Two-year follow-up of outcomes related to scarring and distress in children with severe burns.
Paul Wurzer, Abigail A Forbes, Gabriel Hundeshagen and 8 others
PMID 27685196WHAT IT FOUND
Severely burned children saw pain, itch, and mobility improve over two years, but distress about facial scarring and foot function persisted in nearly half.
Girls reported more pain and sleep problems than boys. Body image concerns remained high throughout the study period.
Key findings
01Pain, itching, and sleep disturbances decreased significantly, while strength and range of motion improved from discharge to 24 months.
02Distress related to mouth scarring and facial expression did not improve over the two-year period, affecting approximately one-third of patients.
03Female patients reported significantly higher pain levels and more sleep disturbances than males, and were more likely to use clothing or wigs to hide scars.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
In young children, questionnaire responses may reflect the parents' perception rather than the child's own experience. The study did not separately analyze the subgroup of patients with massive burns covering more than 70% of their body surface area. There was no healthy control group for comparison, so it is unclear if the 2-year outcomes represent age-predicted baselines. The questionnaires did not specify the body part causing itch, limiting the ability to link pruritus to specific burn locations.
Declared interests
The study was part of a larger multi-institutional project sponsored by the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR). The authors report no conflicts of interest.
The easy way to misread this
Do not assume that all burn-related distress resolves with time. While general pain and mobility improve, mouth scarring, facial expression, and foot function distress often persist, requiring targeted long-term rehabilitation rather than watchful waiting.