Psychologic factors involved in the decision to undergo reconstructive surgery after burn injury.

Burn injuries often result in permanent changes in physical appearance and function. Although reconstructive surgery is often considered to improve function or physical appearance, or a combination, variables that may predict use of surgery are relatively unknown. Burn survivors (N = 46; 48% male) were assessed at an evaluation for potential reconstructive surgery. Measures of adjustment, distress, and personality were administered. Several psychologic and demographic variables differed among those who did versus those who did not subsequently undergo surgery. Social, sexual, and family relationships were poorer among those who later used surgery, and surgery patients had higher scores on somatization. Subjects who had not returned to work, and individuals with private insurance or managed care, were significantly less likely to follow-up with reconstructive surgery. Contrary to hypothesized results, indexes of burn severity and the injury location were not significantly different between the two groups. Results suggest that interventions designed to aid adjustment after injury may result in the best surgical candidates completing reconstruction.