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

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

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.

MeSH terms

  • Adolescent
  • Adult
  • Burns / complications*
  • Child
  • Child, Preschool
  • Contracture / etiology
  • Contracture / psychology
  • Contracture / surgery*
  • Female
  • Humans
  • India
  • Male
  • Medical Missions*
  • Recovery of Function*
  • Surveys and Questionnaires
  • Treatment Outcome
  • Young Adult