What should I do if I develop severe scarring early after a burn injury?

  Today, an “old patient” who was treated 12 years ago visited the hospital and could not help but feel a lot of emotion …… impression that his injury area was more than 90%, and most of them were deep burns. After about 3 months of rescue and treatment, he was successfully discharged from the hospital …… At that time, there were “hypertrophic” scar growths all over the body, but most of them did not affect the function. The patient was instructed to adopt anti-scarring measures such as elastic compression, while strengthening functional exercises; remember that about six months after the injury, the patient once returned to the hospital for a follow-up visit, and at that time, there was still no obvious functional impairment in various parts, but the scar growth on the extremities and face was serious …… and mostly “purple-red” and “hypertrophic” scars. …… In that case, there was no indication for surgical treatment (the patient had a large deep burn, and the skin donor area was very limited). This separation is more than ten years …… if not this “old friend” initiative to identify, but already can not recognize …… on the one hand is more than ten years, itself have occurred a lot of On the other hand, the impressive “thick proliferative scarring almost all over the body” has mostly disappeared …… Most of the once severely damaged skin is already very soft, elastic and nearly normal in color. Of course, look carefully, in some parts, there are still some residual traces of scar …… each other emotionally, ask about the experience over the years, it is said that nearly two years or so after the injury, the scar that has significantly faded. At the same time, there are some regrets: …… because the function of both hands is important, so in compliance with medical advice to strengthen functional exercise at the same time, adhere to wear elastic sleeve compression for a longer period of time; double lower limbs when walking on the ground, in order to reduce the swelling and pain and other discomfort, elastic compression time is also adhere to a longer period of time; double forearms, upper arms, feel too much trouble, in the above anti-scarring measures, not very active. In the end, anyone who insisted on longer time recovered very well; upper arm and forearm, relatively speaking, had some relatively obvious scar residue (though mostly atrophic scar) …… At first, if the upper limbs also insisted on the same measures, the effect was thought to be much better.  In fact, this situation is not uncommon in patients with deep burns …… In the early post-injury scar proliferation period, some have very severe proliferative scars, some almost 1cm thick or more; but after the scar stabilization period, in the 2~3 years post-injury follow-up, some of the scars nearly “miraculously ” disappeared! …… Before that, anti-scarring measures such as elastic compression, are still quite beneficial!  Of course, if there is a “non-recoverable”, “progressive” scar-induced dysfunction, or a “potentially developmental” scar deformity, in most cases, it is likely to require surgical assistance and correction.  However, for the layman, for the patient, it is difficult to see the “distant ray of light” at this stage of the dilemma: “…… Whether compressed or not, whether measures are taken or not, the scar is still progressively The scar is getting heavier”.  The extent and speed of “self-relaxation” of the scar may be reduced after the subsequent scar stabilization period, if the seemingly “trivial but tedious” anti-scar measures such as elastic compression are taken consistently. Similarly, after the subsequent scar stabilization period, the degree and speed of “self-reduction” of the scar may be significantly improved!  On the other hand, for those of you who are troubled with severe scar growth early after deep burn healing, don’t be discouraged …… this is not the end result! It is possible that scarring will gradually worsen over time …… but, with the right measures, it is possible that those unacceptable scars will show substantial improvement by 2 to 3 years post-injury, as long as they do not interfere with function or development! …… Stay the course! The “ray of light”, although seemingly distant, will eventually come!