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Global perspectives on risk factors for major joint burn contractures: A literature review

RUTHANN FANSTONE, Tricia Price

Burns, Volume: 50, Issue: 3, Pages: 537 - 549

Swansea University Authors: RUTHANN FANSTONE, Tricia Price

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DOI (Published version): 10.1016/j.burns.2023.09.014

Abstract

Contractures are a frequent consequence of burn injuries, yet our knowledge of associated risk factors is limited. This paper provides an extensive review of relevant literature from both High-Income Countries (HICs) and Low-Middle Income Countries (LMICs).Ninety-four papers (up to June 2019) and ei...

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Published in: Burns
ISSN: 0305-4179
Published: Elsevier BV 2024
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URI: https://cronfa.swan.ac.uk/Record/cronfa64643
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spelling v2 64643 2023-10-02 Global perspectives on risk factors for major joint burn contractures: A literature review 6d0cd74a3d65e655ba07907d458863b2 RUTHANN FANSTONE RUTHANN FANSTONE true false 72b4943af96c97ef72977c31b9c29624 Tricia Price Tricia Price true false 2023-10-02 Contractures are a frequent consequence of burn injuries, yet our knowledge of associated risk factors is limited. This paper provides an extensive review of relevant literature from both High-Income Countries (HICs) and Low-Middle Income Countries (LMICs).Ninety-four papers (up to June 2019) and eight subsequent publications (up to March 2022) were included, 76% of which were from HICs. The majority of publications were either descriptive studies (4 from HICs, 9 from LMICs) or papers citing putative risk factors (37 from HICs, 10 from LMICs). Seventeen publications (all from HICs) reported on the effects of individual non-surgical therapeutic interventions, often with conflicting results. Two published systematic reviews emphasised the poor quality of evidence available. Only fifteen studies (3 from LMICs) examined potential contracture risk factors with statistical comparisons of outcomes; significant findings from these included demographic, burn, comorbidities, and treatment risk factors. LMIC papers included socioeconomic and healthcare system factors as potential risks for contracture; these were rarely considered in HIC publications. Methodological issues identified from this review of literature included differences in contracture definitions, populations studied, standards of care, joints included and the timing and nature of contracture assessments.This review is the first to collate existing knowledge on risk factors for burn contractures from both HIC and LMIC settings, revealing a surprising lack of robust evidence for many accepted risk factors. In LMICs, where burns are particularly common, universal health provision is lacking and specialist burn care is both scarce and difficult to access; consequently, socioeconomic factors may have more immediate impact on contracture outcomes than specific burn treatments or therapies. Much more work is required to fully understand the relative impacts of risk factors in different settings so that context-appropriate contracture prevention strategies can be developed. Journal Article Burns 50 3 537 549 Elsevier BV 0305-4179 Burn contractures, Risk factors, Global burn injuries, Literature review 1 4 2024 2024-04-01 10.1016/j.burns.2023.09.014 COLLEGE NANME COLLEGE CODE Swansea University SU Library paid the OA fee (TA Institutional Deal) This research was funded by the National Institute for Health Research (NIHR) (project reference:16.137.110) using UK aid from the UK Government to support global health research. 2024-04-11T12:45:12.4871840 2023-10-02T12:36:31.8428256 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Medicine RUTHANN FANSTONE 1 Tricia Price 2 64643__29991__0eaa7b8b6cb74e8a8ea68b4356f7b321.pdf 64643.VOR.pdf 2024-04-11T12:43:39.2150673 Output 1885834 application/pdf Version of Record true © 2023 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY license. true eng http://creativecommons.org/licenses/by/4.0/
title Global perspectives on risk factors for major joint burn contractures: A literature review
spellingShingle Global perspectives on risk factors for major joint burn contractures: A literature review
RUTHANN FANSTONE
Tricia Price
title_short Global perspectives on risk factors for major joint burn contractures: A literature review
title_full Global perspectives on risk factors for major joint burn contractures: A literature review
title_fullStr Global perspectives on risk factors for major joint burn contractures: A literature review
title_full_unstemmed Global perspectives on risk factors for major joint burn contractures: A literature review
title_sort Global perspectives on risk factors for major joint burn contractures: A literature review
author_id_str_mv 6d0cd74a3d65e655ba07907d458863b2
72b4943af96c97ef72977c31b9c29624
author_id_fullname_str_mv 6d0cd74a3d65e655ba07907d458863b2_***_RUTHANN FANSTONE
72b4943af96c97ef72977c31b9c29624_***_Tricia Price
author RUTHANN FANSTONE
Tricia Price
author2 RUTHANN FANSTONE
Tricia Price
format Journal article
container_title Burns
container_volume 50
container_issue 3
container_start_page 537
publishDate 2024
institution Swansea University
issn 0305-4179
doi_str_mv 10.1016/j.burns.2023.09.014
publisher Elsevier BV
college_str Faculty of Medicine, Health and Life Sciences
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hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Medicine{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Medicine
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description Contractures are a frequent consequence of burn injuries, yet our knowledge of associated risk factors is limited. This paper provides an extensive review of relevant literature from both High-Income Countries (HICs) and Low-Middle Income Countries (LMICs).Ninety-four papers (up to June 2019) and eight subsequent publications (up to March 2022) were included, 76% of which were from HICs. The majority of publications were either descriptive studies (4 from HICs, 9 from LMICs) or papers citing putative risk factors (37 from HICs, 10 from LMICs). Seventeen publications (all from HICs) reported on the effects of individual non-surgical therapeutic interventions, often with conflicting results. Two published systematic reviews emphasised the poor quality of evidence available. Only fifteen studies (3 from LMICs) examined potential contracture risk factors with statistical comparisons of outcomes; significant findings from these included demographic, burn, comorbidities, and treatment risk factors. LMIC papers included socioeconomic and healthcare system factors as potential risks for contracture; these were rarely considered in HIC publications. Methodological issues identified from this review of literature included differences in contracture definitions, populations studied, standards of care, joints included and the timing and nature of contracture assessments.This review is the first to collate existing knowledge on risk factors for burn contractures from both HIC and LMIC settings, revealing a surprising lack of robust evidence for many accepted risk factors. In LMICs, where burns are particularly common, universal health provision is lacking and specialist burn care is both scarce and difficult to access; consequently, socioeconomic factors may have more immediate impact on contracture outcomes than specific burn treatments or therapies. Much more work is required to fully understand the relative impacts of risk factors in different settings so that context-appropriate contracture prevention strategies can be developed.
published_date 2024-04-01T12:45:09Z
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