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The Role of Anatomical Site in Outcomes Following Lower Extremity Burn Injuries
Christopher J. Fedor, MS; Hilary Y. Liu, BS; Alexis M. Henderson, MPH; Mare G. Kaulakis, BS; Jose A. Arellano, MD; Garth A. Elias, MD; Alain C. Corcos, MD; Jenny A. Ziembicki, MD; Francesco M. Egro, MD, MSc, MRCS
University of Pittsburgh, School of Medicine
2025-01-02
Presenter: Christopher J. Fedor
Affidavit:
I agree.
Director Name: Vu Nguyen
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: General Reconstruction
PURPOSE:
Lower extremity burn wounds are prone to complications such as graft loss, hypertrophic scarring, and contractures, affecting both function and aesthetics. The biomechanical properties of various anatomical sites, including shearing forces and pressure points, may influence healing. This study aims to identify location-specific risks in lower extremity burn injuries, hypothesizing that joint areas will have higher complication rates compared to non-joint areas, potentially guiding targeted management strategies.
METHODS:
We conducted a retrospective review of patients with acute lower extremity burns at an ABA-certified burn center from January 2012 to January 2024. Data on demographics, wound characteristics, surgical interventions, and outcomes were collected. Burns were categorized by anatomical site, with joint-involved areas (foot, digits, ankle, knee) and non-joint areas (thigh, lower leg). We compared graft failure, hypertrophic scarring, and contracture rates between these groups.
RESULTS:
The study included 507 patients (65.3% male; mean age 39.1 ± 24.2 years). Injuries affected the thigh (48.0%), lower leg (48.5%), foot (35.0%), digits (3.5%), ankle (12.1%), knee (16.0%), and entire lower extremity (4.2%). Surgical intervention occurred in 52.5% of cases. Total graft loss was 3.1%, with no significant difference between joint and non-joint areas (p=0.271). Hypertrophic scarring occurred more frequently in joint areas (19.6% vs 13.7%, p=0.077), while contracture rates were significantly higher in joint areas (4.3% vs 0.9%, p=0.017), particularly in the ankle (p=0.001).
CONCLUSIONS:
The anatomical location of lower extremity burn injuries significantly affects complication rates, particularly in joint areas and the lower leg, which require careful management to optimize outcomes.
