eMedicine Specialties > Physical Medicine and Rehabilitation > Rehabilitation Protocols
Burn Rehabilitation: Multimedia
Updated: Jan 26, 2007
Multimedia
 | Media file 1: Contractures develop rapidly in patients with burns if proper range of motion and splinting are not performed from the outset of acute care. |
 | Media file 2: The set of predictable burn contractures can be minimized through focused and early intervention. |
 | Media file 3: If wounds are not closed promptly, contractures can occur rapidly. |
 | Media file 4: Pressure to the calcaneus can be prevented by extending the footplate of the splint beyond the heel and cutting out the area around the calcaneus. |
 | Media file 5: Successful release of a dorsal hand contracture substantially improves hand function. Do not delay this procedure because it is functionally significant. |
 | Media file 6: Heterotopic ossification may contribute to limited elbow motion and should be excluded by plain radiographs. This condition most commonly presents when bone forms in the soft tissues around the triceps tendon. |
 | Media file 7: Despite its ubiquity, the physiology of hypertrophic scar is not understood. Perhaps the most virulent hypertrophic scarring is seen in deep dermal burns that heal spontaneously over the course of 3 or more weeks, particularly in highly elastic skin (eg, the lower face, submental triangle, anterior neck, chest). |
 | Media file 8: Scar massage optimally is performed several times each day. Use firm slow pressure on evolving hypertrophic areas after applying bland skin emollients. |
 | Media file 9: Steroid injections directly into localized early hypertrophic scars can be useful, especially in highly cosmetic locations or in those that cause extreme pruritus. |
 | Media file 10: Most burn deformities can be corrected with release and grafting procedures. Any contracture around the mouth or the neck that makes airway access difficult assumes a high priority in early reconstruction. |
 | Media file 11: |
More on Burn Rehabilitation |
| References |
References
Ahn ST, Monafo WW, Mustoe TA. Topical silicone gel for the prevention and treatment of hypertrophic scar. Arch Surg. Apr 1991;126(4):499-504. [Medline].
Berger M, Wilson S. Burns rehabilitation is more than skin deep. BMJ. Sep 4 2004;329(7465):573-4.
Brewster LP, Bennett BK, Gamelli RL. Application of rehabilitation ethics to a selected burn patient population''s perspective. J Am Coll Surg. Nov 2006;203(5):766-71.
Carr-Collins JA. Pressure techniques for the prevention of hypertrophic scar. Clin Plast Surg. Jul 1992;19(3):733-43. [Medline].
Esselman PC, Thombs BD, Magyar-Russell G. Burn rehabilitation: state of the science. Am J Phys Med Rehabil. Apr 2006;85(4):383-413.
Kennedy PJ, Young WM, Deva AK. Burns and amputations: a 24-year experience. J Burn Care Res. Mar-Apr 2006;27(2):183-8.
Kischer CW. The microvessels in hypertrophic scars, keloids and related lesions: a review. J Submicrosc Cytol Pathol. Apr 1992;24(2):281-96. [Medline].
Pessina MA, Ellis SM. Burn management. Rehabilitation. Nurs Clin North Am. Jun 1997;32(2):365-74. [Medline].
Ridgway CL, Warden GD. Evaluation of a vertical mouth stretching orthosis: two case reports. J Burn Care Rehabil. Jan-Feb 1995;16(1):74-8.
Rose MP, Deitch EA. The clinical use of a tubular compression bandage, Tubigrip, for burn- scar therapy: a critical analysis. Burns Incl Therm Inj. Oct 1985;12(1):58-64. [Medline].
Sheridan R, Weber J, Prelack K. Early burn center transfer shortens the length of hospitalization and reduces complications in children with serious burn injuries. J Burn Care Rehabil. Sep-Oct 1999;20(5):347-50. [Medline].
Sheridan RL, Hinson MI, Liang MH. Long-term outcome of children surviving massive burns. JAMA. Jan 5 2000;283(1):69-73. [Medline].
Sheridan RL, Baryza MJ, Pessina MA. Acute hand burns in children: management and long-term outcome based on a 10-year experience with 698 injured hands. Ann Surg. Apr 1999;229(4):558-64. [Medline].
Sheridan RL, Hurley J, Smith MA. The acutely burned hand: management and outcome based on a ten-year experience with 1047 acute hand burns. J Trauma. Mar 1995;38(3):406-11. [Medline].
Sheridan RL. Burn care: results of technical and organizational progress. JAMA. Aug 13 2003;290(6):719-22. [Medline].
Simons M, Ziviani J, Tyack ZF. Measuring functional outcome in paediatric patients with burns: methodological considerations. Burns. Aug 2004;30(5):411-7.
Steiner H, Clark WR Jr. Psychiatric complications of burned adults: a classification. J Trauma. Feb 1977;17(2):134-43. [Medline].
Stoddard FJ, Stroud L, Murphy JM. Depression in children after recovery from severe burns. J Burn Care Rehabil. May-Jun 1992;13(3):340-7. [Medline].
Stoddard FJ, Norman DK, Murphy JM. Psychiatric outcome of burned children and adolescents. J Am Acad Child Adolesc Psychiatry. Jul 1989;28(4):589-95. [Medline].
Further Reading
Keywords
burn rehabilitation, burns, burn injury, burn recovery, scar therapy, burn scars, first-degree burns, second-degree burns, third-degree burns, traumatic burn injury, burn care, burn injuries
