Investigating the effects of surgical access time on scar quality and function in pediatric upper-extremity burn contractures in a rural area

Abstract

Background: Burn contractures are a common complication in the pediatric population, leading to significant functional limitations and decreased quality of life. This study aimed to investigate the impact of surgical access time on burn contracture outcomes in pediatric patients, particularly wound quality and hand function. Materials and Methods: This retrospective study included 27 pediatric patients with upper-extremity burn contractures between November 2022 and August 2023. Patients with underlying medical conditions or medications were excluded from this study. A variety of surgical procedures were performed, and complications, follow-up times, access times, and postoperative evaluations were assessed. Contracture locations were divided into four groups: axilla (Group I), elbow (Group II), wrist (Group III), and fingers (Group IV). Access time was defined as the time from symptom onset to first surgical intervention. Results: Among the 27 patients with pediatric burn contractures, Group II had significantly longer access times than the other groups (P < 0.05). This delayed access was associated with lower Patient and Observer Scar Assessment Scale (POSAS) and Michigan Hand Outcome Questionnaire (MHQ) scores in Group II (P < 0.05), indicating worse wound quality and hand function in Group II. Correlation analysis in Group II revealed a significant negative correlation between access time and POSAS (−0.8, P = 0.036) and MHQ scores (r = −0.43, P = 0.039). The changes in Groups I, III, and IV are statistically significant in terms of range of motion (P < 0.05). Conclusion: This study suggests that access time is an important factor for pediatric burn contractures. Early surgical intervention has been associated with improved wound quality and hand function.