Burn and Wound Management
Whether you’re healing from a recent injury or developing scarring from a burn or wound, the skilled therapists at The Centre for Working Hands can help. The first step of successful rehabilitation is a good wound management program, requiring us to have a solid understanding of the physiology of healing.
We also offer an experienced approach to the emotional and mental support required for patients to regain functional use of the affected body part. Part of this is achieved through early intervention, which prevents loss of range of motion and minimizes scarring and sensitivity. We also educate our patients on a home exercise program to ensure a successful outcome. Patients, who are unable to attend therapy session due to traveling from a distance, are provided with a home program so that they can manage their healing process between doctor’s visits from the comfort of their own home.
Types of wounds and burns
Burns are classified into three categories based on the severity of damage to the skin: first, second, and third degree. First degree is the most minor type of burn and third is the most severe. Any accident involving heat or chemicals can cause any degree of burn, dependent on how long the skin is exposed.
First degree burns are characterized by red, non-blistered skin. You may also experience some minor swelling. First degree burns can be expected to clear within a few days and do not require the attention of a surgeon. Home treatment is simple with over the counter ointments, but see your doctor if the burn site becomes extremely painful or infected.
If your skin is blistering or seems thicker than usual, you may have a second degree burn. Blistering is an indicator that damage has extended beyond the first layer of skin. Some blisters may pop, releasing fluid and giving the burn a wet look.
Rinsing, cleaning, and bandaging are good first steps of treatment to take. Call your doctor if the pain does not decrease over the first week. Second degree burns usually heal within two to three weeks but can take longer depending on how widespread blistering is.
Third degree burns cause the most damage across every layer of skin. In the worst cases, damage can reach major organs and bones, which can cause death. You would assume this is the most painful burn, but damage can be so extensive that it damages the nerves, rendering you unable to feel pain.
Third degree burns will appear white with a waxy, leathery appearance and the skin surrounding the area will be significantly thicker. Depending on the source of the burn, your skin may appear charred, brown, or raised. Third degree burns can take a long time to heal, depending on the severity and your doctor’s course of treatment.
You should never attempt to treat a third degree burn. Keep the injury elevated above your heart and call 911 right away. Do not rinse the burn or put any products on it, but do ensure that no clothing is touching the area.
Causes and Complications
A burn can be caused by any number of things, including: scalding from hot liquids, chemicals, electrical burns, sun exposure, and fires/flame. Chemical and electrical burns demand immediate medical attention because they can affect the inside of the body despite minor skin symptoms.
If the burn is third degree, complications can become severe and include blood loss, shock, tetanus, scarring, and other bacterial infections. Serious burns will require frequent bandaging to expedite healing and some may even warrant skin grafting. If you’ve suffered a large burn over any of the following areas, you should seek medical attention immediately:
Wound is an expansive term referring to any injury to living tissue from a cut, blow, or impact that breaks the skin. They can significantly alter one’s physical appearance which, over time, can impact your mental health and self esteem.
Disfiguring wounds can be caused by, but not limited to: amputations, disease, cancer, impalement, flesh eating bacteria, congenital birth defects, frostbite/hypothermia, animal bites, and explosions/work related injuries.
Regardless of the cause, wounds are classified into one of five categories.
Abrasions are caused by the skin scraping or rubbing against a hard surface. A good example of this would be road rash a motorcyclist might experience after an accident. In a home setting, a scraped knee or elbow would be considered a mild abrasion. Since the wound usually affects the first few layers of skin there is often little bleeding. Scrubbing, cleaning, and using an over the counter disinfecting liquid or cream is recommended to avoid infection.
An incision typically occurs after impact with a sharp object like a knife, shard of glass, razor blade, or scrap metal. Understanding the depth of the wound is key. Incisions bleed a lot and fast, which can make it hard to tell how bad the cut is. If deep enough, tendons, ligaments, and muscles may be cut or severed, requiring medical attention and physical therapy.
Lacerations often occur after an incident with tools or machinery. They are, by definition, an irregular or jagged breaking of the skin. Blood loss can be extensive and rapid. Applying pressure to the wound as soon as possible can help stem the bleeding and reduce risk of shock. If bleeding does not subside, call 911.
Punctures are small holes cause by sharp, pointy objects. Nails, needles, ice picks, and spiked shoes can cause puncture wounds, as can bullets. While blood loss may be minimal in the best case scenarios, a puncture can easily damage internal organs. Puncture wounds are one of the many reasons to stay up to date on your tetanus shots. Even if you are, visit your doctor to get a tetanus booster and stave off infection.
Avulsions are a partial or complete tearing of skin or tissue from the body. Car accidents, explosions, and other violent accidents can cause severe avulsions. If any body part is severed, it should be taken to the hospital with the patient in case reattachment is an option. In ideal situations, pack the body part in ice after wrapping in sterile gauze.
How to Care for Wounds and Burns
If you’ve suffered a first or second degree burn, cool it by running cool (not cold) water over the burned area for 10-15 minutes. You can also ease pain by applying a cool, damp towel or using Aloe vera lotion or gel. Remove any jewelry or clothes before swelling sets in. Do not break blisters. Sanitize and bandage them if they break on their own. If the pain is too great, you can take an over the counter pain reliever like Tylenol or Advil.
Seek medical attention if your blisters increase in size or if the burn covers a large portion of your body. Also consult your physician if you see signs of infection like redness, excessive swelling, or oozing, yellowish discharge.
Major or third degree burns need immediate medical attention. Call 911 as soon as possible and take precautionary actions to protect the burn until they arrive. If the victim is still in danger, try to remove them from the situation if you can do so safely. If not, wait for an emergency unit.
Remove restrictive items like belts or jewelry, especially from around the neck, as burning can cause rapid swelling. But, if there is burned clothing stuck to the skin, do not try to remove it. Check the victim for breathing and signs of circulation. If you are certified and there are no signs of a pulse, begin CPR.
Do not immerse or run cold water over large burns. This puts the victim at risk of hypothermia and shock. Keep the wound raised, if possible, above the level of the heart and cover the area with a loose bandage while you wait for help.
Most open wounds people experience are minor and can be treated at home with basic first aid. Take the following steps to treat a small wound:
- Disinfect with antibiotic ointment/cream
- Apply firm, direct pressure
- Bandage with sterile dressing
- Keep clean/dry for 5 days
- Use painkillers as needed
- If bruised or swollen, apply ice
- Do not pick at scabs
- Use sunscreen on injury site until healed
A wound may require you to see your doctor if:
- It is deeper than half an inch
- Bleeding does not stop with direct pressure after 20 minutes
- You’ve been in a serious accident
Procedures to Reduce Burn Scarring
Burn surgery is either acute or reconstructive. Acute burn surgery occurs in the emergency room and is performed by a team of trauma surgeons who specialize in burn care. Reconstructive burn surgery occurs after acute surgery and is usually performed by a trained plastic surgeon.
Reconstructive surgery aims to remove scar tissue and heal the skin as much as possible. This is often accomplished through skin grafting and skin rearrangement.
The therapists at The Centre for Working Hands are trained in the physical and emotional rehabilitation of patients with burns covering the upper extremity. Our board certified surgeons employ the latest technology to reconstruct your body and help you get back to living life on your terms. Learn more about how we can assist with burn care.
Procedures to Reduce Wounds
Recommended treatment depends on the severity and kind of wound. The best course of action is to consult with one of our surgeons. Some of our most common procedures include skin grafts, tissue expansion, flap surgery, microsurgery, and therapeutic wound care. Our goal is to provide your body with the care it needs to facilitate the healing process, both mentally and physically.
If you’ve suffered a wound, consult with the doctors at The Centre P.C. about the possibility of reconstructive surgery. We provide wound care to all areas of the upper extremity, specializing in rehabilitation of hands.
We’ll evaluate the wound and consult you on your options, which range from microsurgery to direct closure. We offer free consultations and work with a number of insurance providers to identify a plan that best suits your unique needs and circumstances.
Helping You Heal
Our surgeons and therapists have years of experience dealing with burns and wounds ranging from simple to complex. We use advanced scar revision techniques to help patients regain partial mobility and function of the affected area. We’ve handled many different kinds of injuries and strive to improve lives, both of those in our community and around North America.
We’re no stranger to helping those who are recovering from a burn or wound and have lost function and mobility due to scar tissue. For more information on reconstructive surgery and scar revision in the wake of a burn or wound, please reach out to our specialized staff at The Centre, P.C. to schedule your free consultation.