Burn scar contracture release surgery effectively improves functional range of motion, disability and quality of life: A pre/post cohort study with long-term follow-up in a Low- and Middle-Income Country

Hendriks, Thom C C; Botman, Matthijs; Haas, Louise E. M. de; Mtui, G.S.; Nuwass, E.Q.; Jaspers, Mariëlle E. H.; Niemeijer, Anuschka S.; Nieuwenhuis, M.K.; Winters, H.A.H.; Zuijlen, Paul P. M. van

doi:10.1016/j.burns.2020.12.024

Cited by 14 publications

(10 citation statements)

References 54 publications

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“…A queimadura mais recente nesse trabalho possuía 11 meses e, a mais antiga, dois anos. O lastro de tempo demonstra a influência da cicatrização sobre as alterações da ADM, especialmente em fase tardia, explicados por não adesão ao tratamento fisioterapêutico na fase inicial, período prolongado de internação hospitalar, presença de contraturas, interrupção da reabilitação, entre outros 1,4,6,16 .…”

Section: Discussionunclassified

“…Na fase ambulatorial avalia-se o caráter da cicatriz como atrófica, normotrófica, hipertrófica ou queloideana, presença de prurido, encurtamentos ou contraturas instaladas e o tratamento do paciente consiste em maleabilizar as cicatrizes para que não afetem a funcionalidade, manter ou aumentar a ADM facilitando autocuidados e alcance, melhorar a força muscular e condicionamento cardiorrespiratório, proporcionando ao paciente a realização de caminhadas por curtas e longas distâncias, subir e descer escadas/rampas 1,4,6,7 .…”

Section: Discussionunclassified

“…A queimadura é uma causa comum de incapacidades funcionais em virtude do desenvolvimento de contraturas cicatriciais 1 . No Brasil entre os anos de 2015 e 2020 houve 19.772 óbitos relacionados a queimaduras térmicas, elétricas e outros agentes etiológicos 2 .…”

Section: Introductionunclassified

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Acometimento do sistema musculoesquelético por queimaduras de terceiro grau em pacientes ambulatoriais: Série de casos

Carto,

Rezende,

Gervásio

et al. 2023

RBQ

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Section: Discussionunclassified

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Acometimento do sistema musculoesquelético por queimaduras de terceiro grau em pacientes ambulatoriais: Série de casos

Carto,

Rezende,

Gervásio

et al. 2023

RBQ

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“…The adapted MASCC used in this study is an effective scale to qualify and rate burn scars by the complexity of the surgery needed for their correction. While previous research has considered acute burn care and the effectiveness of contracture release on functional outcomes, there has been limited work on primary evaluation of burn scars [33][34][35]. The significant agreement between attending physicians and residents shows the scales effectiveness across levels of surgical training.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and Severity of Burn Scars in Rural Mozambique

et al. 2022

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Background Burn injuries are common in low- and middle-income countries (LMICs) and their associated disability is tragic. This study is the first to explore burn scars in rural communities in Mozambique. This work also validated an innovate burn assessment tool, the Morphological African Scar Contractures Classification (MASCC), used to determine surgical need. Methods Using a stratified, population-weighted survey, the team interviewed randomly selected households from September 2012 to June 2013. Three rural districts (Chókwè, Nhamatanda, and Ribáuè) were selected to represent the southern, central and northern regions of the country. Injuries were recorded, documented with photographs, and approach to care was gathered. A panel of residents and surgeons reviewed the burn scar images using both the Vancouver Scar Scale and the MASCC, a validated visual scale that categorizes patients into four categories corresponding to levels of surgical intervention. Results Of the 6104 survey participants, 6% (n = 370) reported one or more burn injuries. Burn injuries were more common in females (57%) and most often occurred on the extremities. Individuals less than 25 years old had a significantly higher odds of reporting a burn scar compared to people older than 45 years. Based on the MASCC, 12% (n = 42) would benefit from surgery to treat contractures. Conclusion Untreated burn injuries are prevalent in rural Mozambique. Our study reveals a lack of access to surgical care in rural communities and demonstrates how the MASCC scale can be used to extend the reach of surgical assessment beyond the hospital through community health workers.

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“…In contrast, generic instruments, such as the EQ-5D, enable these comparisons but may lack sensitivity for burn-specific problems [7]. Important advantages of the EQ-5D are its short form, so it can be applied worldwide as shown by a recent burn study in Tanzania [8], its availability in many languages, and the ability to assess the burden of disease by calculating DALYs [9] and cost-effectiveness of burn care by calculating QALYs [10]. However, because it does not include burn-specific problems, such as itching, disfigurement, fatigue, or cognition, a (potential) limitation of the EQ-5D is its seemingly limited sensitivity for burn-specific problems [11,12].…”

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Assessing Health-Related Quality of Life of Adult Patients with Intermediate Burns: The Added Value of an Itching and Cognition Item for the EQ-5D: A Retrospective Observational Study

Dijkshoorn¹,

Haagsma

Vlies

et al. 2022

EBJ

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The EQ-5D is increasingly used to assess the health-related quality of life (HRQL) of adult patients with intermediate burns. However, this generic instrument may lack sensitivity, as important problems for burn patients, such as itching and cognition problems are not included in this instrument. This retrospective observational study investigates the value of adding an itching and cognition item to the EQ-5D-3L. Patients completed the EQ-5D-3L, and the Patient and Observer Scar Assessment Scale (POSAS), including an itching item and an extra cognition item three months postburn. The potential added value of an itching and cognition item was studied by distribution, informativity, convergent validity, dimension dependency, and explanatory analyses. In total, 120 patients were included of whom 65% reported itching and 23% reported cognition problems. Adding an itching item to the EQ-5D improved the discriminatory power and informativity of the EQ-5D-3L, but barely increased the explanatory power (0.4%) and decreased the convergent validity (r = −0.529 vs. r = −0.612). In contrast, adding a cognition item slightly improved the informativity and discriminatory power. Moreover, convergent validity (r = −0.617 vs. r = −0.612) and explanatory power increased (4.0%). In conclusion, adding an itching item to the EQ-5D-3L provides some additional information, however, the added value is small, whereas adding a cognition item improved the measurement properties of the EQ-5D-3L in our sample and should be considered when assessing HRQL in adult patients with intermediate burns.

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Burn scar contracture release surgery effectively improves functional range of motion, disability and quality of life: A pre/post cohort study with long-term follow-up in a Low- and Middle-Income Country

Cited by 14 publications

References 54 publications

Acometimento do sistema musculoesquelético por queimaduras de terceiro grau em pacientes ambulatoriais: Série de casos

Acometimento do sistema musculoesquelético por queimaduras de terceiro grau em pacientes ambulatoriais: Série de casos

Prevalence and Severity of Burn Scars in Rural Mozambique

Assessing Health-Related Quality of Life of Adult Patients with Intermediate Burns: The Added Value of an Itching and Cognition Item for the EQ-5D: A Retrospective Observational Study

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