Risk factors for burn contractures: A cross-sectional study in a lower income country

Fanstone, RuthAnn; Price, Patricia; Bodger, Owen; Potokar, Tom; Khan, Mohammad Rabiul Karim

doi:10.1016/j.burns.2023.09.003

Cited by 2 publications

(12 citation statements)

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“…Studies exploring contracture risk factors in LMICs are few, 11 but review of the available literature indicates that contracture outcomes are not only related to biomedical or treatment factors, but also to socio-economic and health system factors, which are not routinely considered in HIC literature. 22 – 25 The authors recently conducted a cross-sectional study in Bangladesh to analyse the effect of 48 potential risk factors on major joint contracture outcomes; 22 contractures were defined as any loss of measured ROM as a result of scarring in at least one plane of movement of any major joint at risk. In that population, anatomical joint location, socio-economic factors and health system factors were significantly related to contracture occurrence and/or severity, while other accepted biomedical risk factors were not ( Table 1 ).…”

Section: Introductionmentioning

confidence: 99%

“…In that population, anatomical joint location, socio-economic factors and health system factors were significantly related to contracture occurrence and/or severity, while other accepted biomedical risk factors were not ( Table 1 ). 22 …”

Section: Introductionmentioning

confidence: 99%

“…This article presents the details of four participants from a previous study in Bangladesh, 22 to illustrate how contracture outcomes can vary in patients with similar burns, highlighting those non-burn and non-medical risk factors which likely affected the outcomes.…”

Section: Introductionmentioning

confidence: 99%

“…The original cross-sectional study was conducted at Dhaka Medical College Hospital (DMCH) and the Sheikh Hasina National Institute for Burn and Plastic Surgery (SHNIBPS) in Bangladesh in late 2019. 22 Risk factor data were collected on 48 participants with 126 major joints at risk through semi-structured interviews using interpreters. Eligibility criteria and recruitment for the study are explained in more detail elsewhere.…”

Section: Introductionmentioning

confidence: 99%

“…Data presented for all four reported cases were extracted from the same database used to complete quantitative analysis for the cross-sectional study. 22 …”

Section: Introductionmentioning

confidence: 99%

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Risk factors for burn contractures in a lower income country: Four illustrative cases

Fanstone,

Khan

2024

Scars, Burns & Healing

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Introduction Burns are most prevalent in low- and middle-income countries but the risk factors for burn contractures in these settings are poorly understood. There is some evidence from low- and middle-income country studies to suggest that non-medical factors such as socio-economic and health system issues may be as, or possibly more, important than biomedical factors in the development of post-burn contractures. Methods Four cases are presented to illustrate the impact of non-biomedical factors on contracture outcomes in a low-income setting. The cases were drawn from participants in a cross-sectional study which examined risk factors for contracture in Bangladesh. Discussion The two cases had similar burns but different standards of care for socio-economic reasons, leading to very different contracture outcomes The two cases both had access to specialist care but had very different contracture outcomes for non-medical reasons. The risk factors and contracture outcomes in each case are documented and compared. Conclusion The impact of non-biomedical factors in contracture development after burns in low- and middle-income countries is highlighted and discussed. Lay Summary Burns are common in low- and middle-income countries (LMICs) but the risk factors for burn contractures in these settings are poorly understood. Burn contractures are formed when scarring from a burn injury is near or over a joint and results in limited movement. There is some evidence from LMIC studies which suggests that non-medical factors such as socio-economic (e.g., household income, level of education) and health system issues (e.g., whether specialist burn care could be accessed) may be as, or possibly more, important than non-medical factors (such as the type and depth of burn and the treatments received) in the development of contractures following burn injuries. Four cases are presented to illustrate the impact of non-biomedical factors on contracture outcomes in a low-income setting. The cases were drawn from participants in a larger study which examined risk factors for contracture in Bangladesh. Two cases had similar burns but different standards of care and different outcomes. Two cases had similar access to specialist care but very different outcomes for non-medical reasons. The risk factors present and contractures outcomes in each case are documented and compared. The importance of non-biomedical factors in contracture development after burns in LMICs is highlighted and discussed.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Data presented for all four reported cases were extracted from the same database used to complete quantitative analysis for the cross-sectional study. 22 …”

Section: Introductionmentioning

confidence: 99%

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