Prevalence of scar contractures after burn: A systematic review

- A systematic review concerning prevalence and determinants of burn scar contractures.
- The few available studies demonstrate a prevalence at discharge of 38-54%.
- With longer time after burn, the prevalence of contractures was lower.
- Determinants: severe burns, flame burns, children, female patients, cervical spine, upper extremity.
- Longitudinal studies are needed to improve prevention and treatment of contractures.

ObjectiveBurn scar contractures are the pathological outcome of excessive scarring and ongoing scar contraction. Impairment of joint range of motion is a threat to performing activities in daily living. To direct treatment strategies to prevent and/or correct such contractures, insight into the prevalence, course, and determinants is essential.MethodsA literature search was conducted including Pubmed, Cochrane library, CINAHL, and PEDro. Articles were included if they provided burn scar contracture data to calculate the point prevalence. The quality of the articles was scored. Data were extracted regarding study, subject and burn characteristics, method of scar contracture assessment, point prevalence, and possible determinants.ResultsNine articles and one abstract could be included for data extraction. The prevalence at discharge was 38-54%, but with a longer time after burn, the prevalence was lower. Contractures were more likely to occur in more severe burns, flame burns, children, female, the cervical spine, and the upper extremity.ConclusionsThe prevalence of burn scar contractures varies considerably between studies. When prevalence is unclear, it is also difficult to investigate potential determinants and evaluate changes in interventions. There is a need for extensive, well-designed longitudinal (inter)national studies that investigate prevalence of scar contractures, their evolvement over time, and risk factors.