Post Burn Contracture Neck: Clinical Profile and Management

Mody, Nikunj B; Bankar, Sanket; Patil, Avinash

doi:10.7860/jcdr/2014/10187.5004

Cited by 16 publications

(26 citation statements)

References 17 publications

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“…Due to the wrong position of the head on the neck during burn management and the pillow under the head not the shoulder, the chronic flexion contracture is often seen in deep extensive burns of the neck and this may be attributed to the flexion position taken by the patient to minimize the tension on the neck and hence decreasing the pain sensation. 1 Contractures and hypertrophic scars are two frustrating sequels of thermal injury. Scars of the anterior cervical region are prone to be unusually severe because:…”

Section: Discussionmentioning

confidence: 99%

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Early debridement with physiotherapy for prevention of postburn contracture of neck: a case series

Bakhshi¹,

Marathe²,

Kamat³

et al. 2020

Int Surg J

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Hypertrophic scars and contractures are well known sequelae after burns. They result in high morbidity in severely burned patients who are surviving. Present case study was done to establish the usefulness of early debridement and physiotherapy in preventing these sequelae. Present study was conducted on patients admitted in a tertiary care hospital on patients with alleged history of thermal burns to neck and upper chest over a period of 6 months. These patients were subjected to early debridement, daily dressings and early neck physiotherapy. They were assessed for neck mobility and development of neck contracture. Three patients were studied, two had a favourable outcome due to adherence to above measures while one developed contracture due to her late presentation and non-compliance to early physiotherapy. Post burn contractures are common sequelae of thermal burns involving the neck region. Early Debridement, daily dressing of the raw areas with starting of early neck physiotherapy are important and prove beneficial in preventing neck contractures with early return to normal daily activity.

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Section: Discussionmentioning

confidence: 99%

“…Post burn contractures, though preventable, prove to be a common scenario in case of burn patients in spite of the developments in burn management, thus emphasizing a major role of active patient participation in rehabilitation including physiotherapy immediately after the incident, to restore maximum functionality of the affected part. 1…”

Section: Introductionmentioning

confidence: 99%

Early debridement with physiotherapy for prevention of postburn contracture of neck: a case series

Bakhshi¹,

Marathe²,

Kamat³

et al. 2020

Int Surg J

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“…Глубокие ожоги шеи у детей наблюдаются в 4 раза чаще, чем глубокие ожоги лица [4]. Исходами такой травмы обычно являются рубцовые деформации, приводящие к натяжению тканей лица, а в тяжелых случаях к деформации трахеи [5]. Послеожоговые контрактуры шеи оказывают психосоциальное воздействие на пострадавших, в том числе приводят к мыслям о суициде [6].…”

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“…Послеожоговые контрактуры шеи оказывают психосоциальное воздействие на пострадавших, в том числе приводят к мыслям о суициде [6]. Если у взрослых подобные рубцовые деформации носят статичный характер, то у детей в процессе роста их тяжесть может увеличиваться [5,7]. Извест но, что в случае эпителизации ожоговых ран сроком более 3 нед.…”

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The benefits of early surgical treatment of deep cervical burns in children

Gnipov

Александрович²,

Баиндурашвили

et al. 2020

Pediatr Traum Orthop Reconstr Surg

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Background. The frequency of deep cervical burns in children is four times higher than that of deep face burns. Currently, there is no consensus on the methods for surgical treatment of deep burns in cervical areas; meshed skin autografts continue to be used. Aim. To evaluate the benefits of early surgical treatment of deep сervical burns in children between the third and fifth days from the moment of injury. Materials and methods. Case-control study. Surgical treatment was performed in 81 children with deep cervical burns. The main group with early surgical treatment included 46 children and underwent surgical treatment at 3.37 0.14 days from the moment of injury; the control group received autograft during stage treatment for 35 children at 27.17 0.18 days. The treatment results were evaluated by the following indicators: the number of dressing changes, the period of skin restoration, and the area of graft success. In the long term, functional and cosmetic treatment results were evaluated. Results. In the study and control groups, 7.93 0.45 and 18.75 0.61 dressings were required to complete the treatment, respectively (p 0.001). The skin restoration periods were 16.54 0.68 and 36.94 0.89 days, respectively (p 0.001). The graft success areas were 99.50% 0.13% in the main group and 93.91% 2.68% in the control (p 0.001). During the staged surgical treatment, one patient showed a loss of 90% of the graft, which required regrafting. Other complications in the treatment process have not been noted. When assessing long-term cosmetic results using the Vancouver Scar Scale, the average score was 4.0 0.26 points in the main group and 7 0.28 points in the control (p 0.001). The presence of post-burn cicatricial contracture in the main group was noted in 12 (26%) people and the absence in 34 (74%) children. In the control group, 20 (57%) patients required surgical removal of post-burn deformity, and 15 (43%) children did not need further surgical interventions. Conclusions. Early surgical treatment of deep cervical burns in children on the third and fifth days from injury allows not only to accelerate the process of restoration of the skin but also to directly affect the cosmetic and functional results in a better way.

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“…13 In a study carried out by Mody et al, the rate of recontracture was 13.6% while Cronin has described a rate of 17% in his study. 13,14…”

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confidence: 99%

Clinicoepidemiological study of post burn contractures at a tertiary care centre in western India

Mehta¹,

Ranjan²,

Kulkarni³

et al. 2019

Int Surg J

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INTRODUCTIONBurns constitute the second highest incidence of trauma related deaths globally, second only to vehicular trauma both in developed and developing countries. 1 The most common mechanisms of injuries are scald and flame burns, while Chemical and electrical burns are less prevalent (<10%). 2 Once a patient has been resuscitated, efforts are then made to improve wound healing in order to prevent scarring and contractures as contractures lead to a loss of function, poor cosmetic outcome, and reduced quality of life (QOL), pain and psychological consequences. 3,4 Contracture is abnormal deposition and maturation of collagen, which leads to hampering of function of joint or soft tissue structure and cosmetic disfigurement or both. Individuals with burn injuries are at risk for developing contractures due to multitude of factors. Patients with burns often are immobilized, both globally, as a result of ABSTRACT Background: Burn injuries are one of the commonest form of trauma globally with long term consequences in the form of contractures. The management takes a troll of time, money and stress, despite that the agony remains with the patient only. We intended to study the clinicoepidemiopathological aspects of post burn contractures for a better understanding and management purpose. Methods: This study was conducted from October 2014 to February 2017 in a tertiary care hospital in western India and includes 51 patients. Results: In this study, we observed that the mean age of patients was 21.7 years and females formed 51% of the patient pool. Most of the patients came from a rural background with a mean distance of 77.72 kilometres from the treating hospital. Flame burns contributed to 78% of the cases, with hand (35.7%) being the most commonly involved area, 52.9% patients did not receive splinting or physiotherapy at the initial treatment of burns. Most cases were treated by split skin grafting (64.2%) and the most common complication seen in our study was infection, noted in 15.7% of cases whereas recurrence was seen in only one patient. Conclusions:We observed that young adults were the predominant group of patients with a slight female preponderance. Factors like increased distance from the treating hospital, rural background of patients, poor healthcare facilities with poor rehabilitative facilities and irregular follow up of patients contributed to increased incidence of post burn contractures. We also noted that majority cases can be treated by contracture release with split skin grafting without major complications.

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Post Burn Contracture Neck: Clinical Profile and Management

Cited by 16 publications

References 17 publications

Early debridement with physiotherapy for prevention of postburn contracture of neck: a case series

Early debridement with physiotherapy for prevention of postburn contracture of neck: a case series

The benefits of early surgical treatment of deep cervical burns in children

Clinicoepidemiological study of post burn contractures at a tertiary care centre in western India

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