El yanýklarýnda erken rehabilitasyonun etkinliði

AMAÇ: El yanýklarý sýklýkla oluþan ve sonuclarý kiþinin günlük bakým fonksiyonlarýný, çalýþma hayatýný, istihdamý, serbest zaman etkinliklerini ve genel saðlýkla ilgili yaþam kalitesini önemli ölçüde etkileyen travmalardýr. El yanýðý travmalarýnda genel amaç, el fonksiyonunu optimize etmektir. El fonksi-yonlarýnýn rehabilitasyonu ve restorasyonu; hastanýn baðýmsýzlýðý, topluma ve iþine yeniden entegrasyonu için kritik öneme sahiptir.
GEREÇ VE YÖNTEM: Bu çalýþmanýn amacý, yanýk merkezimize baþvuran ve tedavi edilen 105 el yanýðý travmalý hastayla ilgili deneyimimizi sunmak ve erken rehabilitasyonun hastalarýn önceki sosyal yaþamlarýna ve iþlerine dönme yetenekleri üzerindeki etkinliðini göstermektir.
BULGULAR: Çalýþmamýza 2017-2021 yýllarý arasýnda Gülhane Eðitim Araþtýrma Hastanesi yanýk merkezinde yatarak tedavi gören 105 akut ciddi el yanýðý travmasý olan hastalar dahil edildi. Hastalara her gün seanslar halinde rehabilitasyon programý uygulandý. El yanýðý olan hastalar hareket açýklýðý (ROM), kavrama kuvveti, Cochin El Fonksiyon Ölçeði (CHFS) ve Michigan El Anketi (MHQ) ile taburculuktan 12 ay sonra deðerlendirildi. Parmaklarýn aktif hareket toplamý ortalamasý >180 derece idi. Dominant elin kavrama kuvveti ortalama deðerleri erkeklerde 27.2±9.3 kg, kadýnlarda 22.0±8.8 kg, erkeklerde dominant olmayan el kavrama kuvveti 24.05±13.8 kg, kadýnlarda ise 17.8±10.3 kg idi. CHFS’de 5 maddenin toplam puaný 19.0 idi. MHQ’daki ortalama toplam puan 62.3±27.4 idi. Elde edilen tüm veriler normal veya kabul edilen fonksiyonel aralýklar içindeydi. Spearman korelasyon katsayýsý, MHQ ile CHFS arasýnda negatif bir korelasyon olduðunu göstermektedir (p≤0.01).
TARTIÞMA: El yanýðý travmalarýndan sonra

Effectiveness of early rehabilitation in hand burns

BACKGROUND: Hand burn trauma occurs quite commonly and the outcome of hand burns can significantly impact self-care daily function, work and employment, leisure activities, and overall health-related quality of life. The overall goal of the management of hand burn trauma is to optimize hand function. Rehabilitation and restoration of hand function are critical for the patient’s independence and re-integration into society and work. The purpose of this study is to present our experience with 105 hand burn trauma patients admitted and treated in our burn center and to show the efficacy of early rehabilitation on their ability to return to their prior social life and work.
METHODS: In our study, we included that 105 patients with acute severe hand burn trauma were hospitalized in Gulhane burn center between 2017 and 2021. They underwent rehabilitation program daily sessions. Patients with hand burns are evaluated by ranges of motions (ROM), grip strength, Cochin Hand Function Scale (CHFS), and Michigan Hand Questionnaire (MHQ) 12 months after the injury.
RESULTS: Overall, mean digital total active motion were >180°. The mean values for grip strength of dominant hand for men were 27.2±9.3 kg, for women were 22.0±8.8 kg and non-dominant hand for men were 24.05±13.8 kg, for women were 17.8±10.3 kg. Total score of 5 items was 19.0 in CHFS. The mean overall score on the MHQ was 62.3±27.4. All obtained data were within normal or accepted functional ranges. Spearman correlation coefficient indicates a negative correlation between MHQ and CHFS (p≤0.01).
CONCLUSION: A comprehensive rehabilitation program is essential in helping patients to regain optimal function after hand burn trauma. Physiotherapy and occupational therapy is most beneficial when started at the time of admission.