1006 The Presentation of Microstomia in Burn Survivors
Notice bibliographique
Résumé
Abstract Introduction Microstomia, or small oral aperture, often results from deep facial burns. This condition develops as scars form around the perioral region, narrowing the oral opening. It can impact oral hygiene and a person’s ability to eat, and often produces undesirable cosmetic outcomes. While perioral contractures can be prevented and mitigated, it remains unclear which injury factors cause the highest risk. This study examines the prevalence of microstomia and its relationship to demographic and injury-related factors. Methods Data from a multicenter longitudinal database from 2001-2005, were analyzed. The frequency of microstomia (yes/no) was examined at discharge. Summary statistics were used to describe clinical characteristics and burn location in pediatric and adult burn survivors to assess for predictors of microstomia. Wilcoxon Rank Sum and Fisher’s Exact tests were used to test for significant differences between those with and without microstomia. Results There were 91 pediatric and 214 adult burn survivors during our time period. Among pediatrics, 11% (10) presented with microstomia. Among adults, 4.7% (10) presented with microstomia. In both pediatric and adult survivors, those with microstomia had significantly larger TBSA burned (p=0.002 pediatric, p=0.033 adult), higher rate of inhalation injury (p=0.002 pediatric only), more days on ventilation (p=0.003, p< 0.001), higher rate of head, neck, or face graft (p=0.012 p=0.005), higher rate of nasolabial contractures (p< 0.001, p< 0.001), and higher rate of neck contractures (p=0.033, p< 0.001). No differences were found in age, sex, race, ethnicity, etiology of burn, or discharge location. Conclusions The results of this analysis suggest that burn survivors with larger burn size and greater length of time requiring ventilation are more likely to develop of microstomia than those with small burns and less ventilator time. Other risk factors include the requirement for head, neck or face graft, which suggest an association with deeper burns. Applicability of Research to Practice This study highlights the risk factors for the development of microstomia. Knowledge of these risk factors indicates that therapists should prioritize early microstomia prevention, even during times of ventilation, especially in those with larger burn injuries. The high incidence of associated nasolabial and neck contractures in those with microstomia highlights the importance of consideration of cutaneokinematics and skin recruitment and suggests that perioral areas, as well as surrounding regions, should be considered together when developing treatment and prevention programs. Special attention should be given to burn survivors with larger burns and those requiring prolonged ventilation, as they are at greater risk for microstomia. Funding for the Study NIDILRR #90DPBU0008, 90DPGE0004. Partial Support was obtained from Grant #79136-BOS-23 and 79138-BOS-23.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,007 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».