In burn injury repair the vision is scarless healing, but regeneration remains elusive in all but minor trauma with scar tissue being the result of healing. That scar can be debilitating, restricting normal function or impacting negatively on the psyche of the individual. In July of 2005 the MJA published the vision of clinical care in a number of disciplines in 50 years time;  

“Assessment is key in understanding the extent of injury.

Debridement is focused on tissue salvage.

Reconstruction balances repair with regeneration.

Investigation of multimodality, multiscale characterisation, including confocal microscopy and synchrotron technology will quantify assessment.

Debridement using autolytic inflammatory control techniques with image guided physical methods will ensure the vital tissue frameworks are retained.

Tissue guided regeneration afforded by self-assembly nano-particles will provide the framework to guide cells to express the appropriate phenotype in reconstruction.

To solve the clinical problem a multi-disciplinary scientific approach is needed to ensure the quality of the scar is worth the pain of survival.” 

It is of note that already many of the technologies highlighted are available and in need for research to move along the innovation pathway to ensure safe implementation into health care systems. Progress requires collaboration at all stages from basic science to health economics, driven by improved clinical outcomes. Translation of new technologies into health systems requires the rigor of a research framework to identify and measure the impact of innovation in communication and education. Close working relationships between research and service delivery are essential. The future must blend long term vision with incremental short term improvements to ensure that the quality of the outcome is worth the pain of survival.