Choe Deborah, McMullen Kara, Stewart Barclay T, Kowalske Karen, Schneider Jeffrey C, Ryan Colleen M, Kazis Lewis E, Orton Caitlin M, Yenikomshian Haig A
From the Keck School of Medicine, University of Southern California, Los Angeles, CA.
Department of Rehabilitation Medicine, University of Washington, Seattle, WA.
Ann Plast Surg. 2025 Feb 1;94(2):157-168. doi: 10.1097/SAP.0000000000004173. Epub 2024 Dec 5.
Adults living with head and neck burn injuries experience psychosocial consequences due to scarring as well as functional disabilities. However, the impact of head and neck burns on long-term self-reported psychosocial outcomes, return to work, and need for reconstructive surgery has not been well described. This study investigates the unique longitudinal problems in psychosocial and functional recovery faced by adults with head and neck burn injuries.
Utilizing the multicenter Burn Model System (BMS) National Database, long-term psychosocial and functional outcomes as well as postdischarge reconstructive surgery rates between adult participants with and without head and neck burns injured after 2014 were compared.
Of 1247 participants, 579 had head and neck burns and 668 had non-head and neck burns. Head and neck burn was a significant predictor of worse anxiety (β = 1.63, P = 0.049) and body image (β = -0.30, P = 0.011) at 6 months post burn; worse anxiety (β = 2.68, P = 0.004), depression (β = 2.14, P = 0.021), and body image (β = -0.41, P = 0.001) at 12 months post burn; and worse life satisfaction (β = -1.64, P = 0.036) at 24 months post burn. Head and neck burn participants reported significantly worse anxiety ( P = 0.001), depression ( P = 0.0026), and life satisfaction ( P < 0.001) at 12 months post burn and worse body image at 6 ( P < 0.001), 12 ( P < 0.001), and 24 ( P < 0.001) months post burn. The head-and-neck group had a significantly greater proportion of participants who had undergone contracture surgery at 12 months post burn ( P < 0.001) and a smaller proportion who had returned to work by 6 ( P < 0.001) and 12 ( P < 0.001) months post burn.
This study suggests that adults with head and neck burns might strongly benefit from additional counseling, psychotherapy, and greater aftercare.
头颈部烧伤的成年人会因瘢痕形成以及功能障碍而经历心理社会方面的后果。然而，头颈部烧伤对长期自我报告的心理社会结局、重返工作岗位以及重建手术需求的影响尚未得到充分描述。本研究调查了头颈部烧伤的成年人在心理社会和功能恢复方面所面临的独特的纵向问题。
利用多中心烧伤模型系统（BMS）国家数据库，比较了2014年以后成年期烧伤的头颈部烧伤参与者与非头颈部烧伤参与者之间的长期心理社会和功能结局以及出院后重建手术率。
在1247名参与者中，579人有头颈部烧伤，668人有非头颈部烧伤。头颈部烧伤是烧伤后6个月时焦虑（β = 1.63，P = 0.049）和身体形象（β = -0.30，P = 0.011）较差的显著预测因素；烧伤后12个月时焦虑（β = 2.68，P = 0.004）、抑郁（β = 2.14，P = 0.021）和身体形象（β = -0.41，P = 0.001）较差；烧伤后24个月时生活满意度较差（β = -1.64，P = 0.036）。头颈部烧伤参与者在烧伤后12个月时报告的焦虑（P = 0.001）、抑郁（P = 0.0026）和生活满意度（P < 0.001）显著更差，在烧伤后6个月（P < 0.001）、12个月（P < 0.001）和24个月（P < 0.001）时身体形象更差。头颈部烧伤组在烧伤后12个月接受挛缩手术的参与者比例显著更高（P < 0.001），而在烧伤后6个月（P < 0.001）和12个月（P < 0.001）重返工作岗位的参与者比例更低。
本研究表明，头颈部烧伤的成年人可能会从额外的咨询、心理治疗和更好的后续护理中受益匪浅。
