Prevalence and Predictive Factors of Pathological Scars Post Burn Injuries: A Single-Center, Retrospective Study

Pathological scars represent a frequent entity of burns sequelae that affect the aesthetic, functional and psychological status of patients. This study aims to assess the prevalence of pathological scars following burn injuries in the central-eastern and central-western regions of Tunisia and to replicate the factors that affect scar outcome. A retrospective, monocentric study was conducted among 259 subjects. Factors influencing scar outcomes, such as patient demographics and comorbid conditions, were systematically explored alongside injury characteristics and clinical variables. A logistic regression model was performed for factors significantly associated with the development of pathological scars. In our series, the prevalence of pathological scars was recorded at 45.2%, with hypertrophic scars being the most common type. This study identified injury and clinical predictors of hypertrophic scarring after controlling for confounding variables: feminine gender, young age, 3rd degree burns, anatomical location of the burn in the neck, the thorax or the lower limb, skin graft and multiple surgical procedures. As for keloid scars, the predictive factors were: TBSA and location of the burn in the neck. Ulcerated scars post burn are significantly associated with the development of a retractile band and burns located on the lower limb. This study indicates that these scars affect a substantial proportion of burn survivors, taking into account the Tunisian healthcare system and patient demographics. The reported statistics provide practical benefits for clinical-decision making.