Younger age, prolonged Healing Time, and Burn Location tied to Poorer Long-Term Scar Outcomes in Children: Study
A new study published in the journal of Nature Scientific Reports revealed that among pediatric burn patients, worse long-term scar outcomes—measured by POSAS scores—were associated with younger age at injury, prolonged postoperative healing time, and burns located on the trunk or lower extremities.
Larger, deeper burns, injuries sustained at a younger age, burns in skin types with pigmentation, and a longer recovery period following an accident are all linked to worse scar results. These variables specifically enhance the risk of hypertrophic scarring. Although research on scar quality in children who have had burns has been conducted, there is a dearth of long-term results monitoring.
There is currently no clear international agreement about the best time to do surgery for children who have partial-thickness burns. It might be challenging to choose between debridement as soon as possible (before 72 hours) and debridement after the burn has completely healed (within 1-3 weeks). A crucial stage in this procedure is doing an accurate clinical examination to ascertain the extent of the burn. Therefore, this study examined how patients and therapy characteristics affected the quality of scars in pediatric burn patients one year following skin transplantation.
Age, skin type, and burn location with patient characteristics, surgical kind, timing, and recovery periods were therapy factors. The study included pediatric patients (less than 18 years old) who presented to a National Burn Unit between 2011 and 2020. Those who needed skin grafting as their primary burn treatment and had burn damage ranging from 1% to 14.9% total body surface area (TBSA) were included. Patients were not included if they did not show up for their follow-up appointment after 12 months. A modified version of the Patient and Observer Scar Assessment Scale, version 2.0 (POSAS), was used to evaluate standardized clinical photos.
There were thirty kids (median age: 3.9 years). Younger age at injury time (p < 0.001), body location of the trunk (p < 0.002), or lower extremities (p < 0.001), and a longer healing period following skin grafting were factors that independently contributed to higher (worse) POSAS ratings.
For POSAS scores, the interval between the injury and surgery was not an independent factor.
This research lacked the statistics necessary to distinguish between meshed and non-meshed graft types based on variations in scar quality.
Overall, in this study, researchers discovered that children who had burns at a younger age, had burns on the trunk or lower extremities, or had a longer recovery period following skin grafting had poorer long-term scar results.
Source:
Steinvall, I., Kennedy, S., Karlsson, M., Ellabban, M. A., Sjöberg, F., Andersson, C., Elmasry, M., & Abdelrahman, I. (2025). Evaluating scar outcomes in pediatric burn patients following skin grafting. Scientific Reports, 15(1), 20205. https://doi.org/10.1038/s41598-025-06378-y
