Evaluating scar outcomes in pediatric burn patients following skin grafting 

1. In this cohort of pediatric burn patients, poorer long-term scar outcomes, as indicated by Patient and Observer Scar Assessment Scale (POSAS) scores, were associated with younger age at injury, longer postoperative healing time, and burns located on the trunk or lower extremity. 

Evidence Rating Level: 2 (Good) 

Poor scar outcomes in the pediatric population are linked to larger, deeper burns, pigmented skin types, younger age, and prolonged healing times. However, long-term data on scar quality in children remain limited. There continues to be debate around the timing of surgical debridement for partial thickness burns in pediatric patients, as delayed healing may worsen scarring, though evidence is inconsistent. Assessing burn depth with accuracy is challenging, and while techniques such as laser Doppler imaging (LDI) show promise, clinical judgement remains the most common method. One way to improve accuracy and consistency is by using the Patient and Observer Scar Assessment Scale (POSAS). This study aimed to assess how patient and treatment factors affect long-term scar healing quality in pediatric burn patients, using the POSAS. A total of 30 children (median [SD] age, 3.9 years [1.5-11.6]) were included in the analysis. Younger age was significantly associated with higher POSAS scores, and with each year younger, the mean increase in score was 0.7 points (95% CI 1.0-0.3). Similarly, for each day longer of postoperative healing, the POSAS score increased by a mean of 0.2 points (95% CI 0.1-0.3). Skin grafting on the trunk and lower extremities was also significantly associated with a mean increase in POSAS scores of 7.8 points (95% CI 3.1-12.4) and 11.2 points (95% CI 6.6-15.8), respectively. Whereas the duration of time between injury and surgery was not significantly associated with worse outcomes. Overall, younger age at injury, graft location on the trunk or lower extremity, and increased healing duration were associated with higher POSAS scores.

Click to read the study in Nature

Image: PD

©2025 2 Minute Medicine, Inc. All rights reserved. No works may be reproduced without expressed written consent from 2 Minute Medicine, Inc. Inquire about licensing here. No article should be construed as medical advice and is not intended as such by the authors or by 2 Minute Medicine, Inc.