title: Functional and subjective assessment of burn contracture release in a mission setting.
abstract: OBJECTIVE
  Burns and subsequent contractures are common in developing nations. Contracture release is performed to treat such patients with functional limitations. The aim of this study is to evaluate post-operative functional and psychosocial outcomes following contracture release in a mission setting.
  
  
  METHODS
  During a surgical mission in Mumbai, India, 39 patients burn contractures underwent surgical release. A total of 31 patients (64% female, mean age 27 years) chose to participate in the study. Patients were scored preoperatively and postoperatively using a SF-36 validated survey and AMA impairment guideline assessment.
  
  
  RESULTS
  Thirty-one patients completed questionnaires pre-operative and 6-weeks post operatively. Twenty-four patients completed a survey 3-months post operatively (77.4%). Among those enrolled, 67% were women with the majority sustaining <20% total body surface area burns (70.7%) but had multiple contractures (80.6%). SF-36 physical component score increased from a mean score of 49.8 preoperatively to 55.6 by 3 months following contracture release (P<0.001). The SF-36 mental component score similarly increased from 38.8 to 51.1 by 3 months (P<0.001). AMA Whole Person Impairment (WPI) scores improved from 40.3% impairment pre-operative to 26.6% at 6-weeks post-operative (P<0.001).
  
  
  CONCLUSIONS
  Patients SF-36 and WPI scores improved following burn contracture release, confirming both functional and psychologic improvement following surgery. During the acute post-operative period, this study suggests that contracture release in a mission setting is of benefit to patients.
authors.affiliation: Division of Plastic Surgery, Brigham and Women's Hospital, Boston, MA 02115, United States; Division of Trauma and Burn Surgery, Brigham and Women's Hospital, Boston, MA 02115, United States. Electronic address: isinha@partners.org.
authors.forename: Indranil
authors.initials: I
authors.lastname: Sinha
authors.affiliation: Department of Ophthalmology, University of Southern California, Los Angeles, CA 90089, United States.
authors.forename: Dagny
authors.initials: D
authors.lastname: Zhu
authors.affiliation: Division of Plastic Surgery, Brigham and Women's Hospital, Boston, MA 02115, United States; Division of Trauma and Burn Surgery, Brigham and Women's Hospital, Boston, MA 02115, United States.
authors.forename: Kristin
authors.initials: K
authors.lastname: Ojomo
authors.affiliation: Division of Plastic Surgery, Massachusetts General Hospital, Boston, MA 02114, United States.
authors.forename: Lisa
authors.initials: L
authors.lastname: Gfrerer
authors.affiliation: Division of Plastic Surgery, Yale University School of Medicine, New Haven, CT 06520, United States.
authors.forename: Rajendra
authors.initials: R
authors.lastname: Sawh-Martinez
authors.affiliation: Division of Plastic Surgery, Yale University School of Medicine, New Haven, CT 06520, United States.
authors.forename: Anup
authors.initials: A
authors.lastname: Patel
authors.affiliation: Clinical Division and Burn Center, San Antonio Military Medical Center, San Antonio, TX 78234, United States.
authors.forename: Rodney K
authors.initials: RK
authors.lastname: Chan
authors.affiliation: Division of Trauma and Critical Care, VA Eastern Colorado Healthcare System, Denver, CO 80220, United States.
authors.forename: James F
authors.initials: JF
authors.lastname: Watkins
mesh_terms: D000293:Adolescent; D000328:Adult; D002056:Burns / Q000150:complications*; D002648:Child; D002675:Child, Preschool; D003286:Contracture / Q000209:etiology / Q000523:psychology / Q000601:surgery*; D005260:Female; D006801:Humans; D007194:India; D008297:Male; D008493:Medical Missions; D020127:Recovery of Function; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult
keywords: Burn reconstruction; Contractors; Surgical missions