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Assessment of Pruritus Characteristics and Impact on Burn Survivors

Parnell, Laura K.S. BSc, MSc, CWS; Nedelec, Bernadette BSc, OT, PhD; Rachelska, Grazyna MSc; LaSalle, Léo MD

Journal of Burn Care & Research: May/June 2012 - Volume 33 - Issue 3 - p 407–418
doi: 10.1097/BCR.0b013e318239d206
Original Articles

The goal of this cross-sectional study was to characterize and describe persistent postburn pruritus. Cause and treatment of postburn itch is elusive. It has been suggested that burn survivors with persistent pruritus should be divided into acute itch (≤6 months postinjury) and chronic itch (>6 months postinjury) because the cause of itch may be different. Cross-sectional data of itch characteristics reported here are from the baseline data of a prospective, randomized, double-blind, controlled pilot study of 23 subjects with frequent and bothersome postburn pruritus. Subjects self-completed validated scales for variables of itch sensation, affect of itch, and severity. Variables of quality of life, frequency, pain and itch intensity, skin condition, scar, and medication were also recorded. Itch frequency revealed that 87% of subjects experienced itching daily, 96% experienced three or more episodes a day, and 52% had episode durations lasting 5 to 30 minutes per incidence. Itch was reported as unbearable by 94% of subjects with chronic itch and by 86% of subjects with acute itch, whereas bothersome was 88 and 100%, respectively. Itch sensation dimension of stinging was 74% in both acute and chronic itch subjects. Crawling and burning sensations were often severe. Potential itch triggers and relief activities were identified. Differences in sensory and affective itch components were detected between acute and chronic itch subjects. Combinations of itch mechanisms probably contribute to the development of and changes in pruritus. Characterizing the sensation and affective itch dimensions in conjunction with inflammation, burn injury, recovery, scar maturation, medication, and psychological status should better elucidate postburn itch.

*Precision Consulting, Missouri City, Texas

School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada

Centre de recherche, Centre hospitalier de l’Université de Montréal (CRCHUM), Montreal, Quebec, Canada

§Hôpital de réadaptation Villa Medica, Montreal, Quebec, Canada

Supported by Swiss-American Products, Inc., and performed at Villa Medica Rehabilitation Hospital. A salary grant from Fonds de la recherche en santé du Québec was provided for one of the authors (B.N.). Another author (L.K.S.P.) is an independent scientific consultant for Swiss-American Products, Inc.

Address correspondence to Bernadette Nedelec, PhD, McGill University, Faculty of Medicine, 3654 Promenade Sir William Osler, Montréal, Québec, Canada H3G 1Y5.

© 2012 The American Burn Association