Zhou Ya-Qin, Zhou Jun-Yi, Luo Gao-Xing, Tan Jiang-Lin
Institute of Burn Research, State Key Laboratory of Trauma, Burns and Combined Injuries, Chongqing Key Laboratory for Disease Proteomics, Southwest Hospital, The Third Military Medical University (Army Medical University), Chongqing 400038, China.
World J Clin Cases. 2021 Nov 16;9(32):9741-9751. doi: 10.12998/wjcc.v9.i32.9741.
Hands are one of the most common burn sites in children. Hypertrophic scar contractures in hands after wound healing result in further reductions in their range of motion (ROM), motility, and fine motor activities. Rehabilitation can improve the function of hands. But the optimal time of rehabilitation intervention is still unclear. Therefore, this study was designed to investigate the effects of early rehabilitation management of paediatric burnt hands and to compare the efficacy between early and later rehabilitation intervention.
To investigate the effects of early rehabilitation management of paediatric burnt hands.
A total of 52 children with burnt hands were allocated into the early intervention group (≤ 1 mo from onset) and a late intervention group (> 1 mo from onset) between January 2016 and December 2017. The children received the same rehabilitation programme including skin care, scar massage, passive ROM exercises, active ROM exercises, compression therapy, orthotic devices wearing and game or music therapy. Rehabilitation assessments were performed before and after the rehabilitation treatment.
In the early intervention group, the ROM of the hands was significantly improved after rehabilitation ( = 0.001). But in the late group the effect was not significant statistically ( = 0.142). In the early group, 38.5% of the patients showed significant improvement, while in the late group, 69.2% of the patients showed no significant improvement. The time from onset to posttraumatic rehabilitation ( = 0.0007) and length of hospital stay ( = 0.003) were negatively correlated with the hand function improvement. The length of rehabilitation stay was positively correlated with the hand function improvement ( = 0.005).
These findings suggest that early rehabilitation might show better results in terms of ROM.
手部是儿童最常见的烧伤部位之一。伤口愈合后手部的肥厚性瘢痕挛缩会进一步导致其活动范围（ROM）、运动能力和精细运动活动的下降。康复治疗可以改善手部功能。但康复干预的最佳时机仍不明确。因此，本研究旨在探讨小儿烧伤手部早期康复管理的效果，并比较早期和晚期康复干预的疗效。
探讨小儿烧伤手部早期康复管理的效果。
2016年1月至2017年12月期间，共52例手部烧伤患儿被分为早期干预组（发病≤1个月）和晚期干预组（发病>1个月）。患儿接受相同的康复方案，包括皮肤护理、瘢痕按摩、被动ROM练习、主动ROM练习、压力治疗、佩戴矫形器以及游戏或音乐治疗。在康复治疗前后进行康复评估。
早期干预组康复后手部的ROM有显著改善（=0.001）。但晚期组效果在统计学上不显著（=0.142）。早期组中，38.5%的患者有显著改善，而晚期组中，69.2%的患者无显著改善。从发病到创伤后康复的时间（=0.0007）和住院时间（=0.003）与手部功能改善呈负相关。康复住院时间与手部功能改善呈正相关（=0.005）。
这些发现表明，早期康复在ROM方面可能显示出更好的效果。
