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Paediatric upper limb contracture release following burn injury
1Division of Plastic Surgery, Department of Surgery, Prince of Wales Hospital, Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, SAR.
Burns : Journal of the International Society for Burn Injuries
|October 12, 2004
Summary
This study evaluated three surgical methods for treating upper limb burn contractures in children. Local flaps and free tissue transfer showed excellent functional outcomes, while Integra artificial skin had mixed results.
Area of Science:
- Pediatric surgery
- Burn reconstruction
- Orthopedic surgery
Background:
- Upper limb burn contractures significantly impair function in children.
- Surgical release is often necessary to restore mobility.
Purpose of the Study:
- To assess functional outcomes of three surgical techniques for pediatric upper limb burn contractures.
- Evaluate local flaps, Integra artificial skin, and micro-vascular free tissue transfer.
Main Methods:
- Retrospective study of 10 pediatric patients with axilla, elbow, and wrist contractures.
- Reconstruction utilized local flaps (n=5), Integra (n=10), or free tissue transfer (n=5).
- Functional improvement was assessed over 6 months to 6 years post-surgery.
Main Results:
- All patients achieved full functional release initially.
- Local flaps and free tissue transfer resulted in good to excellent outcomes.
- Integra showed mixed results, with 6 excellent and 4 poor outcomes.
Conclusions:
- Local flaps and free tissue transfer are effective for upper limb burn contracture release in children.
- Integra artificial skin requires careful post-operative management to prevent recontraction.
- Appropriate technique selection leads to sustained excellent functional results.