Miss Andrea Mc Kittrick1, Professor Louise Gustafsson2, Emeritus Professor Jennifer Strong1
1Royal Brisbane And Women’s Hospital, Herston, Australia, 2School of Allied Health Sciences, Griffth University, Nathan QLD
Severe burn injuries are devastating for patients, resulting in life long complications of pain, scarring and disfigurement and psychological damage. The psychological impact and after-effects of sustaining a severe burn injury have been widely explored in the literature. Pain across the spectrum of burn care is dynamic and complex, changing over time. There are a myriad of co- morbidities that can interfere in the recovery process, for example, acute pain, chronic pain, pruritus and sleep disruption. Scars resulting from a burn injury have physical and psychological sequela that can impact and influence many aspects of routine daily life for the burn survivor. With advancements in health care delivery there has been a reduction in severe burn injury mortality (1% of all adult burns admissions in Australia and New Zealand [2013-2014] compared to 1.6% in [2009-2010]). However with increasing survival rates, in high income countries as reported by the World Health Organization (WHO), there have been increasing rates of morbidity. The focus of health care research in burn injuries has thus shifted to reflect on quality of survival versus quantity of survival.
Although hand burns represent a small Total Body Surface Area (TBSA) percentage, hand burns are classified as severe burn injuries that require the advanced skills and interventions that are provided at specialised burns centres thus meeting the criteria for referral to these centres. Patients with hand burns have increased care needs due to the difficulty they experience in personal activities of daily living while burn dressings are in place. In addition to patients who sustain burn injuries to the hands alone, hands are rarely spared in patients with TBSA burn injuries of greater than 60%. Interruption to the function of the hand resulting from a severe burn injury impacts on the patient’s participation in daily life and also on the ability to engage and interact with the surrounding environment. Therefore the primary aim of this systematic review is to investigate outcome tools currently used for patients who have sustained hand burn injuries and to map the psychometric properties of the outcome measures identified from the literature across the ICF.
Andrea is a senior Occupational Therapist working at the Royal Brisbane and Women’s Hospital in Brisbane. She has worked in burn care in Australia for over 12 years. This systematic review is part of her PhD candidature investigating outcome measures for severe hand burn injuries.