• J Nicolaas Dijkshoorn, van BaarMargriet EMEAssociation of Dutch Burn Centres, Maasstad Hospital, Rotterdam, the Netherlands; Erasmus MC, University Medical Centre Rotterdam, Department of Public Health, Rotterdam, the Netherlands., Anouk Pijpe, Marianne Nieuwenhuis, Harold Goei, Cornelis H van der Vlies, and Inge Spronk.
• Burn Centre, Maasstad Hospital, Rotterdam, the Netherlands. Electronic address: dijkshoornj@maasstadziekenhuis.nl.
• Burns. 2024 Dec 1; 50 (9): 107203107203.

BackgroundBurn scar maturation can take several years but is generally studied shortly after injury. Therefore, we investigated patient-reported scar quality up to 5-7 years post-burn.MethodsPatients with ≤ 20 % total body surface area burned completed the Patient Scale of the Patient and Observer Scar Assessment Scale (POSAS 2.0) on the same scar at 3, > 18 months (median 28 months) and 5-7 years (median 63 months) post-burn.ResultsFifty-eight patients (21 children; 37 adults) with a median total body surface area burned (TBSA) of 6.3 % participated. Average patient-reported scar quality (POSAS score) was generally worst at 3 months (median score: 4.2), best at 28 months (median score: 2.2) and intermediate at 63 months post-burn (median score: 3.4) (p < 0.001). Many patients (66 %) reported a median 1.8 point higher (worse) POSAS score at 63 months compared to 28 months post-burn, whereas 14 % reported an identical, and 21 % a lower (better) score. At any assessment, largest differences with normal skin were reported for scar colour. Univariate predictive factors of long-term patient-reported scar quality were scar quality at 3 months (p = 0.002) and 28 months post-burn (p < 0.001), full-thickness burn size (p = 0.033), length of hospital stay (p = 0.003), and number of surgeries (p < 0.001).ConclusionTwo-thirds of patients with burns up to 20 % TBSA scored the quality of their scars worse at 63 months compared to 28 months post-burn. Whether this corresponds to increased dissatisfaction with scars in the long term should be further investigated. These new insights add to the body of knowledge on scar maturation and underscores the importance of discussing patients' expectations.Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.

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