4
|
Parry IS, Schneider JC, Yelvington M, Sharp P, Serghiou M, Ryan CM, Richardson E, Pontius K, Niszczak J, McMahon M, MacDonald LE, Lorello D, Kehrer CK, Godleski M, Forbes L, Duch S, Crump D, Chouinard A, Calva V, Bills S, Benavides L, Acharya HJ, De Oliveira A, Boruff J, Nedelec B. Systematic Review and Expert Consensus on the Use of Orthoses (Splints and Casts) with Adults and Children after Burn Injury to Determine Practice Guidelines. J Burn Care Res 2021; 41:503-534. [PMID: 31504622 DOI: 10.1093/jbcr/irz150] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
The objective of this review was to systematically evaluate the available literature addressing the use of orthoses (splints and casts) with adult and pediatric burn survivors and determine whether practice guidelines could be proposed. This review provides evidence-based recommendations specifically for rehabilitation professionals who are responsible for burn survivor rehabilitation. A summary recommendation was made after the literature was retrieved using a systematic review and critical appraisal by multiple authors. The level of evidence of the literature was determined in accordance with the Oxford Centre for Evidence-based Medicine criteria. Due to the low level of evidence in the available literature, only one practice guideline could be recommended: orthotic use should be considered as a treatment choice for improving range of motion or reducing contracture in adults who have sustained a burn injury. To address the rehabilitation-specific gaps found in the literature regarding orthotic use in burn rehabilitation and provide guidance to clinicians, a formal expert consensus exercise was conducted as a final step to the project. The resultant manuscript provides a summary of the literature regarding orthotic use with burn patients, one practice guideline, proposed orthotic terminology and additional practice recommendations based on expert opinion. The limitations in the current literature are also discussed, and suggestions are made for future studies in the area of orthotic use after burn injury.
Collapse
Affiliation(s)
- Ingrid S Parry
- From the Shriners Hospital for Children, Northern California, University of California-Davis, Sacramento
| | - Jeffrey C Schneider
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, Massachusetts
| | | | - Patricia Sharp
- Cincinnati Children's Hospital, University of Cincinnati College of Allied Health Sciences Program in Occupational Therapy, Ohio
| | - Michael Serghiou
- Bio Med Sciences Inc., Allentown, Pennsylvania Shriners Hospitals for Children Boston, Massachusetts
| | - Colleen M Ryan
- Sumner Redstone Burn Center, Surgical Services, Massachusetts General Hospital, Harvard Medical School, Boston
| | | | | | - Jonathan Niszczak
- Bio Med Sciences Inc., Allentown, Pennsylvania Shriners Hospitals for Children Boston, Massachusetts.,Thomas Jefferson University Burn Center, Philadelphia, Pennsylvania.,Bio Med Sciences, Inc. Allentown, Pennsylvania
| | - Margaret McMahon
- Our Lady's Hopsice and Care Services, Harold's Cross, Dublin, Ireland
| | | | - David Lorello
- The Arizona Burn Center at Maricopa Medical Center, Phoenix
| | | | - Matthew Godleski
- Department of Physical Medicine and Rehabilitation, Ross Tilley Burn Centre, St. John's Rehab, University of Toronto, Ontario, Canada
| | - Lisa Forbes
- Health Sciences Centre, Winnipeg, Manitoba, Canada
| | - Sarah Duch
- Westchester Medical Center, Valhalla, New York
| | - Donna Crump
- Parkland Health and Hospital System, PMR Department, Dallas, Texas
| | - Annick Chouinard
- Hôpital de réadaptation Villa Medica, Montreal, Quebec, Canada.,CHU Sainte-Justine, Montreal, Quebec, Canada
| | - Valerie Calva
- Hôpital de réadaptation Villa Medica, Montreal, Quebec, Canada
| | - Sara Bills
- Madonna Rehabilitation Hospitals, Lincoln, Nebraska University of Nebraska Medical Center, Omaha
| | | | - Hernish J Acharya
- Division of Physical Medicine and Rehabilitation, Department of Medicine, University of Alberta, Edmonton, Canada
| | - Ana De Oliveira
- Centre de recherche du Centre Hospitalier de l'Université de Montréal (CHUM), Quebec, Canada
| | - Jill Boruff
- School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada
| | - Bernadette Nedelec
- Hôpital de réadaptation Villa Medica, Montreal, Quebec, Canada.,Centre de recherche du Centre Hospitalier de l'Université de Montréal (CHUM), Quebec, Canada.,School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada
| |
Collapse
|
5
|
Visscher DO, Te Slaa S, Jaspers ME, van de Hulsbeek M, Borst J, Wolff J, Forouzanfar T, van Zuijlen PP. 3D printing of patient-specific neck splints for the treatment of post-burn neck contractures. Burns Trauma 2018; 6:15. [PMID: 29930950 PMCID: PMC5994077 DOI: 10.1186/s41038-018-0116-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/26/2017] [Accepted: 04/25/2018] [Indexed: 11/26/2022]
Affiliation(s)
- Dafydd O Visscher
- 1Department of Plastic, Reconstructive and Hand Surgery, Amsterdam Movement Sciences, VU University Medical Center, de Boelelaan 1117, 1081HV Amsterdam, the Netherlands.,23D InnovationLab, VU University Medical Center, Amsterdam, the Netherlands
| | - Sjoerd Te Slaa
- 23D InnovationLab, VU University Medical Center, Amsterdam, the Netherlands.,4Department of Medical Technology, VU University Medical Center, Amsterdam, the Netherlands
| | - Mariëlle E Jaspers
- 1Department of Plastic, Reconstructive and Hand Surgery, Amsterdam Movement Sciences, VU University Medical Center, de Boelelaan 1117, 1081HV Amsterdam, the Netherlands.,5Department of Plastic, Reconstructive and Hand Surgery/Burn Center, Red Cross Hospital, Beverwijk, the Netherlands
| | | | - Jorien Borst
- 6Department of Occupational Therapy, Red Cross Hospital, Beverwijk, the Netherlands
| | - Jan Wolff
- 23D InnovationLab, VU University Medical Center, Amsterdam, the Netherlands.,3Department of Oral and Maxillofacial Surgery/Oral Pathology, VU University Medical Center, Amsterdam, the Netherlands
| | - Tymour Forouzanfar
- 23D InnovationLab, VU University Medical Center, Amsterdam, the Netherlands.,3Department of Oral and Maxillofacial Surgery/Oral Pathology, VU University Medical Center, Amsterdam, the Netherlands
| | - Paul P van Zuijlen
- 1Department of Plastic, Reconstructive and Hand Surgery, Amsterdam Movement Sciences, VU University Medical Center, de Boelelaan 1117, 1081HV Amsterdam, the Netherlands.,5Department of Plastic, Reconstructive and Hand Surgery/Burn Center, Red Cross Hospital, Beverwijk, the Netherlands
| |
Collapse
|
9
|
Abstract
The postoperative management of full-thickness burns of the neck can be a challenge for burn therapists despite the availability of many treatment modalities to minimize scar hypertrophy and contracture. Interventions include pressure appliances, massage, exercise, and positioning devices. The objective of this study was to identify factors associated with the development of neck contractures and optimal treatment strategies for their prevention. We performed a retrospective chart review of all patients admitted to our pediatric burn center between 1989 and 2003 with acute full-thickness neck burns. Rehabilitation protocols used for each patient were examined. The necessity of a reconstructive procedure was analyzed, as well as time from initial grafting to that procedure. We identified 49 eligible subjects. Patients ranged in age from 0.6 to 14.2 years at the time of injury. The number of factors present which inhibited both positioning and application of pressure to the neck was found to be significantly related to the need for neck reconstruction (P < .01). Patients who had tracheostomies had a mean time to neck reconstruction of 20.3 months compared with 43.4 months in patients without tracheostomies (P < .05). Also, although not statistically significant, greater than 80% of patients who were discharged with reduced range of motion of the neck required reconstruction compared with fewer than 65% of patients with normal neck range. Delayed pressure and positioning of the neck after skin grafting result in an earlier and more frequent need for neck reconstruction.
Collapse
Affiliation(s)
- Patricia A Sharp
- Shriners Hospitals for Children, 3229 Burnet Avenue, Cincinnati, Ohio 45229-3095, USA
| | | | | |
Collapse
|