Incidence of hypertrophic scarring in burn-injured children.

The occurrence of hypertrophic scarring in burn-injured children under the age of 5 years was studied by examining the records of patients admitted to the Wessex Regional Burns Unit in the years 1968 and 1984. In both years the pattern and nature of injury to the children was the same. The incidence of scar hypertrophy was at least 50 per cent in both years. The occurrence of hypertrophic scarring in these 2 years did not appear to have been influenced by changes in clinical practice.

Serum protein changes after abdominal surgery.

Changes in the concentrations of 11 serum proteins following surgery for a variety of conditions have been investigated. Protein changes were analogous to those observed after injury or trauma, but showed differences in the detailed behaviour of the pattern of change. Marked increases in the concentrations of five acute-phase reactant proteins (APRP) were seen, with maximum concentrations usually being reached 2 days after surgery in patients who made an uncomplicated recovery from their operations. Considerable differences were observed between the patterns of change of APRP in patients who developed complications during recovery and in patients who made an uncomplicated recovery from surgery. Concentrations of C-reactive protein and alpha-1 antichymotrypsin (ACT) were much higher in the patients who developed complications, with ACT concentrations providing the clearest separation between the groups. The main factor influencing the changes in APRP during the recovery period appeared to be the development of sepsis. Preoperative concentrations of APRP had no prognostic value for identifying patients at risk of developing complications. The study suggests that the localisation of inflamed tissue involved in the disease processes may influence the detailed behaviour of the acute-phase reactant proteins.