Epidemiology and Impact of Scarring After Burn Injury: A Systematic Review of the Literature
Epidemiology and Impact of Scarring After Burn Injury: A Systematic Review of the Literature
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DOI：
10.1097/bcr.0b013e3182374452
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发表时间：
2012-01-01
影响因子：
1.4
通讯作者：
Klein, Matthew B.
中科院分区：
文献类型：
--
作者：
Lawrence, John W.;Mason, Shawn T.;Klein, Matthew B.
本研究的目的是对现有文献中关于增生性瘢痕的发生率和烧伤瘢痕的社会心理影响进行系统回顾。在一项全面的文献综述中，作者确定了自1965年以来发表的48篇英文文章，这些文章报告了肥厚性瘢痕的发生率和风险因素或评估了与瘢痕相关的结局。大多数研究都有重要的方法局限性，限制了研究结果的普遍性。特别是，缺乏标准化的有效措施疤痕和其他结果变量是一个主要的障碍，以得出强有力的结论。在对增生性瘢痕的研究中，患病率在32%和72%之间变化。确定的风险因素包括皮肤黝黑、女性、年轻、颈部和上肢烧伤部位、多次手术、网状皮肤图、愈合时间和烧伤严重程度。关于心理社会结果，两项研究比较了儿童烧伤幸存者与非烧伤对照组的身体形象措施;两项研究均未发现组间差异。在所有研究中，烧伤的严重程度和位置与心理社会结果变量有适度的关系。社会心理变量，如社会舒适度和感知的污名化更高度相关的身体形象比烧伤的特点。为了提高我们对疤痕流行病学和疤痕负担的认识，未来的研究需要实施更严格的方法。特别是，应制定瘢痕形成和其他结局的标准化有效措施。烧伤中心之间的国际合作可以促进这一进程。（J Burn Care Res 2012;33：136-146）
The purpose of this study was to perform a systematic review of the existing literature on the incidence of hypertrophic scarring and the psychosocial impact of burn scars. In a comprehensive literature review, the authors identified 48 articles published since 1965 and written in English which reported the incidence and risk factors for hypertrophic scarring or assessed outcomes related to scarring. Most studies had important methodological limitations limiting the generalizability of the findings. In particular, the absence of standardized valid measures of scarring and other outcome variables was a major barrier to drawing strong conclusions. Among studies on hypertrophic scarring, the prevalence rate varied between 32 and 72%. Identified risk factors included dark skin, female gender, young age, burn site on neck and upper limb, multiple surgical procedures, meshed skin graph, time to healing, and burn severity. With regard to psychosocial outcomes, two studies compared pediatric burn survivors with a nonburn comparison group on a body image measure; neither study found differences between groups. Across studies, burn severity and location had a modest relationship with psychosocial outcome variables. Psychosocial variables such as social comfort and perceived stigmatization were more highly associated with body image than burn characteristics. To advance our knowledge of the epidemiology of scars and the burden of scars, future studies need to implement more rigorous methodologies. In particular, standardized valid measures of scarring and other outcomes should be developed. This process could be facilitated by an international collaboration among burn centers. (J Burn Care Res 2012;33:136-146)