To investigate the clinical value of age stratification in the differential diagnosis and treatment of facial trauma scars in children.

A retrospective analysis was conducted on the clinical data of 186 children with facial trauma who received standardized treatment at the Department of Burns and Plastic Surgery, Anhui Provincial Children′s Hospital, between June 2024 and December 2025. The patients were stratified by age into a toddler group (1-3 years, n=92) and a school-age group (6-12 years, n=94). Independent-samples t tests or chi-square tests were used to compare scar width, Vancouver Scar Scale (VSS) scores, complication rates, and scar-related subjective symptoms between the 2 groups at 3 months postoperatively. Multiple linear regression analysis was performed to identify the influencing factors for scar width and VSS scores.

The postoperative scar width in the school-age group [(0.78±0.23)mm] was significantly lower to that in the toddler group[(0.92±0.28)mm](t=9.578, P< 0.01). Furthermore, the total VSS scores (3.02±1.03), scar thickness (0.82±0.36), and scar pliability (0.55±0.27) in the school-age group were significantly lower than those in the toddler group (3.56±1.08, 1.05±0.41, and 0.74±0.30, respectively) (t=3.218, 3.875, 4.012, all P< 0.01). There were no statistically significant differences between the 2 groups regarding the incidence of postoperative complications (infection, suture reaction, and hypertrophic scarring) and scar-related subjective symptoms (pain, pruritus, and burning sensation) (χ²=1.258, 1.784, all P> 0.05). Multiple linear regression analysis demonstrated that age (toddler period) (β=0.215, 95%CI: 0.054-0.376) and initial wound width (β=0.326, 95%CI: 0.147-0.505) were significant influencing factors for the further increase of scar width (t=2.622, 3.582, all P<0.01). Furthermore, age (toddler period) (β=0.198, 95%CI: 0.049-0.347) and inith wound length (β=0.287, 95%CI: 0.119-0.455) were significantly influencing factors for the elevation of VSS scores (t=2.605, 3.376, all P< 0.05).

There are age-related differences in the prognosis of facial traumatic scars in children. Individualized diagnosis and treatment based on age stratification are needed to improve the prognosis.