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Burn contracture risk factors and measurement in low-middle income countries: A clinical perspective

RUTHANN FANSTONE, Tricia Price

Burns, Volume: 50, Issue: 2, Pages: 466 - 473

Swansea University Authors: RUTHANN FANSTONE, Tricia Price

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DOI (Published version): 10.1016/j.burns.2023.09.007

Abstract

There is a lack of high-quality published evidence on risk factors for burn contracture formation. The vast majority of research is from High Income Countries (HICs), where many potential risk factors are controlled for by standardised and high-quality healthcare systems. To augment the published li...

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Published in: Burns
ISSN: 0305-4179
Published: Elsevier BV 2024
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URI: https://cronfa.swan.ac.uk/Record/cronfa64578
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first_indexed 2023-09-20T12:58:00Z
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The vast majority of research is from High Income Countries (HICs), where many potential risk factors are controlled for by standardised and high-quality healthcare systems. To augment the published literature, burn care professionals with Low Middle Income Countries (LMICs) experience were interviewed for their opinion on risk factors for burn contracture formation. Participants were also asked for their views on identification and measurement of contracture. Seventeen semi-structured interviews were conducted (13 burn surgeons and 4 therapists). The average length of experience in burn-care was 13 years. Participants represented Ghana, Ethiopia, Malawi, Nigeria, South Africa, Nepal, and India. Participants reported ninety risk factors. Risk factors were later collated according to topic: Non burn individual factors (n=13), Burn injury factors (n=14), Family and community factors (n=9), Treatment factors (n=18), Complications (n=2), Healthcare capacity factors (n=19) and Societal and environmental factors (n=12). The top five most frequently cited risk factors were lack of splinting, lack of physiotherapy, lack of early excision and skin grafting, low socioeconomic status and presence of infection. Although participants had no doubts that they could recognise a contracture, none provided a standardised system of measurement or an operational definition of contracture. Burn care professionals have a wealth of experience and untapped knowledge of risk factors for burn contracture formation in their own population base, but many of the risk factors highlighted by participants have not yet been explored in the literature. 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spelling v2 64578 2023-09-20 Burn contracture risk factors and measurement in low-middle income countries: A clinical perspective 6d0cd74a3d65e655ba07907d458863b2 RUTHANN FANSTONE RUTHANN FANSTONE true false 72b4943af96c97ef72977c31b9c29624 Tricia Price Tricia Price true false 2023-09-20 There is a lack of high-quality published evidence on risk factors for burn contracture formation. The vast majority of research is from High Income Countries (HICs), where many potential risk factors are controlled for by standardised and high-quality healthcare systems. To augment the published literature, burn care professionals with Low Middle Income Countries (LMICs) experience were interviewed for their opinion on risk factors for burn contracture formation. Participants were also asked for their views on identification and measurement of contracture. Seventeen semi-structured interviews were conducted (13 burn surgeons and 4 therapists). The average length of experience in burn-care was 13 years. Participants represented Ghana, Ethiopia, Malawi, Nigeria, South Africa, Nepal, and India. Participants reported ninety risk factors. Risk factors were later collated according to topic: Non burn individual factors (n=13), Burn injury factors (n=14), Family and community factors (n=9), Treatment factors (n=18), Complications (n=2), Healthcare capacity factors (n=19) and Societal and environmental factors (n=12). The top five most frequently cited risk factors were lack of splinting, lack of physiotherapy, lack of early excision and skin grafting, low socioeconomic status and presence of infection. Although participants had no doubts that they could recognise a contracture, none provided a standardised system of measurement or an operational definition of contracture. Burn care professionals have a wealth of experience and untapped knowledge of risk factors for burn contracture formation in their own population base, but many of the risk factors highlighted by participants have not yet been explored in the literature. Variations in clinicians’ diagnosis and measurement of a burn contracture underscores the need for an agreed, standardised, simple and easily reproducible method of diagnosing and classifying burn contractures Journal Article Burns 50 2 466 473 Elsevier BV 0305-4179 Burn injuries, Risk factors, Burn contractures, Low-Middle Income Countries, Clinician, opinion, Contracture measurement 1 3 2024 2024-03-01 10.1016/j.burns.2023.09.007 COLLEGE NANME COLLEGE CODE Swansea University SU Library paid the OA fee (TA Institutional Deal) 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. 2024-04-16T16:02:33.4678233 2023-09-20T13:54:37.8138065 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Medicine RUTHANN FANSTONE 1 Tricia Price 2 64578__30009__379718c28d404614af08904c08c21850.pdf 64578.VOR.pdf 2024-04-12T13:54:10.6110095 Output 593036 application/pdf Version of Record true Crown Copyright © 2023 Published by Elsevier Ltd. This is an open access article under the CC BY license. true eng https://creativecommons.org/licenses/by/4.0/
title Burn contracture risk factors and measurement in low-middle income countries: A clinical perspective
spellingShingle Burn contracture risk factors and measurement in low-middle income countries: A clinical perspective
RUTHANN FANSTONE
Tricia Price
title_short Burn contracture risk factors and measurement in low-middle income countries: A clinical perspective
title_full Burn contracture risk factors and measurement in low-middle income countries: A clinical perspective
title_fullStr Burn contracture risk factors and measurement in low-middle income countries: A clinical perspective
title_full_unstemmed Burn contracture risk factors and measurement in low-middle income countries: A clinical perspective
title_sort Burn contracture risk factors and measurement in low-middle income countries: A clinical perspective
author_id_str_mv 6d0cd74a3d65e655ba07907d458863b2
72b4943af96c97ef72977c31b9c29624
author_id_fullname_str_mv 6d0cd74a3d65e655ba07907d458863b2_***_RUTHANN FANSTONE
72b4943af96c97ef72977c31b9c29624_***_Tricia Price
author RUTHANN FANSTONE
Tricia Price
author2 RUTHANN FANSTONE
Tricia Price
format Journal article
container_title Burns
container_volume 50
container_issue 2
container_start_page 466
publishDate 2024
institution Swansea University
issn 0305-4179
doi_str_mv 10.1016/j.burns.2023.09.007
publisher Elsevier BV
college_str Faculty of Medicine, Health and Life Sciences
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hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Medicine{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Medicine
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description There is a lack of high-quality published evidence on risk factors for burn contracture formation. The vast majority of research is from High Income Countries (HICs), where many potential risk factors are controlled for by standardised and high-quality healthcare systems. To augment the published literature, burn care professionals with Low Middle Income Countries (LMICs) experience were interviewed for their opinion on risk factors for burn contracture formation. Participants were also asked for their views on identification and measurement of contracture. Seventeen semi-structured interviews were conducted (13 burn surgeons and 4 therapists). The average length of experience in burn-care was 13 years. Participants represented Ghana, Ethiopia, Malawi, Nigeria, South Africa, Nepal, and India. Participants reported ninety risk factors. Risk factors were later collated according to topic: Non burn individual factors (n=13), Burn injury factors (n=14), Family and community factors (n=9), Treatment factors (n=18), Complications (n=2), Healthcare capacity factors (n=19) and Societal and environmental factors (n=12). The top five most frequently cited risk factors were lack of splinting, lack of physiotherapy, lack of early excision and skin grafting, low socioeconomic status and presence of infection. Although participants had no doubts that they could recognise a contracture, none provided a standardised system of measurement or an operational definition of contracture. Burn care professionals have a wealth of experience and untapped knowledge of risk factors for burn contracture formation in their own population base, but many of the risk factors highlighted by participants have not yet been explored in the literature. Variations in clinicians’ diagnosis and measurement of a burn contracture underscores the need for an agreed, standardised, simple and easily reproducible method of diagnosing and classifying burn contractures
published_date 2024-03-01T16:02:29Z
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