Dermabrasion with Split-Thickness Skin Grafting Tied to Better Scar Outcomes in Post-Burn Leukoderma: Study
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Türkiye: A recent observational study has evaluated the effectiveness of a commonly used surgical approach for managing post-burn leukoderma, a condition marked by persistent skin depigmentation after burn injuries.
Dermabrasion followed by split-thickness skin grafting (STSG) yields acceptable scar outcomes in patients with stable post-burn leukoderma, with strong agreement between patient and clinician assessments. Complication-free healing plays a crucial role in achieving better results. However, since POSAS focuses on scar quality rather than pigmentation, further controlled studies using objective pigment or color-based assessments are needed to better evaluate repigmentation outcomes.
The study, published in BMC Surgery, was conducted by Abdulkadir Calavul from the Department of Plastic, Reconstructive and Aesthetic Surgery at Eskişehir City Hospital. The research aimed to systematically assess postoperative scar outcomes using validated tools, addressing a gap in evidence for surgical management of post-burn leukoderma.
Post-burn leukoderma remains a difficult late complication of deep dermal injuries, often presenting as areas of hypopigmentation along with compromised scar quality. While dermabrasion combined with split-thickness skin grafting is widely practiced, robust outcome data—particularly using standardized scar assessment methods—have been limited. To bridge this gap, the investigators conducted a two-center ambispective study involving patients treated at Afrin State Hospital and Şanlıurfa Metrolife Hospital.
A total of 36 patients with stable post-burn leukoderma who underwent superficial dermabrasion followed by STSG between May 2020 and July 2024 were included. Retrospective clinical data were collected, and prospective scar evaluations were later performed between May and July 2025 after obtaining ethical approval. The Patient and Observer Scar Assessment Scale (POSAS), a validated tool for evaluating scar characteristics, was used to assess outcomes from both patient and clinician perspectives.
The researchers reported the following findings:
- Patient-reported and clinician-assessed POSAS scores showed a very strong correlation, indicating high agreement in scar evaluation.
- The strong concordance suggests that subjective patient feedback and objective clinical assessment align well in determining outcomes.
- Age and sex did not have a significant impact on scar quality outcomes.
- Burn size was also not significantly associated with postoperative scar results.
- Postoperative complications emerged as a key factor influencing outcomes.
- Patients with complications had significantly worse scar scores in both patient and clinician assessments.
- The findings emphasize the importance of complication-free healing for better surgical results.
- A large effect size highlights the substantial negative impact of complications on overall scar outcomes.
Overall, the study supports the use of dermabrasion followed by STSG as a viable surgical option for improving scar quality in patients with stable post-burn leukoderma. However, the authors caution that while POSAS effectively evaluates scar characteristics, it does not directly measure pigmentation changes. As such, future research incorporating objective colorimetric or pigment-specific tools will be essential to fully understand the extent of repigmentation achieved with this technique.
Reference:
Calavul, A. Surgical outcomes of dermabrasion followed by split-thickness skin grafting for post-burn leukoderma: a two-center observational study. BMC Surg (2026). https://doi.org/10.1186/s12893-026-03756-9
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