What is the role of rehabilitation in the treatment of the burn patient?

Updated: Jan 10, 2018
  • Author: Robert L Sheridan, MD; Chief Editor: John Geibel, MD, DSc, MSc, AGAF  more...
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Answer

Answer

The final phase of burn care is rehabilitation and reconstruction. As survival has improved, this field has evolved rapidly, becoming highly specialized. Therapy should begin in the critical care setting; priorities include ranging, splinting, and antideformity positioning. Ranging is ideally performed twice daily, with the therapist taking all joints through a passive of range of motion. These activities help prevent the occurrence of many common contractures. As the seriously burned patient begins to recover, priorities include continuing passive ranging, increasing active ranging and strengthening, minimizing edema, pursuing activities of daily living, and preparing for work or play and school. [48]

Important aspects of rehabilitation after discharge include ongoing and progressive ranging and strengthening, postoperative therapy after reconstructive operations, and scar management. The most difficult hypertrophic scarring is seen in deep dermal burns that heal spontaneously in less than 3 weeks. Therapies to minimize hypertrophic scarring are begun as soon as burns are well healed and include scar massage, compression garments, topical silicone, steroid injections, and management of pruritus.

If they participate in a coordinated multidisciplinary burn aftercare program, most patients have satisfying long-term outcomes.


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