La Revue du praticien
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Burn rehabilitation main goal is to minimize the consequences of hypertrophic scars and concomitant contractures. The treatment principles rely on the association of joint posture, continuous pressure completed with range of motion to prevent joint fusion (which happens to adults but not to children). Throughout the different treatment phases and wound evolution, reassessment is necessary to review rehabilitation goals and activities. ⋯ The treatment consists mainly on active/passive range of motion, scar massage, strengthening exercise and endurance retraining. Also modalities (such as thermal bath and high pressure water spray) are used to address itching problems and for scar softening. Finally, reconstructive surgery can be performed to correct excessive scarring or joint contracture for better functional or cosmetic outcome.
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Severely burned patients are at high risk for developing respiratory failure at any time during their treatment. The lung of a thermally injured patient may sustain many injuries such as smoke inhalation, physical forces, inflammation and infection. ⋯ The respiratory injuries are one of the main factors responsible for high mortality in burned patients. Better understanding of the pathophysiology and inflammatory response will lead to future therapeutic advances.