Rom J Morphol Embryol 2012, 53(3 Suppl):703–711 ISSN (print) 1220–0522 ISSN (on-line) 2066–8279 ORIGINAL PAPER Correlations between morphological appearance and psychosocial difficulties in patients with extensive burns who received allotransplant D. R. CALOTĂ 1) , C. NIŢESCU 1) , S. MARINESCU 2) , CARMEN CRISTESCU 3) , ILEANA BOIANGIU 1) , I. P. FLORESCU 2) , I. LASCĂR 4) 1) Clinical Emergency Hospital for Plastic, Reconstructive and Burns Surgery, Bucharest 2) Department of Plastic Surgery and Reconstructive Microsurgery, “Bagdasar–Arseni” Emergency Hospital, Bucharest 3) “Carol Davila” University of Medicine and Pharmacy, Bucharest 4) Department of Plastic Surgery and Reconstructive Microsurgery, Floreasca Emergency Hospital, Bucharest Abstract Extensive burns are devastating traumatic events, with significant potential for development of complex psychosocial problems. The aim of the study was to identify and quantify these difficulties among extensive burns patients. This study was conducted at Clinical Emergency Hospital for Plastic, Reconstructive and Burns Surgery and “Bagdasar–Arseni” Emergency Hospital, in Bucharest, on 43 extensive burn patients. For each patient we developed a statistic sheet with demographic data and medical information. For data collection, subjects completed the following instruments: Hamilton Depression Scale (HAMD) and Satisfaction With Appearance Scale (SWAP). The impact variables evaluated in this study were demographic characteristic of patients, burn injury characteristics, abnormal scarring and visible scars, body image dissatisfaction and depression symptoms. Although performed on a small sample, the results of this pilot study could be a valuable starting point for future larger studies, to achieve more generalizable results on extensive burns survivor’s quality of life. Keywords: extensive burns, scarring, psychosocial difficulties, depression, body image dissatisfaction.  Introduction Extensive burns are complex pathological entities, which affect the body homeostasis at the level of whole organs and systems, with potentially fatal complications [1]. Extensive burns are also devastating traumatic events, with significant potential for development of complex psychological problems. Due to the remarkable progress made in the treatment of burns, nowadays there is a significant improvement in extensive burns prognosis, so that there are recorded cases of survival even after 95% TBSA burns. The increased likelihood of survival of burns victims heightens concerns for potential psychological morbidity for the burn survivors. So, a new group of patients is released: the survivors of severe burns, which confront themselves with psychosocial difficulties in the process of adaptation at their new life. Extensive burns require comprehensive rehabilitation treatment and coordination with the acute care burn team. This interdisciplinary rehabilitation [2, 3] treatment is focused on preventing long-term problems such as scarring, contractures and other problems that limit physical function. Adequate pain management and recognition of psychological issues are important components of treatment after burn injuries [2, 4–7]. Living with visible scars in a society that values physical attractiveness is extremely difficult for burn survivors. Body image dissatisfaction appears to result from a complex range of factors that include burn characteristics, visible scars, gender, age, values/beliefs, socio-cultural background, perceived support and personality. Body image dissatisfaction and limitations in physical function have been associated with social anxiety, isolation, depression and problems with intimacy among survivors of burn injuries [6]. Simultaneously, for the extensive burns survivor follows the stages of recovery, rehabilitation and adaptation, extremely difficult and with deep psychological implications. Extensive burn survivors, experiencing psychosocial adjustment disorders in their new life, are forced to make mental alterations to their body image [8, 9]. The increased likelihood of survival of burns victims heightens concerns for potential psychological morbidity for the burn survivors. Many survivors of extensive burns develop moderate or severe difficulties psychological or social. Depression, anxiety and post-traumatic stress disorder are the most commonly observed psychological problems of extensive burns patients [10]. Between 13% R J M E Romanian Journal of Morphology & Embryology http://www.rjme.ro/