Article

PURPOSE: We assessed the perception of scarring and distress by pediatric burn
survivors with burns covering more than one-third of total body surface area
(TBSA) for up to 2 years post-burn. METHODS: Children with severe burns were
admitted to our hospital between 2004 and 2012, and consented to this
IRB-approved-study. Subjects completed at least one Scars Problems and/or
Distress questionnaire between discharge and 24 months post burn. Outcomes were
modeled with generalized estimating equations or using mixed linear models.
Significance was accepted at p < 0.01. RESULTS: Responses of 167 children with a
mean age of 7 +/- 5 years and burns covering an average 54 +/- 14% of TBSA were
analyzed. Significant improvements over the 2-year period were seen in reduction
of pain, itching, sleeping disturbance, tightness, range of motion, and strength
(p < 0.01). There was a significantly increased persistent desire to hide the
scarred body areas over time (p < 0.01). The perception of mouth scarring,
inability to portray accurate facial expressions, and skin coloration did not
improve over the follow-up period. CONCLUSIONS: According to self-assessment
questionnaires, severely burned children exhibit significant improvements in
their overall perception of scarring and distress. However, these patients remain
self-conscious with respect to their body image even 2 years after burn injury.
Implications for Rehabilitation According to self-assessment questionnaires,
severely burned children perceive significant improvements in scarring and
distress during the first 2 years post burn. Significant improvements were seen
in reduction of pain, itching, sleeping disturbances, tightness, range of motion,
and strength (p < 0.01). Burn care providers should improve the treatment of
burns surrounding the mouth that with result in scarring, and develop strategies
to prevent skin discoloration. Careful evaluation of pain and sleeping disorders
during the first year post burn are warranted to improve the patient
rehabilitation. Overall, significantly more female patients expressed a
persistent desire to hide their scarred body areas.
The rehabilitation team
should provide access to wigs or other aids to pediatric burn survivors to
address these needs.

Langue : ANGLAIS