Deitch E A, Wheelahan T M, Rose M P, Clothier J, Cotter J
J Trauma. 1983 Oct;23(10):895-8.
A major problem in patients surviving thermal injury is the development of hypertrophic burn scars. The current study was performed to determine the factors associated with an increased risk of the development of hypertrophic burn scars. Fifty-nine children (mean age, 3 years; mean TBSA, 14%) and 41 adults (mean age, 37; mean TBSA, 21%) followed from 9 to 18 months formed the study group. The location as well as time required for the burns to heal were recorded in addition to the age and race of the patients. Sixty-three (26%) of the 245 burn areas, in these 100 patients, became hypertrophic. No correlation between patient age and the development of wound problems was found. Blacks had more wound problems than others, if the burn wound took longer than 10 to 14 days to heal. The most important indicator of whether wound problems would occur, in our series, was the time required for the burn to heal. If the burn wound healed between 14 and 21 days then one third of the anatomic sites became hypertrophic; if the burn wound healed after 21 days then 78% of the burn sites developed hypertrophic scars. Based upon these results we have developed a selective, individualized protocol for the use of prophylactic pressure therapy in patients with spontaneously healing burn wounds.
热损伤存活患者的一个主要问题是增生性烧伤瘢痕的形成。本研究旨在确定与增生性烧伤瘢痕形成风险增加相关的因素。9至18个月随访的59名儿童（平均年龄3岁；平均烧伤总面积14%）和41名成人（平均年龄37岁；平均烧伤总面积21%）组成了研究组。除患者的年龄和种族外，还记录了烧伤的部位以及愈合所需的时间。在这100名患者的245个烧伤区域中，有63个（26%）形成了增生性瘢痕。未发现患者年龄与伤口问题的发生之间存在相关性。如果烧伤伤口愈合时间超过10至14天，黑人比其他人有更多的伤口问题。在我们的研究系列中，伤口问题是否会发生的最重要指标是烧伤愈合所需的时间。如果烧伤伤口在14至21天之间愈合，那么三分之一的解剖部位会形成增生性瘢痕；如果烧伤伤口在21天后愈合，那么78%的烧伤部位会形成增生性瘢痕。基于这些结果，我们制定了一个选择性的、个性化的方案，用于对烧伤伤口自然愈合的患者使用预防性压力疗法。
