Management of Hypertrophic Scars in Pediatric Burn Patients

Hypertrophic scarring is still a challenging outcome after a burn, particularly in children. Even within the pediatric population, healing and scar physiology have certain peculiarities. Factors such as the inflammatory response, characteristics of extracellular components, and the environment surrounding the injured tissue are essential to understand the scarring discrepancies between these patient populations. There are several different surgical and nonsurgical approaches available for the management of hypertrophic scars postburn. Optimal management of the initial wound environment decreases mortality and will lessen the burden of hypertrophic scarring as the wound heals and as the patient ages. The current approach is to reduce pathological scar formation with early acute surgical intervention and various nonsurgical modalities, in combination with scar revision. It is crucial to monitor and follow up children with excessive scars during their growth period. This chapter reviews distinctive aspects of hypertrophic scars that make their management so challenging and discusses techniques to improve long-term clinical outcomes.