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[Burn-induced contraction cicatrix in children. Review of 79 cases]
A A Sankale-Diouf1, A Wandaogo, H Tekou
1Unité de Chirurgie Pédiatrique, CHU A. Le Dantec, Dakar, Sénégal.
Insights
Pediatric hand burns often result in flexion contractures due to inadequate initial treatment. Surgical interventions like excision with grafting offer the best outcomes for these severe pediatric hand injuries.
Area of Science:
- Pediatric Surgery
- Burn Contracture Management
- Hand Reconstruction
Context:
- Retrospective analysis of 86 pediatric hands (79 children) treated at the University Hospital of Dakar (1971-1995).
- Peak incidence observed in 2-month-old males.
- Fire (flames/embers) identified as the primary cause in 49.5% of cases.
Purpose:
- To evaluate the outcomes of treating post-burn flexion contractures of the hand in children.
- To identify the most effective treatment modalities and influencing factors.
Summary:
- Inadequate initial burn treatment, often occurring at home or in local clinics, leads to severe hand contractures in children.
- Excision with grafting demonstrated superior results for short flexion contractures, while isolated Z-plasty was also successful.
- Key factors influencing treatment outcomes include lesion severity, surgical technique, immobilization, and physiotherapy.
Impact:
- Highlights the need for improved initial burn care to prevent severe sequelae in pediatric patients.
- Provides evidence-based insights into effective surgical strategies for pediatric hand burn contractures.
- Emphasizes the importance of a multidisciplinary approach including physiotherapy and proper immobilization for optimal functional recovery.
Abstract:
Post-burn flexion contractures of the hands are evaluated in this retrospective study concerning eighty-six hands of seventy-nine children in the pediatric surgery unit of the University hospital of Dakar from 1971 to 1995. A peak frequency was found among 2-months-old males. Fire (flames or embers) is the most frequent etiology (49.5%). The initial treatment of these burns is more often inadequate because it is performed in dispensaries (small clinics) or at home and then causes severe sequelae. Among the methods of treatment, excision with graft gives the best results in short flexion contractures. Isolated Z plasty can be used successfully. Our follow-up is short (6 months) but the results are relatively good. Among the factors influencing the results, the seriousness of the lesions, the type of surgical treatment, immobilization and physiotherapy are the most significant.
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