Chronic Pain and Itch are Common, Morbid Sequelae Among Individuals Who Receive Tissue Autograft After Major Thermal Burn Injury.
Pain and itch symptoms are common after major thermal burn injury (MThBI)-requiring tissue autografting. To our knowledge, no prospective longitudinal studies have characterized pain and itch outcomes after tissue autografting and associations between and functional interference caused by such symptoms.



We prospectively evaluated burn graft site and tissue donor site pain and itch severity (0 to 10, numeric rating scale) over 1 year among a representative cohort of MThBI survivors (n=96) who received tissue autografting within 14 days of MThBI.



Nearly all participants had moderate or severe burn pain at the time of enrollment. Most individuals experienced an upper extremity burn with donor tissue taken from thigh. Persistent moderate or severe burn graft site pain declined thereafter, but remained common, with 25/90 (28%), 24/77 (31%), and 17/82 (21%) experiencing moderate or severe pain at 6 weeks, 3 months, and 6 months, respectively. Although there was improved function after immediate postinjury decline in all participants, those who had moderate or severe pain showed worse functional outcomes at each timepoint. Significant correlations were present between itch and pain burden over time at the same site (ie, autograft site r=0.629, P<0.01) and also across sites (ie, autograft and donor site itch r=0.552, P<0.01).



Pain and itch are common after MThBI, are temporally and spatially concordant and cause significant impact on daily function. Further studies are needed to better understand pain and itch symptom pathogenesis after MThBI, to reduce the tremendous suffering and decline.
*TRYUMPH Research Program Departments of †Anesthesiology #Emergency Medicine ‡Jaycee Burn Center, University of North Carolina, Chapel Hill, NC §The Burn Center, MedStar Washington Hospital Center, Washington, DC ∥Department of Surgery, University of South Florida, Tampa, FL ¶Department of Health Care Policy, Harvard Medical School, Boston, MA.
Matthew C
MC
Mauck
Jennifer
J
Smith
Andrea Y
AY
Liu
Samuel W
SW
Jones
Jeffrey W
JW
Shupp
Marie A
MA
Villard
Felicia
F
Williams
James
J
Hwang
Rachel
R
Karlnoski
David J
DJ
Smith
Bruce A
BA
Cairns
Ronald C
RC
Kessler
Samuel A
SA
McLean
D000293:Adolescent; D000328:Adult; D002056:Burns / Q000150:complications* / Q000601:surgery*; D059350:Chronic Pain / Q000209:etiology* / Q000628:therapy; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010147:Pain Measurement; D011183:Postoperative Complications / Q000209:etiology*; D011537:Pruritus / Q000209:etiology* / Q000628:therapy; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013223:Statistics as Topic; D013997:Time Factors; D014182:Transplantation, Autologous / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult