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Risk factors for burn contractures: A cross-sectional study in a lower income country
,
Patricia Price ,
Owen Bodger ,
Tom Potokar,
Mohammad Rabiul Karim Khan,
RUTHANN FANSTONE,
Tom Potokar
Burns, Volume: 50, Issue: 2, Pages: 454 - 465
Swansea University Authors:
Owen Bodger , RUTHANN FANSTONE, Tom Potokar
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DOI (Published version): 10.1016/j.burns.2023.09.003
Abstract
Risk factors for burn contractures require further study, especially in low and middle-income countries (LMICs); existing research has been predominantly conducted in high income countries (HICs). This study aimed to identify risk factors for burn contractures of major joints in a low-income setting...
| Published in: | Burns |
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| ISSN: | 0305-4179 |
| Published: |
Elsevier BV
2024
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| Online Access: |
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| URI: | https://cronfa.swan.ac.uk/Record/cronfa64577 |
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| Abstract: |
Risk factors for burn contractures require further study, especially in low and middle-income countries (LMICs); existing research has been predominantly conducted in high income countries (HICs). This study aimed to identify risk factors for burn contractures of major joints in a low-income setting. Potential risk factors (n=104) for burn contracture were identified from the literature and a survey of clinicians with extensive experience in low and middle-income countries (LMIC). An observational cross-sectional study of adult burn survivors was undertaken in Bangladesh to evaluate as many of these risk factors as were feasible against contracture presence and severity. Forty-eight potential risk factors were examined in 48 adult patients with 126 major joints at risk (median 3 per participant) at a median of 2.5 years after burn injury. Contractures were present in 77% of participants and 52% of joints overall. Contracture severity was determined by measurement of loss of movement at all joints at risk. Person level risk factors were defined as those that were common to all joints at risk for the participant and only documented once, whilst joint level risk factors were documented for each of the participant’s included joints at risk. Person level risk factors which were significantly correlated with loss of range of movement (ROM) included employment status, full thickness burns, refusal of skin graft, discharged against medical advice, low frequency of follow up and lack of awareness of contracture development. Significant joint level risk factors for loss of ROM included anatomical location, non-grafted burns, and lack of pressure therapy. This study has examined the largest number of potential contracture risk factors in an LMIC setting to date. A key finding was that risk factors for contracture in low-income settings may differ substantially from those seen in high income countries, which has implications for effective prevention strategies in these countries. Better whole person and joint outcome measures are required for accurate determination of risk factors for burn contracture. Recommendations for planning and reporting on future contracture risk factor studies are made. |
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| Item Description: |
In Press |
| Keywords: |
Burn contractures, risk factors, cross-sectional study, Low middle-income countries, Bangladesh |
| College: |
Faculty of Medicine, Health and Life Sciences |
| Funders: |
This research was funded by the National Institute for Health Research (NIHR) (project reference:16.137.110) using UK aid from the UK Government to support global health research. The views expressed in this publication are those of the author(s) and not necessarily those of the NIHR or the UK government. |
| Issue: |
2 |
| Start Page: |
454 |
| End Page: |
465 |