Chipp Elizabeth, Charles Lisa, Thomas Clare, Whiting Kate, Moiemen Naiem, Wilson Yvonne
Burns Centre, Birmingham Children's Hospital, Steelhouse Lane, Birmingham, UK.
Burns Trauma. 2017 Jan 19;5:3. doi: 10.1186/s41038-016-0068-2. eCollection 2017.
It is commonly accepted that burns taking longer than 3 weeks to heal have a much higher rate of hypertrophic scarring than those which heal more quickly. However, some of our patients develop hypertrophic scars despite healing within this 3-week period.
We performed a prospective study of 383 paediatric burns treated non-operatively at a regional burns centre over a 2-year period from May 2011 to April 2013. Scar assessment was performed by a senior burns therapist using the Vancouver Scar Scale.
Overall rates of hypertrophic scarring were 17.2%. Time to healing was the strongest predictor of developing hypertrophic scarring, and the earliest hypertrophic scar developed in a patient who was healed after 8 days. The risk of hypertrophic scarring was multiplied by 1.138 for every additional day taken for the burn wound to heal. There was a trend towards higher rates of hypertrophic scarring in non-white skin types but this did not reach statistical significance.
The risk of hypertrophic scarring increases with every day and, therefore, every effort should be made to get the wound healed as quickly as possible, even within the traditional 3-week period usually allowed for healing. We believe that the traditional dogma of aiming for healing within 3 weeks is overly simplistic and should be abandoned: in paediatric burns, every day counts.
Not applicable.
人们普遍认为，愈合时间超过3周的烧伤产生肥厚性瘢痕的几率远高于愈合较快的烧伤。然而，我们的一些患者尽管在这3周内愈合，仍出现了肥厚性瘢痕。
我们对2011年5月至2013年4月在一个地区烧伤中心接受非手术治疗的383例小儿烧伤患者进行了一项前瞻性研究。瘢痕评估由一位资深烧伤治疗师使用温哥华瘢痕量表进行。
肥厚性瘢痕的总体发生率为17.2%。愈合时间是发生肥厚性瘢痕的最强预测因素，最早的肥厚性瘢痕出现在一名8天后愈合的患者身上。烧伤创面每多愈合一天，发生肥厚性瘢痕的风险就会乘以1.138。非白色皮肤类型的肥厚性瘢痕发生率有升高趋势，但未达到统计学意义。
肥厚性瘢痕的风险与日俱增，因此，应尽一切努力使伤口尽快愈合，即使在通常允许的传统3周愈合期内。我们认为，以3周内愈合为目标的传统教条过于简单，应该摒弃：在小儿烧伤中，每一天都很重要。
不适用。
