Published : 31 March 2026

Adult Burn Contracture Reconstructions Caused by Burn Injury During Childhood: Patients’ Quality of Life and Surgical Challenges

  • I Nyoman Putu Riasa
  • Bertha Kawilarang

Volume 13, Issue 1, (2026) Jurnal Plastik Rekonstruksi | Pages : 29-38

DOI: 10.14228/jprjournal.v13i1.59   Reader : 1 times PDF Download : 0 times

Abstract

Introduction: In many low- and middle-income countries (LMICs), childhood burns continue to be common, and contractures that persist into adulthood lead to significant disability. Observational studies suggest that health-related quality of life (HRQoL) generally improves over time in adult burn survivors; however, individuals with burn-scar contractures experience greater disability and lower HRQoL.
Method: Descriptive, single-centre case series. Four adults with longstanding contractures from childhood flame burns were identified: postoperative qualitative HRQoL data (unstructured interviews). Surgical techniques and outcomes were recorded from clinical notes and photographs.
Results: Growth through the scar caused multilevel deformities (bone/joint, tendon, soft tissue). Staged surgery included: (i) wrist/hand contracture release with ligament stabilisation, K-wire fixation, and tendon lengthening; (ii) multistage auricular reconstruction using a costal-cartilage framework covered by a pedicled temporoparietal fascial flap (TPFF) and ultrathin scalp skin graft; (iii) trunk/inguinoperineal release with abdominoplasty-style umbilical and nipple-areola complex (NAC) repositioning, and pedicled latissimus dorsi myocutaneous (LD-MC) flap; and (iv) staged regional reconstruction following oncologic resection of squamous-cell carcinoma (SCC) arising in a burn scar. In all cases, daily function and psychosocial well-being improved, and patients returned to work, demonstrating strong motivation for staged procedures.
Conclusion: Even when reconstruction is delayed until adulthood, focusing on high-impact functional goals in a staged plan produces meaningful HRQoL improvements for survivors of childhood flame burns in resource-constrained settings.

Data Availability

All data generated during this study are included in this published article [and its supplementary information files].

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Keywords

  • Burn contracture
  • Quality of life
  • Adult reconstruction
  • Temporoparietal fascial flap
  • Costal cartilage

Author Information

I Nyoman Putu Riasa

Division of Plastic Reconstructive and Aesthetic Surgery and Burn Unit, Department of Surgery, Udayana University, Ngoerah Hospital, Bali, Indonesia.

Email: puturiasa@unud.ac.id

ORCID : https://orcid.org/0000-0002-5826-8195

Bertha Kawilarang

Division of Plastic Reconstructive and Aesthetic Surgery and Burn Unit, Department of Surgery, Udayana University, Ngoerah Hospital, Bali, Indonesia.

Email: berthakawilarang12@gmail.com

ORCID : https://orcid.org/0000-0002-4354-9533

Article History

Submitted : 6 January 2026
Revised : 6 January 2026
Published : 31 March 2026

How to Cite This

Riasa, I. N. P., & Kawilarang, B. (2026). Adult Burn Contracture Reconstructions Caused by Burn Injury During Childhood: Patients’ Quality of Life and Surgical Challenges. Jurnal Plastik Rekonstruksi, 13(1), 29–38. https://doi.org/10.14228/jprjournal.v13i1.59

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