Treatment delayed is treatment denied: A review of late burn care in patients presenting with post burn contractures to a tertiary hospital

Abstract

Background: The primary care of a burn victim focuses on the resuscitation. The burns wound draws the attention, with interest of the provider as well as the patient waning after the healing of the wound. “Late burn care” is an important part of burns management that, if delayed, results in the formation of contractures. Simple methods suh as early skin grafting, splintage, and physical therapy prevent the development of these debilitating contractures. Despite this, postburns contractures are a common sequelae. Aims and Objectives: The aim of this paper is to identify the lacunae in late primary care, provided to patients presenting to us with postburn contractures. Materials: A review of all patients admitted with postburns contractures from January 2016 to December 2018, was done. Results: A total of 427 patients were admitted in this period out of which 254 responded for the interviews. The epidemiology of postburn contractures has been described. The lacunae in late primary burn care have been identified. Conclusion: Critical contracture areas are areas, which although innocuous in terms of body surface area burnt, have a high propensity to form contractures and require special care. Public health programs, effective in combating diseases like polio and tuberculosis, can also help preventing burn contractures. Spreading awareness about the basic tenets of contracture prevention will drastically reduce the burden of burn contractures.