Outcomes of post burn flexion contracture release under tourniquet versus tumescent technique in children

Muhammad Mustehsan Bashir, Muhammad Sohail, Ahmad Wahab, Umar Iqbal, Rehan Qayyum, Saadia Nosheen Jan

Research output: Contribution to journalArticle

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 languageEnglish (US)
JournalBurns
DOIs
StateAccepted/In press - Jan 1 2018
Externally publishedYes

Fingerprint

Tourniquets
Contracture
Transplants
Postoperative Pain
Pain
Age Distribution
Operative Time
Ambulatory Care Facilities
Burns
Analgesia
Fingers
Analgesics
Hand

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 journalArticle

Bashir, Muhammad Mustehsan ; Sohail, Muhammad ; Wahab, Ahmad ; Iqbal, Umar ; Qayyum, Rehan ; Jan, Saadia Nosheen. / Outcomes of post burn flexion contracture release under tourniquet versus tumescent technique in children. In: Burns. 2018.
@article{859eb2d237834a62945c2aef7146ab4b,
title = "Outcomes of post burn flexion contracture release under tourniquet versus tumescent technique in children",
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.",
keywords = "Burn, Contracture, Hand, Tourniquet, Tumescent",
author = "Bashir, {Muhammad Mustehsan} and Muhammad Sohail and Ahmad Wahab and Umar Iqbal and Rehan Qayyum and Jan, {Saadia Nosheen}",
year = "2018",
month = "1",
day = "1",
doi = "10.1016/j.burns.2017.10.005",
language = "English (US)",
journal = "Burns",
issn = "0305-4179",
publisher = "Elsevier Limited",

}

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 -