Hypertrophic scarring: the greatest unmet challenge after burn injury

Summary Improvements in acute burn care have enabled patients to survive massive burns that would have once been fatal. Now up to 70% of patients develop hypertrophic scars after burns. The functional and psychosocial sequelae remain a major rehabilitative challenge, decreasing quality of life and d...

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Bibliographic Details
Published in:The Lancet (British edition) 2016-10, Vol.388 (10052), p.1427-1436
Main Authors: Finnerty, Celeste C, Dr, Jeschke, Marc G, Prof, Branski, Ludwik K, MD, Barret, Juan P, Prof, Dziewulski, Peter, FRCS, Herndon, David N, Prof
Format: Article
Language:English
Subjects:
Administration, Cutaneous
Animals
Burn treatment
Burns
Burns - complications
Burns - metabolism
Burns - pathology
Burns - physiopathology
Cicatrix, Hypertrophic - etiology
Cicatrix, Hypertrophic - physiopathology
Cicatrix, Hypertrophic - surgery
Cicatrix, Hypertrophic - therapy
Collagen
Compression Bandages
Dermatologic Agents - administration & dosage
Disease Models, Animal
Fibroblasts
Humans
Internal Medicine
Laser Therapy
Patient Satisfaction
Patients
Phototherapy
Plastic surgery
Pruritus - etiology
Quality of Life
Scars
Skin Transplantation - methods
Skin Transplantation - trends
Surgical Mesh - utilization
Transplantation, Autologous
Transplantation, Homologous
Treatment Outcome
Visual Analog Scale
Wound Healing
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Summary:Summary Improvements in acute burn care have enabled patients to survive massive burns that would have once been fatal. Now up to 70% of patients develop hypertrophic scars after burns. The functional and psychosocial sequelae remain a major rehabilitative challenge, decreasing quality of life and delaying reintegration into society. Approaches to optimise healing potential of burn wounds use targeted wound care and surgery to minimise the development of hypertrophic scarring. Such approaches often fail, and modulation of the established scar is continued although the optimal indication, timing, and combination of therapies have yet to be established. The need for novel treatments is paramount, and future efforts to improve outcomes and quality of life should include optimisation of wound healing to attenuate or prevent hypertrophic scarring, well-designed trials to confirm treatment efficacy, and further elucidation of molecular mechanisms to allow development of new preventive and therapeutic strategies.
ISSN:0140-6736
1474-547X
DOI:10.1016/S0140-6736(16)31406-4