RESUMEN
Background: Treating burn scar contractures remains challenging for reconstructive surgeons; no clear guidelines declare the optimal and most effective technique. We evaluated the efficacy of local flaps in treating patients with post-burn contractures. Methods: This retrospective study included 243 patients with post-burn contractures referred to Taleghani Hospital (Khuzestan, southwest Iran) for local flap reconstruction from 2011 to 2020. Patients' demographic data, detailed descriptions of scars, surgical procedures, and flap outcomes were assessed. A plastic surgeon conducted all surgical procedures, the goals of which were to release the scar and cover the defect. Joint range of motion (ROM) (according to goniometric measurements), complications, need for second-stage surgery, and patient satisfaction were assessed. Results: After scar release, 70.4% of joints were covered with a Z-plasty and similar local flaps, 26.1% with a Z-plasty plus skin grafts, and 3.5% with only skin grafts. The outcome after one year revealed a significant improvement in mean ROM (by 45.80% of the normal ROM; P< 0.001). The mean functional and aesthetic satisfaction scores were 9.45 and 7.61 out of 10, respectively. The complication rate was 10.82%: re-contracture occurred in 3.82%, flap tip necrosis in 1.27%, and partial flap necrosis in 0.31%. Conclusion: Simple local flaps such as the Z-plasty are safe and effective in covering the joint following post-burn contracture release. Due to the feasibility, minimal need for facilities, steep learning curve, acceptable functional and aesthetic outcomes, and low complication rate, we strongly recommend the Z-plasty for reconstructing burn contractures, particularly in LMICs.
RESUMEN
Background: Burns is one of the most important causes of death, and the best way to reduce mortality due to burns is prevention. Aims: To investigate the factors responsible for mortality due to burns in south-western Islamic Republic of Iran. Methods: This was a cross-sectional study of 400 burns patients admitted to different wards of Ayatollah Taleghani Trauma and Burns Hospital, Ahvaz, Islamic Republic of Iran, from October 2020 to September 2021. Logistic regression was used to determine the factors responsible for mortality. Results: The mean age of the patients was 28.47 (19.09) years, and 252 (63.0%) patients were male. There were 257 survivors and 143 deaths (35.75% mortality rate). The multiple logistic regression model showed that age, sex, percentage of total body surface area, burn depth, length of hospital stay, and length of intensive care unit stay were significantly associated with deaths due to burns. Conclusion: The mortality rate due to burns was high at the Ayatollah Taleghani Trauma and Burns Hospital, Islamic Republic of Iran. Improving the quality of care provided to burns patients at health facilities can help reduce the current high mortality rate.