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Burns. 2016 Mar;42(2):466-70. doi: 10.1016/j.burns.2015.07.009. Epub 2016 Jan 6.

Functional and subjective assessment of burn contracture release in a mission setting.

Author information

1
Division of Plastic Surgery, Brigham and Women's Hospital, Boston, MA 02115, United States; Division of Trauma and Burn Surgery, Brigham and Women's Hospital, Boston, MA 02115, United States. Electronic address: isinha@partners.org.
2
Department of Ophthalmology, University of Southern California, Los Angeles, CA 90089, United States.
3
Division of Plastic Surgery, Brigham and Women's Hospital, Boston, MA 02115, United States; Division of Trauma and Burn Surgery, Brigham and Women's Hospital, Boston, MA 02115, United States.
4
Division of Plastic Surgery, Massachusetts General Hospital, Boston, MA 02114, United States.
5
Division of Plastic Surgery, Yale University School of Medicine, New Haven, CT 06520, United States.
6
Clinical Division and Burn Center, San Antonio Military Medical Center, San Antonio, TX 78234, United States.
7
Division of Trauma and Critical Care, VA Eastern Colorado Healthcare System, Denver, CO 80220, United States.

Abstract

OBJECTIVE:

Burns and subsequent contractures are common in developing nations. Contracture release is performed to treat such patients with functional limitations. The aim of this study is to evaluate post-operative functional and psychosocial outcomes following contracture release in a mission setting.

METHODS:

During a surgical mission in Mumbai, India, 39 patients burn contractures underwent surgical release. A total of 31 patients (64% female, mean age 27 years) chose to participate in the study. Patients were scored preoperatively and postoperatively using a SF-36 validated survey and AMA impairment guideline assessment.

RESULTS:

Thirty-one patients completed questionnaires pre-operative and 6-weeks post operatively. Twenty-four patients completed a survey 3-months post operatively (77.4%). Among those enrolled, 67% were women with the majority sustaining <20% total body surface area burns (70.7%) but had multiple contractures (80.6%). SF-36 physical component score increased from a mean score of 49.8 preoperatively to 55.6 by 3 months following contracture release (P<0.001). The SF-36 mental component score similarly increased from 38.8 to 51.1 by 3 months (P<0.001). AMA Whole Person Impairment (WPI) scores improved from 40.3% impairment pre-operative to 26.6% at 6-weeks post-operative (P<0.001).

CONCLUSIONS:

Patients SF-36 and WPI scores improved following burn contracture release, confirming both functional and psychologic improvement following surgery. During the acute post-operative period, this study suggests that contracture release in a mission setting is of benefit to patients.

KEYWORDS:

Burn reconstruction; Contractors; Surgical missions

PMID:
26778704
DOI:
10.1016/j.burns.2015.07.009
[Indexed for MEDLINE]

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