title: Hypertrophic scarring: the greatest unmet challenge after burn injury.
abstract: Improvements in acute burn care have enabled patients to survive massive burns that would have once been fatal. Now up to 70% of patients develop hypertrophic scars after burns. The functional and psychosocial sequelae remain a major rehabilitative challenge, decreasing quality of life and delaying reintegration into society. Approaches to optimise healing potential of burn wounds use targeted wound care and surgery to minimise the development of hypertrophic scarring. Such approaches often fail, and modulation of the established scar is continued although the optimal indication, timing, and combination of therapies have yet to be established. The need for novel treatments is paramount, and future efforts to improve outcomes and quality of life should include optimisation of wound healing to attenuate or prevent hypertrophic scarring, well-designed trials to confirm treatment efficacy, and further elucidation of molecular mechanisms to allow development of new preventive and therapeutic strategies.
authors.affiliation: Department of Surgery, The University of Texas Medical Branch, Galveston, TX, USA; The Institute for Translational Sciences, The University of Texas Medical Branch, Galveston, TX, USA; the Sealy Center for Molecular Medicine, The University of Texas Medical Branch, Galveston, TX, USA; Shriners Hospitals for Children, Galveston, TX, USA. Electronic address: ccfinner@utmb.edu.
authors.forename: Celeste C
authors.initials: CC
authors.lastname: Finnerty
authors.affiliation: Sunnybrook Research Institute, Toronto, ON, Canada; Division of Plastic Surgery Department of Surgery and Immunology, University of Toronto, ON, Canada; Ross Tilley Burn Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
authors.forename: Marc G
authors.initials: MG
authors.lastname: Jeschke
authors.affiliation: Department of Surgery, The University of Texas Medical Branch, Galveston, TX, USA; Shriners Hospitals for Children, Galveston, TX, USA.
authors.forename: Ludwik K
authors.initials: LK
authors.lastname: Branski
authors.affiliation: Department of Plastic Surgery and Burns, University Hospital Vall d'Hebron, Barcelona, Spain.
authors.forename: Juan P
authors.initials: JP
authors.lastname: Barret
authors.affiliation: St Andrew's Centre for Burns and Plastic Surgery, Broomfield Hospital, Chelmsford, UK; StAAR Research Unit, Faculty of Medical Sciences, Anglia Ruskin University, Chelmsford, UK.
authors.forename: Peter
authors.initials: P
authors.lastname: Dziewulski
authors.affiliation: Department of Surgery, The University of Texas Medical Branch, Galveston, TX, USA; The Institute for Translational Sciences, The University of Texas Medical Branch, Galveston, TX, USA; Shriners Hospitals for Children, Galveston, TX, USA.
authors.forename: David N
authors.initials: DN
authors.lastname: Herndon
mesh_terms: D000279:Administration, Cutaneous; D000818:Animals; D002056:Burns / Q000150:complications* / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology*; D017439:Cicatrix, Hypertrophic / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*; D058128:Compression Bandages; D003879:Dermatologic Agents / Q000008:administration & dosage*; D004195:Disease Models, Animal; D006801:Humans; D053685:Laser Therapy; D017060:Patient Satisfaction; D010789:Phototherapy; D011537:Pruritus / Q000209:etiology; D011788:Quality of Life; D016038:Skin Transplantation / Q000379:methods / Q000639:trends; D013526:Surgical Mesh / Q000706:statistics & numerical data; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D064232:Visual Analog Scale; D014945:Wound Healing
chemical_list: D003879:Dermatologic Agents