Burn contractures: incidence, predisposing factors, and results of surgical therapy.

An important element in the care of the burn victim is the prevention and treatment of burn wound contractures. Since limited objective quantitative information is available on the incidence of contractures after thermal injury, or on the factors that predispose individuals to their development, a review of all patients seen from July 1980 through January 1986 for surgical correction of burn wound contractures was conducted. Among the 53 patients selected for study, the incidence of contractures was higher in the pediatric patients, 7.8%, than in the adult patients, 2.0% (P less than 0.001), although burn wound size was comparable in these two groups. There was a direct relationship between wound size and number of contractures per patient (P = 0.003). The majority of contractures occurred at the hand, head, neck, and axilla. Surgical release of contractures of these central body regions (P = 0.056) and of fascially excised burns (P = 0.04), yielded the poorest operative results. Patient age and race, type of operation performed, and timing of surgery did not affect the operative results.