Splinting, Positioning, Edema, and Scar Management After Burn Injury

AbstractThis chapter gives an overview of the different conservative therapeutic strategies that are mostly used in the rehabilitation of patients with severe scars after burn injury. These strategies include pressure therapy, the use of silicones, massage, the use of moisturizers, splinting and positioning, exercise, and mobilizations. Pressure and silicone therapy are the two most evidence-supported conservative treatments of (burn) scars, with compression therapy considered an evidence-based conservative intervention to treat the thickness of the scars. The other noninvasive treatment modalities have less supporting evidence. The relevance of these conservative therapeutic strategies will be situated within the field of the available scientific literature or guidelines.

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Scar Management Following Burn Injury

Journal of Burn Care & Research ◽

10.1097/bcr.0000000000000548 ◽

2017 ◽

Vol 38 (3) ◽

pp. 146-147 ◽

Cited By ~ 14

Author(s):

Edward E. Tredget ◽

Jeffrey W. Shupp ◽

Jeffrey C. Schneider

Keyword(s):

Burn Injury ◽

Scar Management

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Effectiveness of topical silicone gel and pressure garment therapy for burn scar prevention and management in children: a randomized controlled trial

Clinical Rehabilitation ◽

10.1177/0269215519877516 ◽

2019 ◽

Vol 34 (1) ◽

pp. 120-131 ◽

Cited By ~ 2

Author(s):

Jodie Wiseman ◽

Robert S Ware ◽

Megan Simons ◽

Steven McPhail ◽

Roy Kimble ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Burn Injury ◽

Controlled Trial ◽

Research Centre ◽

Burn Scar ◽

Randomized Controlled ◽

Silicone Gel ◽

Pressure Garment Therapy ◽

Scar Management ◽

Topical Silicone Gel

Objective: To determine the effectiveness of silicone and pressure garments (alone and in combination) in children receiving scar management post-burn. Design: Multicentre, parallel-group, randomized controlled trial. Setting: Hospital outpatient clinics, colocated research centre, or the participant’s home. Participants: Children (0–18 years) referred for burn scar management. Interventions: Participants were randomized to (1) topical silicone gel only, (2) pressure garment therapy only, or (3) combined topical silicone gel and pressure garment therapy. Main measures: Primary outcomes included scar thickness and itch intensity at the primary end-point of six months post-burn injury. The outcome assessor and data analyst were blinded for scar thickness. Results: Participants ( N = 153; silicone n = 51, pressure n = 49, combined n = 53) had a median (inter-quartile range) age of 4.9 (1.6, 10.2) years and percent total body surface area burn of 1% (0.5%, 3%) and were 65% male. At six months post-burn injury, intention-to-treat analysis identified thinner scars in the silicone ( n = 51 scar sites) compared to the combined group ( n = 48 scar sites; mean difference (95% confidence interval) = –0.04 cm (–0.07, –0.00), P = 0.05). No other between-group differences were identified for scar thickness or itch intensity at six months post-burn. Conclusion: No difference was identified in the effectiveness of silicone and pressure interventions alone. No benefit to a combined silicone and pressure intervention was identified for the prevention and management of abnormal scarring in children at six months post-burn injury, compared to the silicone or pressure interventions alone.

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638 Auricular Splinting Following Severe Facial Burn Injury and Reconstruction

Journal of Burn Care & Research ◽

10.1093/jbcr/iraa024.259 ◽

2020 ◽

Vol 41 (Supplement_1) ◽

pp. S164-S164

Author(s):

Lisa LePage

Keyword(s):

Low Temperature ◽

Burn Injury ◽

Surgical Reconstruction ◽

Transposition Flap ◽

Thermoplastic Material ◽

Contracture Release ◽

Scar Management ◽

The Many ◽

User Friendly ◽

Facial Burn

Abstract Introduction With a severe facial burn, injury often involves the ear(s) resulting in damage or loss which may require reconstruction. In consideration of the functional and psychological effect that loss of a defined ear lobe may entail, reconstruction is an important consideration for the burn survivor. Two cases described in detail with illustration will highlight an auricular contracture release; one with V-Y Advancement and the other with a transposition flap. Preservation of the auricular reconstruction is accomplished by implementing necessary splinting. The auricular splint fabricated was made from a combination of silicone and low-temperature thermoplastic material. A step-by-step process will illustrate the needed materials and techniques to fabricate a worthy splint in order to preserve what was surgically achieved. The splint maintains the space between the ear and head to properly position and prevent contracture through the healing and scar maturation process. It secured with a one-inch head band that is sublime enough to foster compliance with wear. The auricular splint material also serves as scar management with the many proven benefits of silicone. Methods Two case studies are reviewed with auricular contractures that required release and reconstruction. The auricular splints were fabricated to stabilize and preserve the reconstructed ear lobe. The wear schedule was intermittent during the day and overnight in combination with scar massage. The patients reported good compliance with wear and stability of splint position with overnight wear. Skin integrity was not compromised with overnight or intermittent wear. The splint fabrication process is reviewed and illustrated with a simplistic innovative end result that is user friendly. Results Surgical reconstruction was required following development of auricular contractures and partial loss. With post-operative bandage removal and wound closure, positioning was a necessary consideration to preserve post-surgical reconstruction. Conclusions In conclusion, the peri-auricular splint is fabricated with low temperature splinting material lined in silicone proved worthy for effective positioning and reported comfort with wear. Effective splinting is necessary for the preservation of surgical reconstruction and to prevent contracture from sabotaging surgical efforts. Applicability of Research to Practice Consideration of fabrication of silicone auricular splints to preserve the accomplishments of auricular surgical reconstruction.

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Disseminated Intravascular Coagulation: A Rare Entity in Burn Injury

Yearbook of Plastic and Aesthetic Surgery ◽

10.1016/s1535-1513(08)70098-5 ◽

2007 ◽

Vol 2007 ◽

pp. 107

Author(s):

R.E. Salisbury

Keyword(s):

Disseminated Intravascular Coagulation ◽

Burn Injury ◽

Rare Entity ◽

Intravascular Coagulation

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Supplemental Material for Posttraumatic Stress Symptomatology and Appearance Distress Following Burn Injury: An Interpretative Phenomenological Analysis

Health Psychology ◽

10.1037/hea0000391.supp ◽

2016 ◽

Keyword(s):

Posttraumatic Stress ◽

Interpretative Phenomenological Analysis ◽

Burn Injury ◽

Phenomenological Analysis

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EPIDEMIOLOGY AND OUTCOMES OF ELECTRIC BURN INJURY AT TERTIARY CARE CENTER IN JODHPUR, RAJASTHAN

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v3i6.298 ◽

2019 ◽

Vol 3 (6) ◽

Author(s):

Bharti Saraswat ◽

Ashok Yadav ◽

Krishna Kumar Maheshwari

Keyword(s):

Burn Injury ◽

Low Voltage ◽

Care Center ◽

Tertiary Care ◽

The Body ◽

Electrical Injury ◽

Age Group ◽

Electric Circuits ◽

Medical College ◽

Social Burden

Background- Electric burns and injuries are the result of electric current passing through the body. Temporary or permanent damage can occur to the skin, tissues, and major organs. Methods- This prospective study was carried out on patients admitted in burn unit of department of surgery M.G. Hospital associated with Dr. S.N. Medical College Jodhpur. Records of the patients admitted from January 2018 to December 2018 were studied. Bed head tickets of the patients evaluated in detail. Results- In our study out of 113 patients maximum no. of patients were in age group of 21-30 years 44 (38.94%) followed by age group <11 years in 21 (18.58%) patients and age group of > 60 years in only 3 (2.65%).39 (34.51%) patients were farmer and 15 (13.27%) were electrician in out of 113 total patients, while 37 (32.74%) were without any occupation. 65 (57.52%) cases of high voltage (HV) electrical injury and 48 (42.48%) cases were of low voltage (LV) electrical injury. Conclusion- Morbidity leading to permanent disabilities make the person physically dependent on others. It can be prevented by educating the people about the proper handling to electric circuits & devices. Proper communication among the electricians may help in lowering such accidents. Proper rehabilitation of the handicapped person & employment to the member of the affected family may reduce the social burden caused by such electricity concerned accidents.

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