Acute care strategies to reduce burn scarring

Abstract

Burn scars can have detrimental effects on survivors’ ability to resume their daily activities thereby impairing their quality of life. The medical advances in burn care have reduced mortality but increased morbidity since patients with larger total body surface area burns are now surviving. The combined reality of these phenomenon generates an imperative that all health care professionals across the continuum of burn care prioritized regenerative over fibrotic wound healing. The recent explosion of basic science wound healing research has advanced our understanding of the pathophysiology that culminates in the generation of two types of pathological scars, hypertrophic scar (HSc) or keloids. These findings provide opportunities to review and reiterate existing practices that augment wound healing but also to adopt novel interventions that have been experimentally substantiated. The purpose of this review is to summarize the basic science evidence that differentiates pathological scar formation from regenerative or non-pathological scar, then review the evidence-informed acute care conservative and surgical management which will optimize wound healing outcomes.