A Psychosocial Review of 31 Patients with Severe Facial Burns

過去許多嚴重面部燒傷後的病人均被社會遺忘，我們經追蹤31例嚴重面部燒傷病人以問卷方式得知其善後之情況。這些病人均屬依美國醫學會面部傷殘第三度及第四度之嚴重顏面殘障。我們分析這些病人之燒傷原因，及傷後機能障機，心理及社會適應上之缺殘。本文主要目的是提醒大眾，傷後之後續醫療關照及復健醫治之重要性。我們的病人中男女之比例為14比17，年齡分佈是16歲到62歲。人為燒傷者佔55%（化學燒傷佔大多數），意外燒傷者45%（火傷為主要原因）。面部傷殘之部位分佈為嘴巴周圍65%，耳畸形61%，頸部孿縮32%。傷後完全變盲者有6人均屬化學性燒傷所致。所有病人均經過三次以上之手術以矯正其機能及外觀上缺陷但只有一人對其結果感到滿意。出院後病人均須3到12個月的適應期，心想自殺者有55%，意圖自殺沒有成功的病人佔19%。只有19%的病人與心理醫師接觸過，大部份病人均有經濟上的困難並找不到工作。病人家屬通常扮演著最重要的病人支撐的依靠。

關鍵字

無資料

並列摘要

The psychosocial problems of facial disfigurement following burns have been neglected in our society. We reviewed 31 burned patients with a set of questionnaire. All the patients belonged in Class 3 or Class 4 permanent facial impairment according to American Medical Association Criteria for Facial Impairment. The causes, functional and psycho social impairments were reviewed and analyzed. The main purposes are to draw public attention on the issue of severe facial disfigurement following bums and reemphasize the importance of coordinated and integrated medical, surgical, rehabilitative and follow-up care. 17 females and 14 males, ranging in age from 16 to 62 were included in our study. Inflicted bums were accounted for 55% of the causes of injuries, while 45% were accidental burns. Chemical burns was the most common injury in the former, while flame burn in the latter. The common functional sequalae, in order of frequency of incidence, were microstomia (65%), ear deformity (61%), cervical flexion contracture (58%), lower eyelids ectropirn (55%), and nostril stenosis (32%). Total blindness was noted in six patients sustained of inflicted chemical injuries. All patients received more than three operations in attempts to correct the functional and aesthetic impairment but only one of them was satisfied with the outcome. All patients sustained regressive syndrome for a period of 3 to 12 months after discharge. 55% of them developed suicidal idea and 19% attempted unsuccessful suicides. Only 19% of the patients have been attended by psychologists. Most patients had financial and employment problems. Family is the prime support for social recovery. Face is an important part of the body image. In a society that places a premium on physical beauty, and youth, the psychological and socioeconomic toll of facial disfigurement needs little explanation. A deep burn on the face will cause severe facial disfigurement and lead to disfigured face syndrome that expresses the situation in which the patient losses his value and role in life, feelings of emptiness and absurdity prevail. The main purposes of this paper are to draw public attention on the issue of severe facial disfigurement following burns and the importance of coordinated and integrated medical, surgical, rehabilitative and follow-up care.

並列關鍵字

Severe facial burn ； permanent facial deformities ； psychosocial impairment

國際替代計量

A Psychosocial Review of 31 Patients with Severe Facial Burns

全文下載

主題瀏覽