Total body surface area burned and intensive care unit admission greatly influence scar microbiome composition in patients with burns

Skin microbiome dysbiosis has deleterious effects. Factors influencing pathological burn scar formation, which affects the scar microbiome composition, are unknown. Therefore, we investigated the effects of various factors influencing pathological scar formation on scar microbiome composition in patients with burns. We collected samples from the burn scar center and margin of 40 patients with burns, subgrouped by factors influencing pathological scar formation. Scar microbiome composition-influencing factors were analyzed using univariate and multivariate analyses. Skin graft, hospitalization period, intensive care unit (ICU) admission, burn degree, sex, age, total body surface area burned (TBSA), time post-injury, transepidermal water loss, erythrocyte sedimentation rate, and C-reactive protein levels were factors influencing burn scar microbiome composition. Only TBSA and ICU admission showed significant differences in alpha diversity. Alpha diversity significantly decreased with the increase in TBSA and was significantly lower in patients admitted than in those not admitted to ICU. Furthermore, we identified microorganisms associated with various explanatory variables. Our cross-sectional systems biology study confirmed that various variables influence the scar microbiome composition in patients with burns, each of which is associated with various microorganisms. Therefore, these factors should be considered during application of skin microbiota for burn treatments.