Dr Harriet Semple1, Akane Katsu1, Dr Aruna Wijewardana1, Dr Robert Gates1, Dr John Vandervord1
1Royal North Shore Hospital, St Leonards, Australia
Intra-lesional steroid injection is a widely accepted treatment for hypertrophic scarring secondary to burns and is often used in refractory cases where non-invasive methods have already failed. However, despite decades of use in multiple centres, the literature is surprisingly scant when it comes to high level trials on the use of steroid injections in burns hypertrophic scars specifically, or when these are most effective in relation to scar maturation. At the Royal North Shore Hospital Burns Unit, doctors are injecting hypertrophic burns scars with triamcinolone acetonide 10mg/ml to 40mg /ml between 6 and 18 months post injury. However, even within this unit consensus has not been reached on the most appropriate time to commence intra-lesional steroid therapy. In this presentation we intend to detail the current protocol used at RNSH Burns Unit for the management of burns scars in general, and particularly the determinants for the use of intra-lesional steroid injections for hypertrophic scars such as patient suitability, pre-treatment scar evaluation and timing of injections in relation to scar maturation. This will be compared with the available literature to evaluate where further studies are necessary to provide an evidence based guide on the most effective use of intra-lesional steroid therapy when treating hypertrophic burns scars.
Harriet is a resident at RNSH with a keen interest in burns surgery.