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Author Spotlight: A Multi-Depth Porcine Model for Comprehensive Study of Burn Injuries and Healing Processes
Published on: February 23, 2024
Surgery on burns sequelae in developing countries
O El Ezzi1, M Dolci2, C Dufour1
1Department of Paediatric Surgery, CURCP, University Hospital Centre of the Canton of Vaud (CHUV), Lausanne, Switzerland.
Insights
Surgery effectively treats pediatric burn sequelae in West Africa, but long-term results depend on consistent occupational and physical therapy to prevent recurrence.
Area of Science:
- Pediatric Surgery
- Burn Reconstruction
- Rehabilitation Medicine
Background:
- Burn injuries in children can lead to significant functional impairments due to sequelae like contractures and hypertrophic scarring.
- Effective surgical intervention is crucial for improving mobility and quality of life in pediatric burn survivors.
Purpose of the Study:
- To evaluate the efficacy of surgical treatment and long-term follow-up for children with burn sequelae in West Africa.
- To identify factors influencing the success of surgical interventions and long-term outcomes.
Main Methods:
- Retrospective analysis of 50 pediatric patient files (2002-2011) treated for burn sequelae in Benin and Togo.
- Surgical interventions included skin grafting and Z-plasty for contractures, hypertrophic scars, and hard cords.
- Data collected via a non-governmental organization (NGO) referral system and local pediatrician assessments.
Main Results:
- No immediate surgical complications such as infection or necrosis were reported.
- High recurrence rates observed: 47% hypertrophic scarring, 24% retractions, and 2% hard cords.
- Recurrence was primarily attributed to insufficient occupational therapy and physiotherapy post-surgery.
Conclusions:
- Surgical treatment of pediatric burn sequelae in West Africa is feasible and safe.
- Long-term success mandates consistent and prolonged occupational and physical therapy to prevent recurrence.
- Initiation of local rehabilitation therapy in 2010 aims to improve sustained patient care.
Abstract:
The purpose of this study is to analyze the effectiveness of surgery and follow-up of children operated on for burn sequelae. For many years, we have organized two missions per year to Benin and Togo, one for surgery and one for follow-up. We analyzed the files of children born in Africa and victims of burns from the years 2002 to 2011. Children were referred through a non-governmental organization (NGO) and assessed in Africa by local paediatricians before and after surgery. Treatment consisted in operating on burn sequelae such as contractures, hypertrophic scars and hard cords. Impaired mobility was our only indication for the operation. We kept a database on all patients. Sixty files were reviewed, of which fifty were deemed suitable for analysis. The most common methods of surgery were skin grafting and Z-plasty. There were no complications, such as infection or graft/flap necrosis after immediate surgery. Long-term follow-up revealed a recurrence of hypertrophic scarring (47%), retractions (24%) and hard cords (2%) due to a lack of occupational therapy and physiotherapy treatment. Partnership with an NGO and a local team allows us to treat children with burn injury sequelae in Western Africa. A continued and often long-lasting follow-up by occupational therapists and physiotherapists is highly mandatory in order to guarantee good long-term results. In 2010, we initiated local rehabilitation therapy.
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