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Risk factors for hypertrophic burn scar pain, pruritus, and paresthesia development
Author(s) -
Xiao Yongqiang,
Sun Yu,
Zhu Banghui,
Wang Kangan,
Liang Pengfei,
Liu Wenjun,
Fu Jinfeng,
Zheng Shiqing,
Xiao Shichu,
Xia Zhaofan
Publication year - 2018
Publication title -
wound repair and regeneration
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.847
H-Index - 109
eISSN - 1524-475X
pISSN - 1067-1927
DOI - 10.1111/wrr.12637
Subject(s) - medicine , hypertrophic scar , scars , odds ratio , surgery , hypertrophic scars , muscle hypertrophy , confidence interval , anesthesia
Hypertrophic scar pain, pruritus, and paresthesia symptoms are major and particular concerns for burn patients. However, because no effective and satisfactory methods exist for their alleviation, the clinical treatment for these symptoms is generally considered unsatisfactory. Therefore, their risk factors should be identified and prevented during management. We reviewed the medical records of 129 postburn hypertrophy scar patients and divided them into two groups for each of three different symptoms based on the University of North Carolina “4P” Scar Scale: patients with scar pain requiring occasional or continuous pharmacological intervention (HSc pain, n = 75) vs. patients without such scar pain (No HSc pain, n = 54); patients with scar pruritus requiring occasional or continuous pharmacological intervention (HSc pruritus, n = 63) vs. patients without such scar pruritus (No HSc pruritus, n = 66); patients with scar paresthesia that influenced the patients’ daily activities (HSc paresthesia, n = 31) vs. patients without such scar paresthesia (No HSc paresthesia, n = 98). Three multivariable logistic regression models were built, respectively, to identify the risk factors for hypertrophic burn scar pain, pruritus, and paresthesia development. Multivariable analysis showed that hypertrophic burn scar pain development requiring pharmacological intervention was associated with old age (odds ratio [OR] = 1.046; 95% confidence interval [CI], 1.011–1.082, p = 0.009), high body mass index (OR = 1.242; 95%CI, 1.068–1.445, p = 0.005), 2–5‐mm‐thick postburn hypertrophic scars (OR = 3.997; 95%CI, 1.523–10.487, p = 0.005), and 6–12‐month postburn hypertrophic scars (OR = 4.686; 95%CI, 1.318–16.653, p = 0.017). Hypertrophic burn scar pruritus development requiring pharmacological intervention was associated with smoking (OR = 3.239; 95%CI, 1.380–7.603; p = 0.007), having undergone surgical operation (OR = 2.236; 95%CI, 1.001–4.998; p = 0.049), and firm scars (OR = 3.317; 95%CI, 1.237–8.894; p = 0.017). Finally, hypertrophic burn scar paresthesia development which affected the patients’ daily activities was associated with age (OR = 1.038; 95%CI, 1.002–1.075; p = 0.040), fire burns (OR = 0.041; 95%CI, 0.005–0.366; p = 0.004, other burns vs. flame burns), and banding and contracture scars (OR = 4.705; 95%CI, 1.281–17.288, p = 0.020).