title: [Clinical study on the relationship among the dermis, fat dome and postburn hyperplastic scar formation].
abstract: OBJECTIVE
  To explore the influence of dermal defect and fat dome structure destruction in burn wounds on the formation of hyperplastic scar.
  
  
  METHODS
  Fifty two wounds in 24 burn patients with deep partial thickness burn indicating tangential excision in the extremities were enrolled in the study, and they were divided into three groups according to the extent of exposure of dermal fat granules, i.e. A (without fat exposure), B (with little fat exposure) and C (with much fat exposure) groups. These three groups were subdivided into A1 (without grafting), A2 (grafting with razor thin skin), B1 (without grafting), B2 (with razor thin skin grafting), C1 (without grafting) and C2 (with split-thickness skin grafting) groups, with 9 wounds in each group. The dermal depth and exposure rate of the fat granules in each group were measured and analyzed by KS400 photography analysis apparatus. The follow-up conditions of the scars 6 months after operation were evaluated with Vancouver remark system by Vancouver score assessment.
  
  
  RESULTS
  There was obvious difference in the dermal depth and exposure rate of the fat granules among all the groups (P < 0.05 or 0.01). The fat exposure rate was positively correlated with the extent of the dermal defect (gamma = 0.554, P < 0.05). The Vancouver score in group A was lower than that in B and C groups (P < 0.05), while that in B1 group (3.714 +/- 2.498) was evidently higher than that in other groups (P < 0.01). The scar score was lowered when the wounds were grafted with the dermis with its thickness similar to the depth of the defect, The scar score was increased along with the elevation of fat exposure rate (P < 0.05).
  
  
  CONCLUSIONS
  There was a positive correlation between the degree of dermal defect and that of hyperplastic scar after burns. The disruption of fat dome structure might also be an important factor in the scar development.
authors.affiliation: Department of Burns, The Fifth Hospital of Harbin, Harbin 150040, P.R. China.
authors.forename: Zong-yu
authors.initials: ZY
authors.lastname: Li
authors.forename: Hai-tao
authors.initials: HT
authors.lastname: Su
authors.forename: Shu-liang
authors.initials: SL
authors.lastname: Lu
authors.forename: Li-bin
authors.initials: LB
authors.lastname: Huang
authors.forename: Xin-bo
authors.initials: XB
authors.lastname: Yang
authors.forename: Tie-bin
authors.initials: TB
authors.lastname: Shao
authors.forename: Yi-shu
authors.initials: YS
authors.lastname: Li
authors.forename: Bin
authors.initials: B
authors.lastname: Qu
authors.forename: Cheng-gang
authors.initials: CG
authors.lastname: Wang
authors.forename: Xiu-ying
authors.initials: XY
authors.lastname: Zhang
authors.forename: Shao-feng
authors.initials: SF
authors.lastname: Yang
authors.forename: Jia-xin
authors.initials: JX
authors.lastname: Sun
authors.forename: Bing-zhou
authors.initials: BZ
authors.lastname: Xu
authors.forename: Man
authors.initials: M
authors.lastname: Sun
authors.forename: Jun
authors.initials: J
authors.lastname: Xiang
mesh_terms: D000273:Adipose Tissue / Q000473:pathology*; D000328:Adult; D002056:Burns / Q000150:complications / Q000473:pathology*; D017439:Cicatrix, Hypertrophic / Q000209:etiology / Q000473:pathology*; D020405:Dermis / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D014945:Wound Healing