Retrospective Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Nov 16, 2021; 9(32): 9741-9751
Published online Nov 16, 2021. doi: 10.12998/wjcc.v9.i32.9741
Effects of early rehabilitation in improvement of paediatric burnt hands function
Ya-Qin Zhou, Jun-Yi Zhou, Gao-Xing Luo, Jiang-Lin Tan
Ya-Qin Zhou, Jun-Yi Zhou, Gao-Xing Luo, Jiang-Lin Tan, Institute of Burn Research, State Key Laboratory of Trauma, Burns and Combined Injuries, Chongqing Key Laboratory for Disease Proteomics, Southwest Hospital, The Third Military Medical University (Army Medical University), Chongqing 400038, China
Author contributions: Zhou YQ and Zhou JY analyzed and interpreted the patient data, they contributed equally to this work; Luo GX performed the systematic rehabilitation treatment; Tan JL performed the rehabilitation program and wrote the manuscript; All authors read and approved the final manuscript.
Supported by the State Key Laboratory of Trauma, Burn and Combined Injury, No. SKL11201802; and Chongqing Basic Research and Frontier Exploration Project, No. cstc2017jcyjAX0242.
Institutional review board statement: This retrospective study was approved by the Ethical Committee in the First Affiliated Hospital of Third Military Medical University. All the patients’ information was kept confidential.
Conflict-of-interest statement: The authors declare that they have no competing interests, and all authors should confirm its accuracy.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jiang-Lin Tan, MD, PhD, Associate Professor, Doctor, Institute of Burn Research, State Key Laboratory of Trauma, Burns and Combined Injuries, Chongqing Key Laboratory for Disease Proteomics, Southwest Hospital, The Third Military Medical University (Army Medical University), No. 30 Gao Tanyan Street, Sha Pingba District, Chongqing 400038, China. jianglintan@aliyun.com
Received: June 3, 2021
Peer-review started: June 3, 2021
First decision: July 5, 2021
Revised: May 26, 2021
Accepted: September 7, 2021
Article in press: September 7, 2021
Published online: November 16, 2021
Processing time: 159 Days and 18.1 Hours
Abstract
BACKGROUND

Hands are one of the most common burn sites in children. Hypertrophic scar contractures in hands after wound healing result in further reductions in their range of motion (ROM), motility, and fine motor activities. Rehabilitation can improve the function of hands. But the optimal time of rehabilitation intervention is still unclear. Therefore, this study was designed to investigate the effects of early rehabilitation management of paediatric burnt hands and to compare the efficacy between early and later rehabilitation intervention.

AIM

To investigate the effects of early rehabilitation management of paediatric burnt hands.

METHODS

A total of 52 children with burnt hands were allocated into the early intervention group (≤ 1 mo from onset) and a late intervention group (> 1 mo from onset) between January 2016 and December 2017. The children received the same rehabilitation programme including skin care, scar massage, passive ROM exercises, active ROM exercises, compression therapy, orthotic devices wearing and game or music therapy. Rehabilitation assessments were performed before and after the rehabilitation treatment.

RESULTS

In the early intervention group, the ROM of the hands was significantly improved after rehabilitation (P = 0.001). But in the late group the effect was not significant statistically (P = 0.142). In the early group, 38.5% of the patients showed significant improvement, while in the late group, 69.2% of the patients showed no significant improvement. The time from onset to posttraumatic rehabilitation (P = 0.0007) and length of hospital stay (P = 0.003) were negatively correlated with the hand function improvement. The length of rehabilitation stay was positively correlated with the hand function improvement (P = 0.005).

CONCLUSION

These findings suggest that early rehabilitation might show better results in terms of ROM.

Keywords: Burns; Children; Rehabilitation; Range of motion; Hand flexion; Hand extension

Core Tip: This is a retrospective study to evaluate the efficacy of early rehabilitation management of paediatric burnt hands. Hands are one of the most common burn sites in children. Hypertrophic scar contractures in hands after wound healing result in further reductions in their range of motion (ROM), motility, and fine motor activities. In order to investigate the situation of hand function in burned children with rehabilitation, we analyzed the demographic and medical information in these burned children and compared the efficacies of early rehabilitation and late rehabilitation for children with hand burns. We found that in the early intervention group, 38.5% of the patients showed significant improvement in the active ROM, while in the late group, 69.2% of the patients showed no significant improvement. Hand function improvement in burned children was negatively correlated with the time from onset to posttraumatic rehabilitation intervention, while the length of rehabilitation stay was positively correlated with the improvement of hand function.