Recovery period for deep burns
In deep thermal injuries, surgical treatment plays a key role. The main task of surgeons at this stage is plastic replacement of the skin. Subsequently, sequela surgery comes to the forefront. Doctors perform reconstructive and restorative operations for the consequences of mechanical injuries and their complications to eliminate scar deformities and contractures.
Comprehensive conservative rehabilitation necessarily includes exercise therapy (physical therapy) and physical therapy modalities.
Rehabilitation after limb loss (post-amputation)
In cases where the severity of the burn or concomitant injury requires planned amputation, rehabilitation measures begin as early as the early postoperative period.
- Immobilization: To prevent the development of contracture in a vicious position, the stump must be fixed with a plaster splint.
- Early exercise therapy: As early as 5–7 days after surgery, the patient is prescribed isometric muscle contractions.
- Scar formation: In planned surgeries, a myoplastic method is used, which improves the blood supply and functionality of the stump. The skin scar should be located outside the weight-bearing zone (displaced posteriorly on the lower limb, and dorsally on the upper limb).
- Prosthetics: A crucial stage in compensating for lost functions and preventing secondary deformities of the musculoskeletal system. Actual prostheses (replacing the lost segment), orthopedic support devices (orthoses, braces, corsets), and specialized orthopedic footwear are used.
Features of recovery in radiation burns
If a burn injury is combined with radiation exposure (combined radiation injuries), the recovery period (stage IV) proceeds with specific complications. Due to the extremely slow recovery of the immunobiological status and hematopoietic function, surgical activity is strictly limited.
The clinical picture during this period includes pronounced asthenic syndrome, long-healing trophic ulcers, osteomyelitis, as well as scar deformities and contractures.
Treatment tactics require an expanded conservative approach:
- Prescription of enhanced nutrition combined with anabolic drugs.
- Use of general tonic agents.
- Use of hemopoiesis stimulators.
- Cautious administration of exercise therapy and physical therapy modalities.
Surgical treatment (skin autoplasty, elimination of contractures) is performed only as part of the therapy for residual effects of radiation injury. The application of any types of sutures and skin autoplasty in preceding periods is strictly contraindicated and dangerous.
Multi-stage treatment and rehabilitation for eye burns
Restoration of vision and eyeball structures after burns is a complex process that takes more than a year and is divided into four consecutive stages:
- Acute period (1 day — 2 weeks): Doctors remove necrotic tissue, perform revascularization of the outer membranes (sclera), and stimulate wound epithelization. The most important task is the prevention of eyelid scar deformity, such as lagophthalmos and entropion.
- Treatment of complications (3 weeks — 6 months): Therapy is aimed at combating dry eye syndrome, secondary post-burn glaucoma, and persistent defects of the eye membranes. Prevention and treatment of eyelid deformities continue.
- Reconstructive stage (4–12 months): Surgical reconstruction of the eyelids, conjunctival fornices, and the surface of the eyeball is performed (elimination of scar deformity). Comprehensive glaucoma treatment and preparation of the eye for optical reconstructive interventions are carried out.
- Functional rehabilitation (12 months and more): At the final stage, high-tech methods are used: autolimbal and allolimbal transplantation, keratoplasty, and keratoprosthesis (using the Fedorov–Zuev prosthesis).
To memorize the stages of eye burn treatment, use the "ORRF" rule: Observed clearance (removal of necrosis), Resolution of complications (glaucoma, dryness), Reconstruction (eyelids, fornices), Function (keratoplasty, prosthetics).
Class and exam questions
When can surgical elimination of contractures be initiated in combined radiation injuries?
Surgical activity in such cases is strictly limited due to the slow recovery of immunity and hematopoiesis. Skin plasty and elimination of contractures are performed only in the recovery period against the background of therapy with hemopoiesis stimulators.
What surgeries are used for functional rehabilitation after eye burns?
At late stages (a year or more later), keratoplasty, limbal transplantation, and keratoprosthesis using the Fedorov–Zuev prosthesis are performed.
What is included in the conservative rehabilitation complex for patients with deep burns?
The basis is exercise therapy (physical therapy) and physical therapy modalities. For exhaustion and radiation injuries, high-calorie nutrition, anabolics, and general tonic drugs are added.
On what day after amputation is physical therapy prescribed?
Exercise therapy, consisting of isometric muscle contractions, is prescribed on days 5–7 after surgery.
What else to study on this topic
- Primary surgical debridement of wounds contaminated with radioactive substances.
- Rules for processing bone sawdust and neurovascular bundles during amputations.
- Types of prosthetic and orthopedic products and stump preparation.
- Providing first aid for chemical eye burns.
- Specifics of immobilization and hemostasis in polytrauma.
Master the entire topic in the "Traumatology" course
This is a summary. The course covers everything tested in classes and exams.
- Complete study guide on "Burn rehabilitation" and another 812 pages of the subject
- Assignments and quizzes after every topic — just like in a colloquium
- AI tutor answers questions on the topic anytime
- 35 video lessons on the subject
Other topics in the "Additional Topics" section
Prepared by WhiteCoat Pro faculty in accordance with the medical school curriculum. For educational purposes only.