Persistent burn scar pain is common after blast and drone-related injuries and may be driven by scar fibrosis, vascular activity, and peripheral nerve involvement within scar tissue. This prospective cohort study aims to determine whether early ultrasound features of scars and nerves predict persistent clinically significant scar pain at 3 and 6 months. Ultrasound measures include scar thickness, echogenicity, Power Doppler vascularity, dynamic adhesion (gliding) assessment, and ultrasound signs of nerve involvement ("US-nerve positive"). Clinical outcomes include pain intensity (NRS), neuropathic pain screening (DN4), and functional interference.
Age ≥18 years
Burn injury with clinically formed scar
Enrollment 2-12 weeks after injury
Scar located on extremities, chest wall, or neck
Severe cognitive impairment preventing valid questionnaires
Hemodynamic instability or inability to complete baseline evaluation
Active systemic infection (enrollment deferred until stable)
Pre-existing chronic pain condition unrelated to burn scar that would confound outcomes (investigator judgment)
The study population will consist of adult patients (≥18 years) with clinically formed burn scars following blast-related, drone-related, or comparable burn injuries. Participants will be enrolled between 2 and 12 weeks after injury and followed prospectively for 6 months. Scars may be located on extremities, chest wall, or neck. The study population represents individuals at risk of developing persistent scar pain after combat-related or high-energy burn trauma.
Cohort
Prospective
Not listed
Persistent clinically significant scar pain
Persistent scar pain defined as Numeric Rating Scale (NRS) ≥4 during movement or on light touch at follow-up assessment. The primary endpoint is the presence of clinically significant pain at 3 months after enrollment.
Persistent Clinically Significant Scar Pain at 6 Months
Presence of clinically significant scar pain defined as Numeric Rating Scale (NRS) ≥4 during movement or on light touch at 6 months after enrollment.
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