such as contraction, pruritus, pain and visibility. The keywords and corresponding MeSH terms were inputed into PubMed, EMBASE, Cochrane database of Systematic Reviews, University Library of Hull, York and Queen Mary, University of London. Following the implementation of predetermined inclusion and exclusion criteria, ten papers were included for data extraction. Quality assessment of all papers was performed using the Cochrane Risk of Bias tool and ROBINS-I tool. Data pertaining to the nature of the participant demographics, scar massage treatment, and study outcomes was extracted. Nine of the ten studies showed a significant improvement for scar massage treatment of hypertrophic burn scar symptoms despite using different massage techniques. Friction and oscillation massage was used in partnership to improve scar function, whereas effleurage and petrissage used in longer sessions was seen to improve scar visibility and pain. Scar pruritus was improved by each massage technique. Scar massage has been shown to be effective at improving scar outcomes. This paper suggests massage techniques should be tailored to the patients' symptoms. A large, randomized control trial is required to advance this area of research.

An audit of the use of fractional CO2 laser for hypertrophic burn scars: a real-life perspective.

An audit of the use of fractional CO2 laser for hypertrophic burn scars: a real-life perspective.

557 Adverse Events Associated with Fractional CO2 Laser Therapy for Hypertrophic Burn Scars

Abstract Introduction Laser therapy is a growing intervention in hypertrophic scar treatment. This therapy is associated with minimal risks, however these are poorly studied in the burn population. Anecdotal reports of adverse effects such as pain and dyspigmentation exist. As patients, stakeholders, and insurance companies decide on reimbursement for this therapy, a better studied safety profile is necessary. This study is a retrospective review of all laser therapies for adverse events. Methods A retrospective review of patients who underwent laser therapy at two centers between May 2019 and June 2022. Patient demographics, details of laser treatments, adverse events, and scar characteristics before and after laser therapy were collected. Results A total of 167 patients underwent 533 laser treatments. There were 75 (44.9%) males and 92 (55.1%) females, with an average age of 26 (SD: 20.6) years. In total, 94 patients (56.3%) were Hispanic or Latino, 24 (14.4%) Caucasian, and 49 (29.3%) identified as "Other". All patients were treated for hypertrophic scars after burn injuries. For all patients, average number of laser treatments was 3 (SD: 2.2), with a range of 1 to 17 sessions. There were 9 (1.68%) instances of adverse events out of the total laser encounters. There were 5 (0.93%) reports of increased pain, 1 (0.18%) of an open wound, 2 (0.37%) of increased scar discoloration, and 1 (0.18%) of decreased scar pliability. Of the 5 (2.98%) total patients who encountered adverse events, 3 continued with laser therapy. There was no correlation between number of laser treatments and adverse events. Conclusions Patients undergoing laser treatment for burn scar management rarely face adverse events, of which the most common were increased scar pain and dyspigmentation. Even so, most patients experiencing adverse events chose to continue treatments. Laser therapy remains effective in burn scar treatment with minimal risks regarding safety profile. Applicability of Research to Practice This review will assist patients in making more informed decisions when considering laser therapy for burn scar management.

54 Prophylactic Antibiotics are Unnecessary for Routine CO2 Laser Burn Scar Treatment

Abstract Introduction Many providers utilize prophylactic cephalexin prior to Co2 ablation laser for hypertrophic scarring. Many providers use this as standard of treatment despite a paucity of high-quality literature supporting the practice. The purpose of this study is to report a single-center experience in performing laser-assisted delivery of triamcinolone and destruction of burn scars without the use of antibiotics. Methods This was a retrospective descriptive study from a single center with a new laser scar program. The first 14 patients received cephalexin 500mg by mouth every 6 hours starting the day of the procedure for 5 days and valaciclovir 1000mg by mouth daily for 5 days for their first two procedures- as per manufacturer recommendations. After that, cephalexin was no longer utilized nor were any antibiotics given at the start time of procedure. Valacyclovir is given on a case-by-case basis for patients with a history of cold sores, known herpes simplex, or extensive facial procedures. Burn team staff members followed up with the patients within 48 -72 hours by phone call. Burn staff called patients after each laser treatment to assess for any adverse reactions. Adverse reactions include open areas, rashes, or blisters to laser site. The two groups were compared with a Fisher’s exact test for number of infections. Results Patients who received cephalexin accounted for the first 28 cases and none developed an infection. In 201 cases without antibiotics, only one patient developed cellulitis (0.5%), p=1. This patient was noncompliant with restrictions on hand hygiene and used a cheap lotion with parabens, dyes, and perfumes on post operative day 2. Another patient experienced a self-limiting dermatitis on their back of uncertain etiology. In 36 cases, valacyclovir was given. None of the patients in either group developed vesicular lesions consistent with HSV. Conclusions There were no significant differences in number of infections whether patients treated with or without prophylactic antibiotics before laser treatment of hypertrophic burn scars. The authors continue to treat patients without administering prophylactic antibiotics. Applicability of Research to Practice laser programs are common in burn centers

The importance of biomechanics and the kinetic chains of human movement in the development and treatment of burn scars - A narrative review with illustrative cases.

Burn scars are a major clinical sequelae of severe burn wound healing. To effectively establish a successful treatment plan and achieve durable results, understanding the pathophysiology of scar development is of utmost importance. A narrative review of the principles of the kinematic chain of movement and the hypothesised effect on burn scar development based on properties of burn scars was performed. An examination of the literature supporting these concepts is presented in conjunction with illustrative cases, with a particular focus on the effect of combination treatments that include ablative fractional resurfacing with surgical contracture releases. Ablative fractional resurfacing combined with the surgical release of contractures are an effective treatment modality for burn scar reconstruction. This treatment approach seems particularly effective because it is one of the only approaches where the principles of functional kinematics can be addressed when tailoring a reconstructive approach to an individual burn patient. The presented cases illustrate the importance of recognising and including the principles of functional kinematic chains in any reconstructive treatment approach for burn scars. Further, epifascial contracture bands are cord like structures which can be found underneath the subcutaneous fat of scar contractures which follow the principles of functional kinematics. Contractures can be more efficiently released if these structures are divided as well. Ablative fractional resurfacing combined with local tissue re-arrangements is a promising approach to address the underlying forces leading to hypertrophic burn scarring. To achieve an optimal outcome, it is essential to recognise and address the origin of the pathology when treating burn scars. Ablative fractional laser resurfacing allows a different scar approach as it is not limited to one surgical site and thus enables for effective treatment at the cause of the pathology.

Burn Hypertrophic Scar Profile Based on POSAS Score at Prof. Dr. R. D. Kandou Hospital Manado

Burn injury is skin damage due to extreme temperature resulting in hypertrophic scar if impaired of wound healing occurs that can impact on the quality of life. Evaluation of hypertrophic scar objectively and subjectively including scar quality and quality of life patient could performed with POSAS score. This study aimed to evaluate burn hypertrophic scar profile based on POSAS core at Prof. Dr. R. D. Kandou Hospital Manado. This was a retrospective study using medical records of burn patients from 2018 to 2020 at Prof. Dr. R. D. Kandou Hospital. The results obtained 64 samples. Most of the patients were male (75.0%). The most dominant age of patients was over the age of 21 years (79.7%). The most frequent cause of burns was exposure to hot water (71.9%) followed by fire (21.9%). The undergraduate education level was the most affected by burns (79.7%). The type of work most affected was the professional group (62.5%) followed by housewives (18.8%). Most of the wounds were superficial-middermal degree (71%) followed by superficial degree (15,6%) and deep dermal full thickness (12,5%). Assessment of hypertrophic scars using the POSAS score showed almost the same results between observers and patients. In conclusion, hypertrophic scar evaluation with POSAS score is very useful because it can evaluate the scar quality and the quality of life. POSAS score evaluation is depended on wound treatment, duration of wound healing, grading and wound burn area, and length of stay. Keywords: hypertrophic scar; POSAS score; quality of life