Burns and occupational therapy
The month of May marks burns awareness month on the health calendar. A significant burn can alter all areas of daily living and have a significant effect on one’s life. Therefore, it is essential to seek immediate care for the burn area to prevent impairment and maximise independence following the burn.
Classifying a burn is dependent on which layers of skin are damaged. The skin has three layers – the epidermis, the dermis and the deeper subcuta- neous tissue. The epidermis is the outer layer. The dermis is the layer beneath it and consists of connective tissue, hair follicles and sweat glands. The subcutaneous tissue is made up of fat and connective tissue.
When classifying a burn, there are four main types – a superficial epidermal burn, a superficial dermal burn, a deep dermal/partial thickness burn, and a full thickness burn.
If one has burnt the superficial epidermis, the skin will appear red and sore but not blistered. When small blisters appear, a superficial dermal burn has occurred as only part of the dermis is damaged. When the skin is moist and painful with bloody blisters and the skin does not blanch (turn white when pressure is applied) then a deep partial thickness burn has taken place. When the skin turns black and all three layers of skin are damaged, it is called a full thickness. If a significant burn has occurred, it is essential to get immediate medical help for proper wound care to prevent infection.
Occupational therapists can help with the healing process by maintaining an active range of motion of the burn area with early mobilisation to prevent a loss of movement. This is important, especially if the burn area is over a joint because it often needs to be mobilised to prevent contractures (permanent shortening of a muscle or joint).
OTs can also use splinting or positioning to prevent joint contractures. Proper positioning can also reduce oedema (swelling) of the burn area. During the healing process, collagen production forms scars. Occupational therapists perform scar massage by applying pressure to promote collagen remodelling, provide moisture and increase pliability, and decrease itching and discolouration. OTs can also make custom pressure garments which are worn to decrease excessive collagen growth by limiting scar formation and deformity. For more information contact 056 816 2154. (Resource: rehabmedicine.pitt.edu)
