Abstract
Objective: To compare the clinical outcomes of release of flexion contractures after burn of the hand in children using tourniquet or tumescent technique in terms of operative time, postoperative pain score, and percentage of graft take. Methods: Patients aged 3 to 12 years who required release of post-burn flexion contractures involving volar aspect of palm and fingers were enrolled from outpatient clinic. Patients were randomized in 1:1 ratio to the use of either tumescent technique or tourniquet during contracture release. Duration of procedure, postoperative pain score, percentage of graft take, and any complications were assessed and analyzed in both groups by a blinded observer. Results: Of the 160 patients randomized in the study (80 in each group), 84 (52.5%) were males. The mean. ±. SD age of participants was 7.84. ±. 3.49 years, with no statistically significant difference in gender and age distribution between the groups. Similarly, there was no statistically significant difference in duration of surgery in both groups. However, there was a statistically significant difference in percentage of graft take at the 14th postoperative day; significantly more graft take was noted in the tumescent group (8.97. ±. 3.7. cm vs. 7.26. ±. 2.6. cm; P = 0.001). Mean analgesia consumed in the tumescent group was significantly less than that of the tourniquet group (6.26. ±. 1.9. mg vs. 9.41. ±. 2.2. mg; P. ≤. 0.001). Similarly, statistically significant difference in the mean FLACC pain score was noted, with remarkably low pain score in the tumescent group. Conclusion: We found that the use of the tumescent technique for the release of flexion contracture resulted in better graft take, lower pain scores, and lesser consumption of analgesic than the use of tourniquet.
| Original language | English (US) |
|---|---|
| Journal | Burns |
| DOIs | |
| State | Accepted/In press - Jan 1 2018 |
| Externally published | Yes |
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Keywords
- Burn
- Contracture
- Hand
- Tourniquet
- Tumescent
ASJC Scopus subject areas
- Surgery
- Emergency Medicine
- Critical Care and Intensive Care Medicine
Cite this
Outcomes of post burn flexion contracture release under tourniquet versus tumescent technique in children. / Bashir, Muhammad Mustehsan; Sohail, Muhammad; Wahab, Ahmad; Iqbal, Umar; Qayyum, Rehan; Jan, Saadia Nosheen.
In: Burns, 01.01.2018.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Outcomes of post burn flexion contracture release under tourniquet versus tumescent technique in children
AU - Bashir, Muhammad Mustehsan
AU - Sohail, Muhammad
AU - Wahab, Ahmad
AU - Iqbal, Umar
AU - Qayyum, Rehan
AU - Jan, Saadia Nosheen
PY - 2018/1/1
Y1 - 2018/1/1
N2 - Objective: To compare the clinical outcomes of release of flexion contractures after burn of the hand in children using tourniquet or tumescent technique in terms of operative time, postoperative pain score, and percentage of graft take. Methods: Patients aged 3 to 12 years who required release of post-burn flexion contractures involving volar aspect of palm and fingers were enrolled from outpatient clinic. Patients were randomized in 1:1 ratio to the use of either tumescent technique or tourniquet during contracture release. Duration of procedure, postoperative pain score, percentage of graft take, and any complications were assessed and analyzed in both groups by a blinded observer. Results: Of the 160 patients randomized in the study (80 in each group), 84 (52.5%) were males. The mean. ±. SD age of participants was 7.84. ±. 3.49 years, with no statistically significant difference in gender and age distribution between the groups. Similarly, there was no statistically significant difference in duration of surgery in both groups. However, there was a statistically significant difference in percentage of graft take at the 14th postoperative day; significantly more graft take was noted in the tumescent group (8.97. ±. 3.7. cm vs. 7.26. ±. 2.6. cm; P = 0.001). Mean analgesia consumed in the tumescent group was significantly less than that of the tourniquet group (6.26. ±. 1.9. mg vs. 9.41. ±. 2.2. mg; P. ≤. 0.001). Similarly, statistically significant difference in the mean FLACC pain score was noted, with remarkably low pain score in the tumescent group. Conclusion: We found that the use of the tumescent technique for the release of flexion contracture resulted in better graft take, lower pain scores, and lesser consumption of analgesic than the use of tourniquet.
AB - Objective: To compare the clinical outcomes of release of flexion contractures after burn of the hand in children using tourniquet or tumescent technique in terms of operative time, postoperative pain score, and percentage of graft take. Methods: Patients aged 3 to 12 years who required release of post-burn flexion contractures involving volar aspect of palm and fingers were enrolled from outpatient clinic. Patients were randomized in 1:1 ratio to the use of either tumescent technique or tourniquet during contracture release. Duration of procedure, postoperative pain score, percentage of graft take, and any complications were assessed and analyzed in both groups by a blinded observer. Results: Of the 160 patients randomized in the study (80 in each group), 84 (52.5%) were males. The mean. ±. SD age of participants was 7.84. ±. 3.49 years, with no statistically significant difference in gender and age distribution between the groups. Similarly, there was no statistically significant difference in duration of surgery in both groups. However, there was a statistically significant difference in percentage of graft take at the 14th postoperative day; significantly more graft take was noted in the tumescent group (8.97. ±. 3.7. cm vs. 7.26. ±. 2.6. cm; P = 0.001). Mean analgesia consumed in the tumescent group was significantly less than that of the tourniquet group (6.26. ±. 1.9. mg vs. 9.41. ±. 2.2. mg; P. ≤. 0.001). Similarly, statistically significant difference in the mean FLACC pain score was noted, with remarkably low pain score in the tumescent group. Conclusion: We found that the use of the tumescent technique for the release of flexion contracture resulted in better graft take, lower pain scores, and lesser consumption of analgesic than the use of tourniquet.
KW - Burn
KW - Contracture
KW - Hand
KW - Tourniquet
KW - Tumescent
UR - http://www.scopus.com/inward/record.url?scp=85042034339&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85042034339&partnerID=8YFLogxK
U2 - 10.1016/j.burns.2017.10.005
DO - 10.1016/j.burns.2017.10.005
M3 - Article
C2 - 29454711
AN - SCOPUS:85042034339
JO - Burns
JF - Burns
SN - 0305-4179
ER -