By entering the picture early, therapists get a head start on preventing skin breakdown, guarding against long-term functional impairments, and eliminating contractures. The early phase of burn treatment incorporates several components beyond surgery and infection management, one of which is education. When the patient is stable, therapy teams should discuss the recovery and scar process and explain how rehab will progress. Therapists must encourage movement, even though patients have difficulty with normal activities during the acute phase Sitting and walking optimize pulmonary function and help prevent edema. But mobility is often an exercise in pain, and for therapists mobilizing patients and restoring tissue pliability may be one of the hardest parts of the job.
Scar management is another key component of a wound care program.
The scar process is most active within the first six to eight months post-injury, although maturation can continue for two to three years. Compression garments can minimize scarring while the burn area matures, says Cynthia Lundy, PT, burn therapy supervisor at Intermountain Burn Center in Salt Lake City. Therapists often start with elastic wrap or tubular support bandages, then slowly progress to tighter compression garments when the damaged skin can tolerate it. While burns on any part of the body are challenging, hands are difficult to manage because multiple joints and motions are involved. Severe difficulties could mean a loss of function, stripping someone's ability to hold or grip items.