Retrospective study of the association between hypertrophic burn scarring and bacterial colonization

Although the association between hypertrophic burn scarring and infection is well described, an association with colonization has not been established. This retrospective study sought to determine whether a significant association between hypertrophic scarring and bacterial colonization exists. Details from the case notes of all patients seen in our institution's burns unit over a two-year period were recorded and the incidence of hypertrophic scarring and burn bacterial colonization was noted. A total of 127 scars were recorded, and of these, 51 were hypertrophic and 76 nonhypertrophic. The incidence of bacterial colonization in the hypertrophic scar group was 88%, an association that achieved significance (P < .05) in comparison with nonhypertrophic scars (27%). This association holds true for individual organisms such as Staphylococcus aureus and Escherichia coli and for all burn depths and healing times. This study suggests that burn wound bacterial colonization may be more important than previously believed and perhaps suggests that striving toward an aseptic burn wound environment may reduce the incidence of hypertrophic scarring.