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Post-Burn Contracture

Kenji Hayashida, Sadanori Akita
Burn contractures produce restrictions in motion and unacceptable aesthetic results, frequently with persistent wounds. Proper planning and tissue selection are essential to minimize donor site morbidity optimizing outcomes. The principle of burn reconstructive surgery requires that the defects after release should be replaced with donor tissues which have matching texture and color as well as enough pliability. Autologous skin grafting or flap surgeries meet these criteria to replace scar tissues and resurface the subsequent to post-released scar defects...
2017: Burns and trauma
H Ismail, A Elshobaky
Anterior cervical contractures of the neck represent a great challenge for plastic and reconstructive surgeons. Necks can be reconstructed with a wide range of surgical techniques, including chimeric flaps, supercharged flap, pre-expanded flaps, "superthin" flaps and perforator flaps. The supraclavicular flap is easy to harvest without the need for free tissue transfer. It provides a relatively large flap for neck resurfacing with tissue very similar to that of the neck. Between January 2013 and March 2015, 20 patients suffering from postburn neck contracture underwent reconstruction with 20 unilateral supraclavicular artery perforator flaps...
September 30, 2016: Annals of Burns and Fire Disasters
Yuanbo Liu, Qiang Ding, Mengqing Zang, Shengji Yu, Shan Zhu, Bo Chen, Jianhua Zhang
BACKGROUND: The lateral circumflex femoral artery system with its anatomical variations is a common source vessel for numerous thigh flaps. However, the anatomic variations of the distally based thigh flaps have not been well classified. METHODS: Between July 2008 and July 2016, 19 patients (13 men and 6 women; age range, 3-58 years; mean, 27.5 years) underwent reconstruction of defects around the knee using distally based thigh flaps. Defect etiologies included malignant neoplasm (6 cases) and post-burn scar contracture (13 cases)...
May 2017: Annals of Plastic Surgery
Q Liu, X B You, Z Cai, K Y Tang, H Zhang
Objective: To investigate the method and timing of reconstruction of anal stenosis induced by scar contracture after repair of defect in perineal region with paraumbilical flap using random pattern flap. Methods: Ten patients who suffered anal stenosis induced by scar contracture after the first phase repair of defect of perineal region with paraumbilical flap were hospitalized from July 2009 to September 2015. Eight patients were with central type scar contracture of perineal region after healing of burn wound, and two patients were with lesion of perineal region which had been excised...
November 20, 2016: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
H A Ismail, L E El-Bassiony
We evaluate function outcomes of the reverse-flow ALT perforator flap to reconstruct severe post-burn knee contracture. Between October 2012 and December 2014, 10 patients with severe post-burn knee contracture were subjected to reconstruction with 10 ipsilateral reversed-flow ALT perforator flaps. All the patients were male. Ages ranged from 15 to 47 years (mean = 32 years). Time from burn injury to patient presentation ranged from 2-8 months. All patients demonstrated post-burn flexion contracture of the knee joint, ranging from 35 to 75 degrees...
March 31, 2016: Annals of Burns and Fire Disasters
I Tocco-Tussardi, B Presman, M Cherubino, C Garusi, F Bassetto
Post-burn contractures account for up to 50% of the workload of a plastic surgery team volunteering in developing nations. Best possible outcome most likely requires extensive surgery. However, extensive approaches such as microsurgery are generally discouraged in these settings. We report two successful cases of severe hand contractures reconstructed with free flaps on a surgical mission in Kenya. Microsurgery can be safely performed in the humanitarian setting by an integration of: personal skills; technical means; education of local personnel; follow-up services; and an effective network for communication...
March 31, 2016: Annals of Burns and Fire Disasters
Durga Karki, Nikhil Mehta, Ravi Prakash Narayan
BACKGROUND: Post-burn axillary and elbow scar contracture is a challenging problem to the reconstructive surgeon owing to the wide range of abduction and extension that should be achieved, respectively, while treating either of the joint. The aim of this paper is to highlight the use of subcutaneous pedicle propeller flap for the management of post-burn axillary and elbow contractures. METHODOLOGY: This is a prospective case study of axillary and elbow contractures managed at a tertiary care hospital using propeller flap based on subcutaneous pedicle from 2009 to 2014...
May 2016: Indian Journal of Plastic Surgery: Official Publication of the Association of Plastic Surgeons of India
Qazi Ehsan Ali, Obaid Ahmed Siddiqui, Syed Hussain Amir, Sarfaraz Ahmad, Shaista Jamil
BACKGROUND AND OBJECTIVES: Managing the airway of post burn contracture of the neck has always been challenging to anesthesiologists as it limits the alignment of oro-pharyngo-laryngeal axes because of functional and anatomical deformities that occur as a result of long standing contractures. Here the role of the King Vision video laryngoscope which is the latest in the series of video laryngoscope has been evaluated for such patients. CASE REPORT: A 35 year old male patient with post burn contracture of neck was scheduled for release of the contracture...
September 20, 2016: Revista Brasileira de Anestesiologia
Kathryn Isaac, Nisha Umraw, Robert Cartotto
Prominent scars and contractures may form along the seams between adjacent skin grafts. Seams may be constructed either by approximating the graft edges (AP), or by slightly overlapping the graft edges (OV), but it is not known if one technique creates a less conspicuous seam scar. The purpose of this study was to compare seam scars between seams constructed using the AP and OV techniques. This was a prospective within-patient and within-seam controlled study in adult burn patients treated at an American Burn Association-verified burn center...
August 25, 2016: Journal of Burn Care & Research: Official Publication of the American Burn Association
Anders H Carlsson, Lloyd F Rose, John L Fletcher, Jesse C Wu, Kai P Leung, Rodney K Chan
Current standard of care for full-thickness burn is excision followed by autologous split-thickness skin graft placement. Skin grafts are also frequently used to cover surgical wounds not amenable to linear closure. While all grafts have potential to contract, clinical observation suggests that antecedent thermal injury worsens contraction and impairs functional and aesthetic outcomes. This study evaluates the impact of antecedent full-thickness burn on split-thickness skin graft scar outcomes and the potential mediating factors...
February 2017: Burns: Journal of the International Society for Burn Injuries
Nicola A Clayton, Elizabeth C Ward, Peter K Maitz
BACKGROUND: Dysphagia following severe burns can be significant and protracted, yet there is little evidence describing the rehabilitation principles, process or outcomes. PURPOSE: Outline current evidence and detail the clinical outcomes of two cases who underwent a multifaceted intensive treatment programme aimed at rehabilitating dysphagia by strengthening swallow function and minimising orofacial contractures after severe head and neck burns. METHODS: Two men (54 and 18 years) with full-thickness head and neck burns and inhalation injury underwent intensive orofacial scar management and dysphagia rehabilitation...
February 2017: Burns: Journal of the International Society for Burn Injuries
Nanze Yu, Xiao Long
No abstract text is available yet for this article.
February 2017: Annals of Plastic Surgery
S V Soumya, S S Daniel, K G Ashish, K Santosh
AIM: To prevent cicatrical scar formation of the oral commissure post commissuroplasty. METHOD: Bilateral commisuroplasty followed by tooth borne static orthosis and then after dynamic orthosis for a period of one year. CONCLUSION: The use of both static and dynamic orthosis in appropriate sequence resulted in good scar outcome.
June 2016: Journal of Maxillofacial and Oral Surgery
U Mirastschijski, J T Sander, U Zier, H O Rennekampff, B Weyand, P M Vogt
Deep burns lead to scarring and contractures for which there is little or no published data on treatment costs. The purpose of this study was to fill this gap by analysing treatment costs for burn sequelae. To do this, German-DRG for in-patient treatment was collected from the Burn Centre Lower Saxony. DRG-related T95.-coding served as a tool for burn-associated sequelae. Data on scar occurrence, plastic-reconstructive surgery and sick leave were collected by a questionnaire. The findings showed that 44.6% patients reported post-burn scarring and 31% needed surgical intervention...
September 30, 2015: Annals of Burns and Fire Disasters
Z Buja, H Arifi, E Hoxha, S Duqi
Burn injuries are very frequent in Kosovo, leading to long-lasting physical, functional, aesthetic, psychological and social consequences directly proportional to the time of healing; the longer it takes for the burn wound to heal, the more serious are the sequelae. The objectives of the present study are to review the epidemiological, clinical and therapeutic aspects of burn patients presenting with post-burn sequelae and treated at the Department of Plastic and Reconstructive Surgery, Pristina, Kosovo, from January 2005 until December 2011...
September 30, 2015: Annals of Burns and Fire Disasters
Chunmei Wang, Junyi Zhang, Sifen Yang, Hiko Hyakusoku, Ping Song, Lee L Q Pu
OBJECTIVE: Based on our previous animal study, we applied the "bridging effect" to the neighboring axial flap through preexpansion and prefabrication of a skin perforator flap as a new method to reconstruct a large skin defect after release of severe neck burn scar contracture. METHODS: Twelve patients suffering from severe post-burn cervical contractures underwent reconstruction of large skin defects after surgical release of severe scar contractures with preexpanded and prefabricated super-thin skin perforator flaps supplied primarily by a number of perforators via the "bridging effect" from the branches of the adjacent arteries as 2-stage procedures...
February 2016: Annals of Plastic Surgery
Ahmed M Afifi, Tarek A Mahboub, Amr Ibrahim Fouad, Kodi Azari, Haitham H Khalil, James E McCarthy
This works aim is to evaluate the efficacy of skin grafts and flaps in reconstruction of post-burn hand and wrist deformities. A prospective study of 57 burn contractures of the wrist and dorsum of the hand was performed. Flaps were used only if there was a non-vascularized structure after contracture release, otherwise a skin graft was used. Active range of motion (ROM) was used to assess hand function. The extension deformity cohort uniformly underwent skin graft following contracture release with a mean improvement of 71 degrees (p<0...
June 2016: Burns: Journal of the International Society for Burn Injuries
Sheng-Sung Chen
Burn injuries nearly always occur by accident. Burn injuries that cover large areas of the body typically cause hypertrophic scarring and joint contractures that affect the ability of the burn patient to handle normal activities of daily living. Occupational therapists begin the related interventions as early as possible, and patients require rehabilitation continuously until scar maturation. The present article provides an overview of the approach that occupational therapists should take in treating burn patients...
February 2016: Hu Li za Zhi the Journal of Nursing
Yu-Hsun Lin, Hsiu-Hua Lin, Li-Ping Shi, Eng-Kean Yeong
Major burn injuries constitute a systemic disease. In addition to completely understanding the mechanisms of wound healing, precise burn depth and area assessment is critical to the successful management of burn injuries. The recent advancements in post-burn fluid resuscitation, tangential burn excision and grafting, effective enteral tube feeding, and aggressive sepsis treatment have helped greatly increase the survival rates for major burn injuries. However, the restricted joint motion that results from hypertrophic scar contracture remains the main challenge facing burn survivors...
February 2016: Hu Li za Zhi the Journal of Nursing
Rajeev B Ahuja, Amit M Mulay, Aarti Ahuja
INTRODUCTION: The Burn Specific Health Scale-Brief (BSHS-B) is a popular instrument to measure quality of life (QoL) in burn patients. The current study aims at identifying the prognostic variables for our burn population using the BSHS-RBA (revised, brief and adapted) scale. MATERIALS AND METHODS: The study was conducted on 60 post-burn patients using the BSHS-RBA scale. The questionnaire was administered by an interview as majority of patients were illiterate...
May 2016: Burns: Journal of the International Society for Burn Injuries
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