title: Epidemiology and risk factors for pathologic scarring after burn wounds.
abstract: OBJECTIVE
  To describe the clinical characteristics of postburn scars and determine the independent risk factors specific to these patients. While burns may generate widespread and disfiguring scars and have a dramatic influence on patient quality of life, the prevalence of postburn pathologic scarring is not well documented, and the impact of certain risk factors is poorly understood.
  
  
  METHODS
  A retrospective analysis was conducted of the clinical records of 703 patients (2440 anatomic burn sites) treated at the Turin Burn Outpatient Clinic between January 1994 and May 15, 2006. Prevalence and evolution time of postburn pathologic scarring were analyzed with univariate and multivariate risk factor analysis by sex, age, burn surface and full-thickness area, cause of the burn, wound healing time, type of burn treatment, number of surgical procedures, type of surgery, type of skin graft, and excision and graft timing.
  
  
  RESULTS
  Pathologic scarring was diagnosed in 540 patients (77%): 310 had hypertrophic scars (44%); 34, contractures (5%); and 196, hypertrophic-contracted scars (28%). The hypertrophic induction was assessed at a median of 23 days after reepithelialization and lasted 15 months (median). A nomogram, based on the multivariate regression model, showed that female sex, young age, burn sites on the neck and/or upper limbs, multiple surgical procedures, and meshed skin grafts were independent risk factors for postburn pathologic scarring (Dxy 0.30).
  
  
  CONCLUSIONS
  The identification of the principal risk factors for postburn pathologic scarring not only would be a valuable aid in early risk stratification but also might help in assessing outcomes adjusted for patient risk.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Burn Center, Traumatological Center, Via Zuretti 29, 10126 Turin, Italy. ezio.nicola@tele2.it
authors.forename: Ezio Nicola
authors.initials: EN
authors.lastname: Gangemi
authors.forename: Dario
authors.initials: D
authors.lastname: Gregori
authors.forename: Paola
authors.initials: P
authors.lastname: Berchialla
authors.forename: Enrico
authors.initials: E
authors.lastname: Zingarelli
authors.forename: Monica
authors.initials: M
authors.lastname: Cairo
authors.forename: Daniele
authors.initials: D
authors.lastname: Bollero
authors.forename: Jamal
authors.initials: J
authors.lastname: Ganem
authors.forename: Roberto
authors.initials: R
authors.lastname: Capocelli
authors.forename: Franca
authors.initials: F
authors.lastname: Cuccuru
authors.forename: Pompeo
authors.initials: P
authors.lastname: Cassano
authors.forename: Daniela
authors.initials: D
authors.lastname: Risso
authors.forename: Maurizio
authors.initials: M
authors.lastname: Stella
mesh_terms: D000293:Adolescent; D000328:Adult; D002056:Burns / Q000150:complications* / Q000473:pathology / Q000601:surgery; D002921:Cicatrix / Q000209:etiology* / Q000473:pathology; D017439:Cicatrix, Hypertrophic / Q000209:etiology / Q000473:pathology; D003286:Contracture / Q000209:etiology / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012885:Skinfold Thickness; D014945:Wound Healing