El Ezzi O, Dolci M, Dufour C, Bossou R, de Buys Roessingh A
Department of Paediatric Surgery, CURCP, University Hospital Centre of the Canton of Vaud (CHUV), Lausanne, Switzerland.
Department of Anaesthesiology, University Hospital Centre of the Canton of Vaud (CHUV), Lausanne, Switzerland.
Ann Burns Fire Disasters. 2017 Mar 31;30(1):47-51.
The purpose of this study is to analyze the effectiveness of surgery and follow-up of children operated on for burn sequelae. For many years, we have organized two missions per year to Benin and Togo, one for surgery and one for follow-up. We analyzed the files of children born in Africa and victims of burns from the years 2002 to 2011. Children were referred through a non-governmental organization (NGO) and assessed in Africa by local paediatricians before and after surgery. Treatment consisted in operating on burn sequelae such as contractures, hypertrophic scars and hard cords. Impaired mobility was our only indication for the operation. We kept a database on all patients. Sixty files were reviewed, of which fifty were deemed suitable for analysis. The most common methods of surgery were skin grafting and Z-plasty. There were no complications, such as infection or graft/flap necrosis after immediate surgery. Long-term follow-up revealed a recurrence of hypertrophic scarring (47%), retractions (24%) and hard cords (2%) due to a lack of occupational therapy and physiotherapy treatment. Partnership with an NGO and a local team allows us to treat children with burn injury sequelae in Western Africa. A continued and often long-lasting follow-up by occupational therapists and physiotherapists is highly mandatory in order to guarantee good long-term results. In 2010, we initiated local rehabilitation therapy.
本研究的目的是分析烧伤后遗症患儿手术及后续跟进的效果。多年来，我们每年组织两次前往贝宁和多哥的任务，一次进行手术，一次进行后续跟进。我们分析了2002年至2011年出生在非洲且有烧伤经历的儿童的病历。儿童通过一个非政府组织（NGO）被转诊，并在非洲由当地儿科医生在手术前后进行评估。治疗包括对烧伤后遗症如挛缩、增生性瘢痕和硬索进行手术。行动能力受损是我们进行手术的唯一指征。我们为所有患者建立了数据库。审查了60份病历，其中50份被认为适合分析。最常见的手术方法是植皮和Z成形术。术后即刻没有出现感染或移植皮片/皮瓣坏死等并发症。长期随访发现，由于缺乏职业治疗和物理治疗，增生性瘢痕复发率为47%，挛缩复发率为2%，硬索复发率为2%。与一个非政府组织和当地团队合作使我们能够治疗西非烧伤后遗症患儿。职业治疗师和物理治疗师持续且通常是长期的随访对于保证良好长期效果非常必要。2010年，我们启动了当地康复治疗。
