Postburn contracture treatment: a healthcare project in Bangladesh

Over the last 6 years, a health care program aimed at the surgical correction of postburn contractures has taken place in Faridpur, Bangladesh. People in this rural region are very poor and often cannot afford medical treatment. Often secondary flexion contractures of the face and chin as well as the upper and lower extremity impede daily functioning and have an enormous psycho-social impact. The application of basic plastic surgical principles such as local transposition of skin flaps as well as skin grafts restores function dramatically and results in stable skin cover. It is quite challenging - both for the surgeon and the anaesthesiologist - to perform these operations within a rather limited infrastructure. In Bangladesh, there is a monumental need for correction of postburn contractures for the social needs of the patient as well as for functional purposes. Future actions should be directed to the training of surgeons and the development of specialized hospitals to demonstrate social as well as political commitment to health care programs.