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Burn Rehabilitation

A definition of Burns (tight skin)

After a second or third degree burn, the skin and connective tissue often shrinks during the healing stages. As the fibrous connective tissue begins to harden, becoming stiff, it will decrease movement of the affected joint. As the connective tissue (tendons and ligaments) was shortened during the trauma/ burn, it can also become elongated through a low-load, prolonged-duration stretch. A Dynasplint® System is specifically designed to mimic therapists’ hands and provide a gradual stretch to the stiff joint, restoring range of motion. If you have suffered from a severe burn, you may want to consider using a Dynasplint® System to aid you in the recovery process. Select your burn area from the "Browse Products" area at left.

 

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A burn is an injury to the superficial or deep tissues of the skin, sometimes extending into muscle, blood vessels and fatty layers, which may be caused by heat, chemicals, radiation, light or electricity. Burns are generally classified by the depth of injury, and include three distinct categories:

  • First degree – These burns cause redness and mild pain at the burn site, and involve only the upper layer of skin (the epidermis). In some cases, a white area, or plaque, may also appear in the area of injury. Most sunburns are considered first-degree burns.
  • Second degree – These burns include redness and blistering, and usually also cause greater pain than first-degree burns. Second-degree burns that involve the deeper layers of skin may take a month or more to heal, and a doctor should be consulted to ensure infection does not set in. Without proper care, second-degree burns can result in significant scarring.
  • Third degree – A third-degree burn results in loss of the upper skin layers, as well as scarring and significant damage to the surrounding epidermis. Hard areas of burned tissue may be present. These burns require skin grafts in order to ensure proper healing. Because nerves are also destroyed as a result of third-degree burns, these areas are not painful; however, they will be surrounded by first- and second-degree burns.

Burn management can be a complicated process, involving fluid loss, pain and infection. Pain relievers, antibiotics and fluids are often given to patients with second- and third-degree burns, and care must be taken to ensure the injured area is kept clean during healing. In severe burn patients, fluid loss that occurs when blood vessels are damaged can cause life-threatening shock.

The success of burn rehabilitation relies primarily on the age and health condition of the patient and the extent of the burn. Chemicals released by injured tissues can cause complications affecting major organs, including the kidney and heart. Because of the significant risk of infection in second- and third-degree burn patients, tetanus shots are usually given following any burn. In general, the chances of a burn developing an infection depend upon several risk factors, including:

  • Burns over 30% of the body surface
  • Full-thickness burns
  • Age (elderly and very young patients are at increased risk)
  • Certain pre-existing diseases, including heart disease and diabetes
  • Strength and resistance of bacteria causing the infection
  • Length of time wound remains open
  • Improper initial wound/burn care
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Burns that surround a body area – called circumferential burns – can cause blood flow restriction; when the chest and back are burned, swelling and tissue tightening and stricture can interfere with breathing. Often, the wound area must be treated surgically and tissues released to enable proper blood flow and/or respiration.

Scarring and tissue loss from second- and especially third-degree burns can result in deformities of involved limbs, fingers and toes. In some patients, contracture – a thickening and shortening of muscle, skin and other tissues – can occur, causing limbs, fingers and toes to remain in flexion or extension, creating debilitating deformities that can be quite painful. Physicians who specialize in burn treatment can help ensure tissues heal properly and help prevent formation of contractures. In some cases, physical therapy, surgery and/or dynamic splinting may be required to help injured tissues heal more naturally and to help improve flexibility and mobility.

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