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For: Schouten HJ, Nieuwenhuis MK, van Baar ME, van der Schans CP, Niemeijer AS, van Zuijlen PPM. The degree of joint range of motion limitations after burn injuries during recovery. Burns 2022;48:309-318. [PMID: 34955294 DOI: 10.1016/j.burns.2021.01.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 12/01/2020] [Accepted: 01/08/2021] [Indexed: 12/14/2022]

For:	Schouten HJ, Nieuwenhuis MK, van Baar ME, van der Schans CP, Niemeijer AS, van Zuijlen PPM. The degree of joint range of motion limitations after burn injuries during recovery. Burns 2022;48:309-318. [PMID: 34955294 DOI: 10.1016/j.burns.2021.01.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 12/01/2020] [Accepted: 01/08/2021] [Indexed: 12/14/2022]

Number

Cited by Other Article(s)

Cuijpers MD, Meij-de Vries A, van Zuijlen PPM, Baartmans MGA, Nieuwenhuis M, van Baar ME, Pijpe A. The prevalence and predictors of reconstructive surgery in pediatric burn care. Burns 2024:S0305-4179(24)00217-1. [PMID: 39317543 DOI: 10.1016/j.burns.2024.07.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 05/23/2024] [Accepted: 07/13/2024] [Indexed: 09/26/2024]

Affiliation(s)

M D Cuijpers Association of Dutch Burn Centers, Burn Center, Red Cross Hospital, Beverwijk, the Netherlands; Department of Plastic, Reconstructive and Hand Surgery, Amsterdam UMC, Location VU University Amsterdam, De Boelelaan 1117, Amsterdam, the Netherlands; Amsterdam Movement Sciences (AMS) Institute, Amsterdam UMC, Amsterdam, the Netherlands.
A Meij-de Vries Association of Dutch Burn Centers, Burn Center, Red Cross Hospital, Beverwijk, the Netherlands; Department of Surgery, Red Cross Hospital, Beverwijk, the Netherlands; Pediatric Surgical Center, Emma Children's Hospital, Amsterdam UMC, Location University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands
P P M van Zuijlen Association of Dutch Burn Centers, Burn Center, Red Cross Hospital, Beverwijk, the Netherlands; Department of Plastic, Reconstructive and Hand Surgery, Amsterdam UMC, Location VU University Amsterdam, De Boelelaan 1117, Amsterdam, the Netherlands; Amsterdam Movement Sciences (AMS) Institute, Amsterdam UMC, Amsterdam, the Netherlands; Pediatric Surgical Center, Emma Children's Hospital, Amsterdam UMC, Location University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands; Department of Plastic, Reconstructive, and Hand Surgery, Red Cross Hospital, Beverwijk, the Netherlands
M G A Baartmans Department of Pediatrics, Maasstad Hospital, Rotterdam, the Netherlands; Association of Dutch Burn Centers, Burn Center, Maasstad Hospital, Rotterdam, the Netherlands
M Nieuwenhuis Department of Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands; Association of Dutch Burn Centers, Burn Center, Martini Hospital, Groningen, the Netherlands; Research group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, the Netherlands
M E van Baar Association of Dutch Burn Centers, Burn Center, Maasstad Hospital, Rotterdam, the Netherlands; Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
A Pijpe Association of Dutch Burn Centers, Burn Center, Red Cross Hospital, Beverwijk, the Netherlands; Department of Plastic, Reconstructive and Hand Surgery, Amsterdam UMC, Location VU University Amsterdam, De Boelelaan 1117, Amsterdam, the Netherlands.

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Jeong T, Alessandri-Bonetti M, Pandya S, Liu H, Stofman GM, Egro FM. The Development and Management of Neck Burn Scar Contracture Recurrence: A Single-Center Retrospective Cohort Study. Ann Plast Surg 2024;92:S142-S145. [PMID: 38556663 DOI: 10.1097/sap.0000000000003854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/02/2024]

Abstract

INTRODUCTION

Burn neck contractures pose a great challenge for reconstructive surgeons. A paucity of literature exist regarding long-term outcomes based on different surgical management strategies. The aim of this study was to evaluate the long-term outcomes of the treatment of neck burn scar contractures and evaluate surgical strategies according to their long-term effectiveness and associated complications.

METHODS

A retrospective cohort study was conducted to review outcomes of neck contractures release after burn injury. All patients operated on between January 2009 and February 2023 at a single institution were included.

RESULTS

A total of 20 patients developed neck burn scar contracture and were included in this study. The mean age was 32.9 ± 20.3 years. The burn injuries were most commonly thermal (n = 19, 95%). All burn injuries were full-thickness burns, with an average neck defect size of 130.5 ± 106.0 cm2. Overall, 45 surgical scar release procedures were performed on the 20 patients who developed a neck contracture. Patients underwent 1.65 ± 1.04 surgeries on average to address neck contracture. Although 25% of patients only received 1 surgery to treat neck contracture, some patients underwent as many as 8 surgeries. Contracture recurrence (CR) was the most common complication and occurred in 28.9% of the cases. The mean percentage total body surface area did not significantly differ in CR patients (26.7% ± 14.9%) and no-CR patients (44.5% ± 30.2%). However, there was a significant difference (P = 0.01) in the average neck defect size between CR patients (198.5 ± 108.3 cm2) and no-CR patients (81.1 ± 75.1 cm2).

CONCLUSIONS

This study showed that risk factors for initial burn scar contractures may differ from those associated with CR, highlighting the importance of neck defect size as a predictor. The study also examines various surgical approaches, with Z-plasty showing promise for managing CR. However, the absence of data on neck range of motion is a limitation. This research underscores the complexity of managing CR and emphasizes the need for ongoing postoperative monitoring.

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Alvedro-Ruiz P, Díaz-Ros N, García-García M, Merino-Romero M, Heredia-Alcalde I, Andresen-Lorca B, Pérez-Plaza A, Pérez-Del-Caz MD. Occipito-Cervico-Dorsal Flap for Neck Reconstruction After Postburn Contractures: A Case Report and Literature Review. PLASTIC AND AESTHETIC NURSING 2024;44:124-127. [PMID: 38639969 DOI: 10.1097/psn.0000000000000552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/20/2024]

Affiliation(s)

Pedro Alvedro-Ruiz Pedro Alvedro-Ruiz, MD, is at Plastic and Reconstructive Surgery and Burns Department, La Fe University and Polytechnic Hospital, Valencia, Spain Nerea Díaz-Ros, MD, is at Plastic and Reconstructive Surgery and Burns Department, La Fe University and Polytechnic Hospital, Valencia, Spain María García-García, MD, is at Plastic and Reconstructive Surgery and Burns Department, La Fe University and Polytechnic Hospital, Valencia, Spain Mar Merino-Romero, MD, is at Plastic and Reconstructive Surgery and Burns Department, La Fe University and Polytechnic Hospital, Valencia, Spain Iván Heredia-Alcalde, MD, is at Plastic and Reconstructive Surgery and Burns Department, La Fe University and Polytechnic Hospital, Valencia, Spain Belén Andresen-Lorca, MD, is at Plastic and Reconstructive Surgery and Burns Department, La Fe University and Polytechnic Hospital, Valencia, Spain Aranzazu Pérez-Plaza, MD, is at Plastic and Reconstructive Surgery and Burns Department, La Fe University and Polytechnic Hospital, Valencia, Spain María Dolores Pérez-Del-Caz, MD, PhD, is at Plastic and Reconstructive Surgery and Burns Department, La Fe University and Polytechnic Hospital, Valencia, Spain
Nerea Díaz-Ros Pedro Alvedro-Ruiz, MD, is at Plastic and Reconstructive Surgery and Burns Department, La Fe University and Polytechnic Hospital, Valencia, Spain Nerea Díaz-Ros, MD, is at Plastic and Reconstructive Surgery and Burns Department, La Fe University and Polytechnic Hospital, Valencia, Spain María García-García, MD, is at Plastic and Reconstructive Surgery and Burns Department, La Fe University and Polytechnic Hospital, Valencia, Spain Mar Merino-Romero, MD, is at Plastic and Reconstructive Surgery and Burns Department, La Fe University and Polytechnic Hospital, Valencia, Spain Iván Heredia-Alcalde, MD, is at Plastic and Reconstructive Surgery and Burns Department, La Fe University and Polytechnic Hospital, Valencia, Spain Belén Andresen-Lorca, MD, is at Plastic and Reconstructive Surgery and Burns Department, La Fe University and Polytechnic Hospital, Valencia, Spain Aranzazu Pérez-Plaza, MD, is at Plastic and Reconstructive Surgery and Burns Department, La Fe University and Polytechnic Hospital, Valencia, Spain María Dolores Pérez-Del-Caz, MD, PhD, is at Plastic and Reconstructive Surgery and Burns Department, La Fe University and Polytechnic Hospital, Valencia, Spain
María García-García Pedro Alvedro-Ruiz, MD, is at Plastic and Reconstructive Surgery and Burns Department, La Fe University and Polytechnic Hospital, Valencia, Spain Nerea Díaz-Ros, MD, is at Plastic and Reconstructive Surgery and Burns Department, La Fe University and Polytechnic Hospital, Valencia, Spain María García-García, MD, is at Plastic and Reconstructive Surgery and Burns Department, La Fe University and Polytechnic Hospital, Valencia, Spain Mar Merino-Romero, MD, is at Plastic and Reconstructive Surgery and Burns Department, La Fe University and Polytechnic Hospital, Valencia, Spain Iván Heredia-Alcalde, MD, is at Plastic and Reconstructive Surgery and Burns Department, La Fe University and Polytechnic Hospital, Valencia, Spain Belén Andresen-Lorca, MD, is at Plastic and Reconstructive Surgery and Burns Department, La Fe University and Polytechnic Hospital, Valencia, Spain Aranzazu Pérez-Plaza, MD, is at Plastic and Reconstructive Surgery and Burns Department, La Fe University and Polytechnic Hospital, Valencia, Spain María Dolores Pérez-Del-Caz, MD, PhD, is at Plastic and Reconstructive Surgery and Burns Department, La Fe University and Polytechnic Hospital, Valencia, Spain
Mar Merino-Romero Pedro Alvedro-Ruiz, MD, is at Plastic and Reconstructive Surgery and Burns Department, La Fe University and Polytechnic Hospital, Valencia, Spain Nerea Díaz-Ros, MD, is at Plastic and Reconstructive Surgery and Burns Department, La Fe University and Polytechnic Hospital, Valencia, Spain María García-García, MD, is at Plastic and Reconstructive Surgery and Burns Department, La Fe University and Polytechnic Hospital, Valencia, Spain Mar Merino-Romero, MD, is at Plastic and Reconstructive Surgery and Burns Department, La Fe University and Polytechnic Hospital, Valencia, Spain Iván Heredia-Alcalde, MD, is at Plastic and Reconstructive Surgery and Burns Department, La Fe University and Polytechnic Hospital, Valencia, Spain Belén Andresen-Lorca, MD, is at Plastic and Reconstructive Surgery and Burns Department, La Fe University and Polytechnic Hospital, Valencia, Spain Aranzazu Pérez-Plaza, MD, is at Plastic and Reconstructive Surgery and Burns Department, La Fe University and Polytechnic Hospital, Valencia, Spain María Dolores Pérez-Del-Caz, MD, PhD, is at Plastic and Reconstructive Surgery and Burns Department, La Fe University and Polytechnic Hospital, Valencia, Spain
Iván Heredia-Alcalde Pedro Alvedro-Ruiz, MD, is at Plastic and Reconstructive Surgery and Burns Department, La Fe University and Polytechnic Hospital, Valencia, Spain Nerea Díaz-Ros, MD, is at Plastic and Reconstructive Surgery and Burns Department, La Fe University and Polytechnic Hospital, Valencia, Spain María García-García, MD, is at Plastic and Reconstructive Surgery and Burns Department, La Fe University and Polytechnic Hospital, Valencia, Spain Mar Merino-Romero, MD, is at Plastic and Reconstructive Surgery and Burns Department, La Fe University and Polytechnic Hospital, Valencia, Spain Iván Heredia-Alcalde, MD, is at Plastic and Reconstructive Surgery and Burns Department, La Fe University and Polytechnic Hospital, Valencia, Spain Belén Andresen-Lorca, MD, is at Plastic and Reconstructive Surgery and Burns Department, La Fe University and Polytechnic Hospital, Valencia, Spain Aranzazu Pérez-Plaza, MD, is at Plastic and Reconstructive Surgery and Burns Department, La Fe University and Polytechnic Hospital, Valencia, Spain María Dolores Pérez-Del-Caz, MD, PhD, is at Plastic and Reconstructive Surgery and Burns Department, La Fe University and Polytechnic Hospital, Valencia, Spain
Belén Andresen-Lorca Pedro Alvedro-Ruiz, MD, is at Plastic and Reconstructive Surgery and Burns Department, La Fe University and Polytechnic Hospital, Valencia, Spain Nerea Díaz-Ros, MD, is at Plastic and Reconstructive Surgery and Burns Department, La Fe University and Polytechnic Hospital, Valencia, Spain María García-García, MD, is at Plastic and Reconstructive Surgery and Burns Department, La Fe University and Polytechnic Hospital, Valencia, Spain Mar Merino-Romero, MD, is at Plastic and Reconstructive Surgery and Burns Department, La Fe University and Polytechnic Hospital, Valencia, Spain Iván Heredia-Alcalde, MD, is at Plastic and Reconstructive Surgery and Burns Department, La Fe University and Polytechnic Hospital, Valencia, Spain Belén Andresen-Lorca, MD, is at Plastic and Reconstructive Surgery and Burns Department, La Fe University and Polytechnic Hospital, Valencia, Spain Aranzazu Pérez-Plaza, MD, is at Plastic and Reconstructive Surgery and Burns Department, La Fe University and Polytechnic Hospital, Valencia, Spain María Dolores Pérez-Del-Caz, MD, PhD, is at Plastic and Reconstructive Surgery and Burns Department, La Fe University and Polytechnic Hospital, Valencia, Spain
Aranzazu Pérez-Plaza Pedro Alvedro-Ruiz, MD, is at Plastic and Reconstructive Surgery and Burns Department, La Fe University and Polytechnic Hospital, Valencia, Spain Nerea Díaz-Ros, MD, is at Plastic and Reconstructive Surgery and Burns Department, La Fe University and Polytechnic Hospital, Valencia, Spain María García-García, MD, is at Plastic and Reconstructive Surgery and Burns Department, La Fe University and Polytechnic Hospital, Valencia, Spain Mar Merino-Romero, MD, is at Plastic and Reconstructive Surgery and Burns Department, La Fe University and Polytechnic Hospital, Valencia, Spain Iván Heredia-Alcalde, MD, is at Plastic and Reconstructive Surgery and Burns Department, La Fe University and Polytechnic Hospital, Valencia, Spain Belén Andresen-Lorca, MD, is at Plastic and Reconstructive Surgery and Burns Department, La Fe University and Polytechnic Hospital, Valencia, Spain Aranzazu Pérez-Plaza, MD, is at Plastic and Reconstructive Surgery and Burns Department, La Fe University and Polytechnic Hospital, Valencia, Spain María Dolores Pérez-Del-Caz, MD, PhD, is at Plastic and Reconstructive Surgery and Burns Department, La Fe University and Polytechnic Hospital, Valencia, Spain
María Dolores Pérez-Del-Caz Pedro Alvedro-Ruiz, MD, is at Plastic and Reconstructive Surgery and Burns Department, La Fe University and Polytechnic Hospital, Valencia, Spain Nerea Díaz-Ros, MD, is at Plastic and Reconstructive Surgery and Burns Department, La Fe University and Polytechnic Hospital, Valencia, Spain María García-García, MD, is at Plastic and Reconstructive Surgery and Burns Department, La Fe University and Polytechnic Hospital, Valencia, Spain Mar Merino-Romero, MD, is at Plastic and Reconstructive Surgery and Burns Department, La Fe University and Polytechnic Hospital, Valencia, Spain Iván Heredia-Alcalde, MD, is at Plastic and Reconstructive Surgery and Burns Department, La Fe University and Polytechnic Hospital, Valencia, Spain Belén Andresen-Lorca, MD, is at Plastic and Reconstructive Surgery and Burns Department, La Fe University and Polytechnic Hospital, Valencia, Spain Aranzazu Pérez-Plaza, MD, is at Plastic and Reconstructive Surgery and Burns Department, La Fe University and Polytechnic Hospital, Valencia, Spain María Dolores Pérez-Del-Caz, MD, PhD, is at Plastic and Reconstructive Surgery and Burns Department, La Fe University and Polytechnic Hospital, Valencia, Spain

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Fanstone R, Price P. Global perspectives on risk factors for major joint burn contractures: A literature review. Burns 2024;50:537-549. [PMID: 37977897 DOI: 10.1016/j.burns.2023.09.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 07/31/2023] [Accepted: 09/22/2023] [Indexed: 11/19/2023]

Abstract

Contractures are a frequent consequence of burn injuries, yet our knowledge of associated risk factors is limited. This paper provides an extensive review of relevant literature from both High-Income Countries (HICs) and Low-Middle Income Countries (LMICs). Ninety-four papers (up to June 2019) and eight subsequent publications (up to March 2022) were included, 76% of which were from HICs. The majority of publications were either descriptive studies (4 from HICs, 9 from LMICs) or papers citing putative risk factors (37 from HICs, 10 from LMICs). Seventeen publications (all from HICs) reported on the effects of individual non-surgical therapeutic interventions, often with conflicting results. Two published systematic reviews emphasised the poor quality of evidence available. Only fifteen studies (3 from LMICs) examined potential contracture risk factors with statistical comparisons of outcomes; significant findings from these included demographic, burn, comorbidities, and treatment risk factors. LMIC papers included socioeconomic and healthcare system factors as potential risks for contracture; these were rarely considered in HIC publications. Methodological issues identified from this review of literature included differences in contracture definitions, populations studied, standards of care, joints included and the timing and nature of contracture assessments.This review is the first to collate existing knowledge on risk factors for burn contractures from both HIC and LMIC settings, revealing a surprising lack of robust evidence for many accepted risk factors. In LMICs, where burns are particularly common, universal health provision is lacking and specialist burn care is both scarce and difficult to access; consequently, socioeconomic factors may have more immediate impact on contracture outcomes than specific burn treatments or therapies. Much more work is indicated to fully understand the relative impacts of risk factors in different settings so that context-appropriate contracture prevention strategies can be developed.

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Fanstone R, Price P, Bodger O, Potokar T, Khan MRK. Risk factors for burn contractures: A cross-sectional study in a lower income country. Burns 2024;50:454-465. [PMID: 37980272 DOI: 10.1016/j.burns.2023.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 07/31/2023] [Accepted: 09/09/2023] [Indexed: 11/20/2023]

Abstract

Risk factors for burn contractures require further study, especially in low and middle-income countries (LMICs); existing research has been predominantly conducted in high income countries (HICs). This study aimed to identify risk factors for burn contractures of major joints in a low-income setting. Potential risk factors (n = 104) for burn contracture were identified from the literature and a survey of clinicians with extensive experience in low and middle-income countries (LMIC). An observational cross-sectional study of adult burn survivors was undertaken in Bangladesh to evaluate as many of these risk factors as were feasible against contracture presence and severity. Forty-eight potential risk factors were examined in 48 adult patients with 126 major joints at risk (median 3 per participant) at a median of 2.5 years after burn injury. Contractures were present in 77% of participants and 52% of joints overall. Contracture severity was determined by measurement of loss of movement at all joints at risk. Person level risk factors were defined as those that were common to all joints at risk for the participant and only documented once, whilst joint level risk factors were documented for each of the participant's included joints at risk. Person level risk factors which were significantly correlated with loss of range of movement (ROM) included employment status, full thickness burns, refusal of skin graft, discharged against medical advice, low frequency of follow up and lack of awareness of contracture development. Significant joint level risk factors for loss of ROM included anatomical location, non-grafted burns, and lack of pressure therapy. This study has examined the largest number of potential contracture risk factors in an LMIC setting to date. A key finding was that risk factors for contracture in low-income settings may differ substantially from those seen in high income countries, which has implications for effective prevention strategies in these countries. Better whole person and joint outcome measures are required for accurate determination of risk factors for burn contracture. Recommendations for planning and reporting on future contracture risk factor studies are made.

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Li R, Zheng Y, Fan X, Cao Z, Yue Q, Fan J, Gan C, Jiao H, Liu L. Establishment and validation of a nomogram to predict the neck contracture after skin grafting in burn patients: A multicentre cohort study. Int Wound J 2023;20:3648-3656. [PMID: 37245866 PMCID: PMC10588345 DOI: 10.1111/iwj.14243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 05/08/2023] [Accepted: 05/09/2023] [Indexed: 05/30/2023] Open

Li R, Zheng Y, Fan X, Cao Z, Yue Q, Fan J, Gan C, Jiao H, Liu L. Epidemiology and Predictors for Cervical Burn Scar Contractures: A Multicenter Cohort Study. J Craniofac Surg 2023;34:1795-1798. [PMID: 37184463 DOI: 10.1097/scs.0000000000009344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 02/20/2023] [Indexed: 05/16/2023] Open

Hair-Bearing Expanded Scalp Flap for Total Beard Reconstruction in Patients With Chin and Submental Postburn Scars. J Craniofac Surg 2023;34:731-734. [PMID: 36089697 DOI: 10.1097/scs.0000000000008944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 07/10/2022] [Indexed: 11/27/2022] Open