Burns

Question 1

Superficial Burn

Answer 1

Superficial epidermis only
minimal pain and edema, no blisters
healing time is 3-7 days

Question 2

Superficial partial-thickness burns

Answer 2

epidermis and upper part of dermis
severe sunburn
red, blistering, wet
painful, heals on own in 7-14 days

Question 3

Deep Partital-thickness burn

Answer 3

involves epidermis and deep portion of dermis, hair follicles and sweat glands
red, blotchy, white
severe pain at site
healing is 21-35 days, may require skin grafts

Question 4

Full thickness burn

Answer 4

The epidermis and dermis are completely damaged, including nerve endings
white, leathery, waxy, non-elastic
sensation absent
requires surgery

Question 5

Emergent Phase of Burn Intervention

Answer 5

time of initial injury to 72 hours later
The focus is on medical management
OT may be ordered for positioning and orthotics

Question 6

Acute Phase of Burn intervention

Answer 6

continues until wounds are closed
Includes OT eval
ROM is contraindicated at this phase
edema control
Gentle AROM and PROM depending on tolerance

Question 7

Rehabilitation phase of Burn Intervention

Answer 7

follows acute phase until scar maturation
focus is to return pt to prior level of function
pain-free A/PROM, blanching, and no pain
Scar management
Orthotics
Sensation

Question 8

Scar management during burn healing

Answer 8

Hypertrophic scars may occur after burn/wound healing
Massage:performed several times a day to improve elasticity
AROM to reorganize tissue
Pressure Therapy

Question 9

Pressure therapy for Scar Management

Answer 9

compression applied with Tubigrip, elastic bandage wrap, gloves or Coban wrap
wearing schedule starts at 2 hours and tolerance is built up to 23
Custom-made garments are worn for 1-2 years until scars have matured

Question 10

Anticontracture position for burn on the anterior neck

Answer 10

Contracture tendency: neck flexion
Positioning: remove pillows, use half-mattress to extend neck or neck extension splint/collar

Question 11

Anticontracture position for burn on axilla (arm pit)

Answer 11

Contracture tendency: adduction
Positioning: 120 degrees abduction with slight external rotation, positioning wedges,
BE AWARE OF BRACHIAL PLEXUS STRAIN

Question 12

Anticontracture position for burn on anterior elbow

Answer 12

Contracture tendency: flexion
Positioning: elbow extension splint in 5-10 degrees flexion

Question 13

Anticontracture position for burn on dorsal wrist

Answer 13

Contracture tendency: wrist extension
Positioning: wrist support in neutral

Question 14

Anticontracture position for burn on volar wrist

Answer 14

Contracture tendency: wrist flexion
Positioning: wrist cock-up splint in 5-10 degrees extension

Question 15

Anticontracture position for burn on hand dorsal

Answer 15

Contracture tendency: claw hand
Positioning: functional hand splint with MP joints 70-90 degrees, DIP joints fully extended, fist web open, thumb in opposition

Question 16

Anticontracture position for burn on the hand volar

Answer 16

Contracture tendency: palmar contracture cupping of hand
Positioning: palm extension splint, MPs in slight hyperextension, and wrist in 0-30 degrees extension