Medical therapy of burn scar before any plastic surgery by using topical corticosteroid combined with oral zinc sulfate

INTRODUCTION: Burn scar is one of the commonest medical problems that need intervention as initially treat burn infection, then preventing the scar, followed by treatment of scar.Plastic surgery interference should be considered as a last resort.
METHODS: This is case series descriptive and therapeutic interventional study where a total of 170 patients with burn scar were managed and evaluated. Their ages ranged from 1-40 years with a mean 25 year, 120(70.58%) males and 50(29.41% ) females. All had history of burn and the age of scar was ranged from 0.5-3years. All cases were treated with topical diluted clobetasol ointment combined with oral zinc sulfate with duration of 2-4 months. Scoring system of reduction of burn scar was introduced and applied and three parameters of response were considered: scar size reduction, improvement of itching and pigmentation whether hyper or hypopigmentation. The reduction in scoring was estimated as mild, moderate and marked reduction.
RESULTS: The results of this study showed 50% reduction rate while scoring system demonstrated statistically significant reduction with p value ≤ 0.001 at two months of therapy. While at four months, there was 75% reduction rate and with highly statistically significant reduction of scoring system p value ≤ 0.0001.The reduction of scar scoring was mild in 20% of cases and moderate in 30% while marked in 50% of patients at the end of four months of therapy
DISCUSSION AND CONCLUSION: Medical therapeutic intervention should be started as early as possible to minimize scar formation, to reduce the scar size and treat pigmentary problems.This therapeutic trial will minimize plastic surgery need. Also newly invented scoring system was introduced to evaluate the response to treatment.