Burn Rehabilitation

Under supervision

- Prof. Dr. Mohamed Latif, CEO of the Egyptian Health Council

 Dr. Kawthar Mahmoud, Head of the Egyptian Nursing Syndicate - Member of the Senate 

Prepared by

• Initial diagnosis and evaluation of injuries and overall medical condition, as well as fluid resuscitation during the first three days.
• Excision and primary closure of wounds within the days following the burn.
• Final wound closure and facial and hand reconstructive surgery.
• Patient rehabilitation and reintegration into society.

 Goals of Burn Rehabilitation:

 The goals of burn rehabilitation include:

• For individuals with severe burns:
• Minimizing joint mobility loss, fluid accumulation in the body, and skin contractures that may hinder movement.
• For patients preparing to leave the hospital:
• Ensuring they are capable of standing, walking, eating, and using the bathroom (basic life activities).

 Steps of Burn Rehabilitation:

The rehabilitation steps undertaken by physicians and occupational therapists include:

• Taking necessary steps to prevent muscle and tendon contractures if movement is not possible. This is done by choosing the correct sleeping position for the patient in the hospital (which also helps reduce fluid accumulation in the body).
• Taking necessary steps to prevent skin contractures by choosing the appropriate positioning for the patient and moving the patient’s body twice a day. The muscles are moved by the doctor or therapist without effort from the patient to help the body get used to movement.
• Reducing neck flexion deformities by applying appropriate splints, which can be placed in various parts of the body such as the shoulder, elbow, and ankle.
• Checking splints twice a day to ensure they fit properly and are not putting pressure on the patient.
• Educating and informing the patient about the importance of the actions performed by the doctors and therapists.
• After the patient surpasses the first phase of treatment, therapists begin attempting to move the patient’s body with their assistance and encourage the patient to try moving as well.
• Reducing fluid accumulation in the body through massage, leg elevation, and appropriate bandaging.
• Preparing the patient for discharge by ensuring they are capable of performing basic life skills like walking, eating, and using the bathroom, as well as preparing them for a return to work or school.

1. Critical Illness Stage In this stage, survival is the primary concern for the patient and their family, and immediate psychological issues such as anxiety, fear, pain, delirium, sleep deprivation, and confusion prevail. These problems are managed by the ICU team and psychological counselors.
2. Burn Healing Stage Patients enter this stage once it is confirmed that they have survived, surgery intensity has decreased, and they have been transferred out of the ICU.
• In this stage, patients become more aware of the impact of their burn injuries and their long-term effects.
• Depression is common, and up to 30% of patients may experience post-traumatic stress disorder (PTSD) symptoms, such as hyperactivity, fear, and sleep disorders.
3. Final Stage of Psychological Healing
• The final stage of psychological recovery occurs during the first and second years after discharge, and it is often emotionally challenging.
• Patients in this stage begin to adjust to new life limitations at home and work, and PTSD symptoms typically diminish.
• Mild depression is common during this stage, and the condition may worsen if not treated properly.