However, if all other parameters are negated, extensive burns are associated with poorer scarring outcomes than small burns of the same depth caused by the same agent. It could be surmised that the differences in the environment of the burn injury might result in additional injuries (such as smoke inhalation ), which will affect treatment course and even survival. This is despite the skin being damaged to the same depth in both scenarios. However, even when comparing the scarring outcome from an identical aetiology, such as flame burns, the skin injury sustained in a house fire and affecting a high proportion of the total body surface area often generates significantly poorer outcomes than flame injuries from, for example, localised clothing ignition from being too close to a naked flame. Such insult is often associated with major limb amputations, which markedly diminish outcome, and this might be expected. One example is the injuries caused by high-voltage-driven electrical current conduction. The outcome picture is complicated somewhat because certain burn aetiologies are destined to proffer poorer outcomes. Poor outcomes do occur however these almost exclusively follow the deepest and most extensive burn injuries. ![]() In reality, the majority of the outcomes that we achieve as burn surgeons are both functionally and aesthetically excellent. Scarring in the aftermath of burn injury is generally perceived (at least by the media and the general public) to be universally both horribly disfiguring and permanently disabling.
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