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Published on: November 6, 2018
Statistical analysis of factors affecting re-operative times in paediatric patients with scar deformity after deep
Baoguo Chen1, Xiaotong Yue1, Ruijuan Zhang1
1Plastic and Reconstructive Surgery, The First Hospital Affiliated to the People's Literative Army Hospital, Beijing, China.
Insights
Scar size and specific surgical methods significantly impact re-operation frequency in pediatric burn patients. Understanding these factors can help reduce the need for multiple surgeries in treating scar deformities.
Area of Science:
- Plastic Surgery
- Pediatric Burn Care
- Scar Management
Background:
- Deep second-degree burns in children can lead to challenging scar deformities requiring multiple surgical interventions.
- Factors influencing the number of re-operations for pediatric burn scar deformities are not well-documented in existing literature.
Purpose of the Study:
- To identify key factors contributing to the frequency of re-operative times in pediatric patients with scar deformities resulting from deep second-degree burns.
- To analyze the influence of various clinical and surgical parameters on re-operation rates.
Main Methods:
- A retrospective study of 177 pediatric patients (ages 0-18) who underwent one or more re-operations for burn scar deformities between 2010 and 2016.
- Statistical analysis using one-way ANOVA, multi-way ANOVA, and multivariate logistic regression to evaluate factors like scar size, gender, reconstruction method, and location.
- Key factors analyzed included age, gender, scar size, reconstruction method, anatomical location, postoperative treatment, and combined deformities/methods.
Main Results:
- Scar size (P=0.000), operation method (P=0.001), and combined deformity (P=0.026) were statistically significant factors influencing re-operative times via one-way ANOVA.
- Operation methods for head/neck and lower extremities were critical factors in multi-factor variance analysis.
- Multivariate logistic regression identified scar size as an independent risk factor and combined operative method as a protective factor for the number of operations.
Conclusions:
- Scar size and specific surgical approaches, particularly for head/neck and lower extremities, are significant determinants of re-operative times in pediatric burn scar management.
- Utilizing combined operative methods can be protective, potentially reducing the number of necessary re-operations.
- Further research and tailored surgical strategies focusing on these identified risk factors can optimize treatment outcomes and minimize repeat surgeries.
Abstract:
Deep second-degree burn injuries pose a challenge for treating scar deformity in developing paediatric patients. Some patients underwent several re-operations during their development. There was no literature reporting which factors affect re-operative times. In this article, we intend to analyse possible influential factors that are responsible for re-operative times in paediatric patients with scar deformity after deep second-degree burn injuries. From 2010 to 2016, 177 paediatric cases with a history of deep second-degree burn injury who underwent re-operation once, twice, and equal to or more than thrice were recruited to this study, with age ranging from 0 to 18 years. The following factors were analysed: age, gender, size of scar, method for reconstruction, location, postoperative anti-scar treatment, preschool group, school group, combined deformity, and combined method for reconstruction. One-way ANOVA and multi-way ANOVA analysis were used as statistical tools to analyse the above factors and re-operative times. There were 83 male cases and 94 female cases, with an average age of 7.47 years. Statistical significance was achieved for the size of scar (P = 0.000), operation method (P = 0.001), and combined deformity (P = 0.026) under 1-way ANOVA in different re-operative times. The operation methods for the head and neck area (P < 0.05) and the lower extremities (P < 0.05) are critical factors for multi-factor variance analysis in different re-operative times. Multivariate logistic regression analysis also demonstrated that the size of scar was an independent risk factor for the number of operations. Combined operative method was a protective risk factor for the number of operations. There was no statistical significance obtained for other factors. Size of scar, operation method, and combined operation method are the risk factors for re-operative times, while operation methods for the head and neck area and lower extremities are the critical factors for re-operative times. We can use the combined method to resolve scar-related problems in order to reduce re-operative times.
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