The treatment of post-burn scars and contractures at the locomotorum

Abstract

Introduction. Historically, survival was the only gauge of success in managing those with serious burns. Survival is no doubt the immediate concern; it is the restoration to pre-injury status, and social return becomes important for the victim and the treating team. An extensive burn is the most devastating injury a person can sustain and yet hope to survive. More recently, the overriding objective of all aspects of burn care has become the reintegration of the patient into his or her home and community. This objective has extended the traditional role of the burn care team to well beyond completion of acute wound closure. The 3 broad aspects of this effort are rehabilitation, reconstruction, and reintegration. Materials and methods. Different principles of the surgical treatment were implemented in the practical activity thorough various plastic methods. The research includes a lot consisting of 386 patients with post-burn sequels in the locomotors system. Patients were divided into 3 groups according to the location of their lesions: upper limb and axillary region (n=192); trunk and neck (n=88); lower limb and perineum (n=106). Results. Various surgical procedures were applied: Excision and plasty through advancement-53 (13,7%) cases; Excision and plasty with expanded flaps-102 (26,4%) cases; Incision or scar excision and grafting-93 (24,1%) cases; Excision and plasty by rearrangement-89 (23,1%) cases; Excision and combined plasty-32 (8,3%)cases; Vascularized flap plasty method-17 (5,9%)cases. Conclusion. According to our data scarring sequelae of post-combustion limited locomotor function in 56,3% cases, involving predominately the upper limbs (48,3%). Data from the study show that the post-combustion surgical rehabilitation of scarring sequelae of locomotor medical biological process is difficult, with gradual improvement in 47,9 % of cases. Surgical treatment has ensured both the functional and aesthetic recovery.