Speech Pathology Department, Building 42, Hospital Road, Concord Repatriation General Hospital, Sydney NSW 2139, Australia; Burns Unit, Level 7 North, Hospital Road, Concord Repatriation General Hospital, Sydney NSW 2139, Australia.
School of Health & Rehabilitation Sciences, The University of Queensland, QLD 4072, Australia; Centre for Functioning and Health Research, Queensland Health, Buranda QLD 4102, Australia.
Burns. 2015 Nov;41(7):1599-606. doi: 10.1016/j.burns.2015.04.003. Epub 2015 May 12.
To document orofacial rehabilitation and outcomes after full thickness orofacial burn.
Participants included 12 consecutive patients presenting with full thickness orofacial burns. A group of 120 age-matched healthy participants was recruited for normative comparison. Non-surgical exercise was initiated within 48 h of admission and continued until wounds had healed, circumoral scar tissue had stabilised and functional goals were achieved to the best of the patient's ability. Outcomes were documented using vertical and horizontal mouth opening measures at start and end of treatment and therapy duration was recorded.
At commencement of treatment, participants had significantly (p<0.001) reduced vertical and horizontal mouth opening range compared to controls. Average duration of orofacial contracture management was 550 days, with half requiring >2 years rehabilitation. By end of treatment, significant (p<0.01) positive improvement in vertical and horizontal mouth opening had been achieved, however measures had returned to lower limits of normal function and remained significantly (p<0.05) reduced compared to the control group.
This study demonstrates that although positive gains can be achieved through non-surgical exercise after full thickness burn, the duration of rehabilitation is considerable and some degree of long term loss in functional mouth opening remains.
记录全层口腔烧伤后的口腔康复和结果。
纳入了 12 名连续出现全层口腔烧伤的患者作为参与者。招募了一组 120 名年龄匹配的健康参与者作为对照。非手术运动在入院后 48 小时内开始,并持续到伤口愈合、口周瘢痕组织稳定以及根据患者的最佳能力实现功能目标为止。使用治疗开始和结束时的垂直和水平张口测量来记录结果,并记录治疗持续时间。
在治疗开始时,参与者的垂直和水平张口范围明显(p<0.001)低于对照组。口腔挛缩管理的平均持续时间为 550 天,其中一半需要>2 年的康复。治疗结束时,垂直和水平张口有显著(p<0.01)的正向改善,但测量结果仍处于正常功能的较低范围,并且与对照组相比仍显著(p<0.05)降低。
本研究表明,尽管全层烧伤后通过非手术运动可以获得积极的效果,但康复时间相当长,并且在功能张口方面仍存在一定程度的长期损失。