Functional and subjective assessment of burn contracture release in a mission setting. Issue 2 (March 2016)

• Record Type: Journal Article
• Authors: Sinha, Indranil; Zhu, Dagny; Ojomo, Kristin; Gfrerer, Lisa; Sawh-Martinez, Rajendra; Patel, Anup; Chan, Rodney K.; Watkins, James F.
• Is Part Of: Burns. Volume 42:Issue 2(2016)
• Page Start: 466
• Page End: 470
• Publication Date: 2016-03
• Subjects: Burn reconstruction -- Contractors -- Surgical missions; Burns and scalds -- Periodicals; 617.11
• DOI: 10.1016/j.burns.2015.07.009
• Languages: English
• ISSNs: 0305-4179

Abstract

Highlights: Burn contracture operations improve both SF-36 mental health and physical ability scores. Contracture release results in a decrease of the 'whole person impairment' score. Standardized surveys can be completed in a mission setting. 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.