23 Wound Characteristics and Other Predictive Factors of Hypertrophic Scarring in Pediatric Burns
Notice bibliographique
Résumé
Abstract Introduction Though generally accepted, it is not a definitive rule that burn injuries under 10% TBSA that heal in less than 21 days will have no scarring. The aim of this study was to assess what factors impact the likelihood of a child developing hypertrophic scarring secondary to a burn injury healed under 21 days compared to those who healed over 21 days. Methods A retrospective study of 2,016 pediatric patients with burn injuries under 10% TBSA from a five-year period at a single burn center’s outpatient clinic was conducted. Descriptive statistics, Chi-square analysis, and logistic regression were used to describe the patients, compare those who developed scars to those who did not, and identify which factors increased a patient’s odds of developing hypertrophic scarring. A scar was considered present if the patient’s chart included a Modified Vancouver Scar Scale score or if medical notes or photography indicated a raised scar. Results Of the patients reviewed, 1,667 patients healed under 21 days, 349 healed over 21 days, and 13.5% of all patients developed hypertrophic scarring. There were three factors that significantly predicted higher odds of developing hypertrophic scarring in both populations: deeper wounds (OR = 13.324, p < 0.001; OR = 0.344, p = 0.018), increased time to healing (OR = 11.819, p < 0.001; OR = 0.254, p < 0.001), and higher %TBSA (OR = 1.497, p < 0.001; OR = 0.860, p = 0.039). This research indicated that children with Fitzpatrick skin type 6 whose wounds healed in over 21 days were less likely to develop hypertrophic scars than patients with lighter skin tones (OR = 5.426; p = 0.010). In the under 21 days group, being born female significantly increased the odds of hypertrophic scarring (OR = 1.934; p = 0.014). Additionally in this group, injuries on any part of the upper extremity, anterior trunk, thighs, head or face were significantly less likely to develop hypertrophic scarring than injuries on the palmar hand. Conclusions The results of this study are consistent with previous findings that larger and deeper wounds taking longer to heal are more likely to develop hypertrophic scarring. Contrary to previous research, patients with Fitzpatrick skin type 6 had lower odds of developing hypertrophic scarring. This result should be interpreted with caution as only 4.86% of all patients were Fitzpatrick skin type 6. The model accurately predicted scarring in the over 21-days group 64.8% of the time. However, within the under 21-days group, the model was only able to accurately predict development of hypertrophic scarring 5.5% of the time. Applicability of Research to Practice The ability to identify children who are at risk for development of hypertrophic scarring allows practitioners to provide interventions sooner to help decrease the sequelae from troublesome scars. Funding for the Study N/A
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,004 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».