Epidemiology of burn scars
Burn injury can lead to scarring, including hypertrophic scars and contractures.
How often do scars and contractures occur?
Hypertrophic scars are estimated to occur in 32-72% of burn injuries (though the data is incomplete and from high-income populations).
38-54% of cases lead to contractures
Contractures are reported in 38-54% of cases, as measured at discharge. The longer the time after the burn injury, the lower the prevalence of contractures.
32-72% of burn injuries lead to hypertrophic scars
Although the prevalence data is limited and varies greatly between studies and populations, given that 11 million people require medical care due to severe burns each year, this is an evident problem.
As burn care improves, more and more people survive serious burn injuries. This has led to an increase in the number of patients with problematic scars that require aftercare and surgical treatment.
In low- and middle-income countries, where more than 95% of fire-related burns occur, specialized burn care is limited. Burn care, including skin grafting, is often not available, and when it is, treatment can be delayed. In these cases, burn wounds heal by secondary intention, which leads to problematic scarring, including contractures.
Life long consequences
Burn injuries are not only a major cause of prolonged hospital stays and death, but also a common cause of disfigurement and disability.
Predictive factors
Injury and treatment characteristics are predictive factors for pathological scar formation and contractures.
| Pathological scars | Contractures |
|---|---|
| Total Body Surface Area (TBSA) burned | Severe burns |
| Required number of surgical procedures for an acute burn | Flame burns |
| Duration of wound healing | Children |
| Duration of hospital stay | Women |
| Complications (e.g. infection) | Burns to the upper extremity, specifically the shoulder and elbows |