Comparative Study Between Botulinum Toxin-A Injection and Shock Waves on Hypertrophic Scars in Hand-burned Children

Botulinum Toxin-A Injection and Shock Waves on Hypertrophic Scars in Hand-burned Children

PURPOSE: The study aims to compare study between Botulinum toxin-A injection and shock waves therapy on hypertrophic scars in hand-burned children.

BACKGROUND: Burn injuries can cause significant physical and psychological distress, especially when they result in hypertrophic scarring. In children, who are particularly vulnerable to these injuries, it is important to accurately assess the severity of these scars and their impact on functionality.

HYPOTHESES: There is no significant difference between the combined effect of the traditional physical therapy program with botulinum toxin-A injection and the traditional physical therapy program with shock waves therapy on improving wrist extension, ulnar deviation, radial deviation, hand grip strength, and severity of the scar on hypertrophic scars in hand-burned children.

Inclusion Criteria:

• Age will range from 6-18 years
• Diagnosed with hypertrophic scars resulting from hand burns.
• Has burn injuries caused by flame, scald or chemical agents.
• With a total body surface area (TBSA) varied from 10 to 30%
• A resistant partial or complete loss of wrist flexion attributable to wrist flexor contracture
• After wound and skin graft healing (~ 90 days post-surgery),

Exclusion criteria:

• Children with underlying medical conditions that could interfere with scar healing or treatment outcomes
• Skin flap surgery, malignancies, cardiac arrhythmias, pacemaker implantation, coagulopathies, fractures about the treatment area, articular adhesions, and psychiatric co-morbidities