Course of prevalence of scar contractures limiting function: A preliminary study in children and adolescents after burns. Issue 8 (December 2019)

• Record Type: Journal Article
• Authors: Oosterwijk, Anouk M.; Mouton, Leonora J.; Akkerman, Moniek; Stoop, Matthea M.; van Baar, Margriet E.; Scholten-Jaegers, Sonja M.H.; van der Schans, Cees P.; Nieuwenhuis, Marianne K.
• Is Part Of: Burns. Volume 45:Issue 8(2019)
• Page Start: 1810
• Page End: 1818
• Publication Date: 2019-12
• Subjects: ROM range of motion -- ADL activities of daily living -- TBSA total body surface area; Range of motion -- Prevalence -- Paediatric -- Flexibility -- Activities of daily living -- Quality of life; Burns and scalds -- Periodicals; 617.11
• DOI: 10.1016/j.burns.2019.05.003
• Languages: English
• ISSNs: 0305-4179

Abstract

Highlights: Studies on the course of prevalence of scar contractures are important for improvement of burn care. Longitudinal studies are scarce in children and adolescents and not focussed on function. Prevalence of functional limited contractures remains substantial during 6 months after discharge. On joint level, the prevalence of scar contractures in upper and lower extremity joints varied. More longitudinal studies are needed investigating the prevalence in the light of functionality. Abstract: Background: Scar contracture is a well-known sequela of burns that is specifically relevant as it may limit function. Reports regarding the course of scar contractures, however, are scarce and, moreover, not focussed on function. This study describes the course of prevalence of scar contractures that limit function in children and adolescents after burns. Method: Range of motion (ROM) of extremity joints of 20 children and adolescents after burns were assessed at discharge (T0) and at six weeks (T1), three months (T2), and six months (T3) after discharge. A scar contracture limiting function was defined as a measured ROM lower than the functional ROM, i.e., ROM used to perform daily activities by unimpaired subjects. Results: At discharge (T0), 89.5% of the subjects had one or more scar contractures that limited function. Six months later (T3), this prevalence was 76.5%. At discharge (T0), less function limiting scar contractures were found for the upper extremity (29.7%) than the lower extremity (53.3%). Over time, prevalence of contractures in both extremities fluctuated between 22% and 35%. Conclusions: The majority of children and adolescents (13/17) still had scar contractures limiting function six months after discharge (T3). Substantial longitudinal studies over a longer period of time are needed to increase our knowledge on the course of these scar contractures in order to support improvements in burn care. Trial registration : The study is approved by the Regional Committee for Patient-Oriented Research Leeuwarden in the Netherlands (NL45917.099.13).