Serious burns, especially when they encompass large portions of the body, are not only disfiguring but can be a life-threatening injury. Fortunately, improvements in the treatment of burn victims has improved the initial stabilization of patients and resulted in better long-term management of severe, widespread burns.

Specialized Burn Centers

One of the best resources for serious burns is the development of burn centers, which may be called the burn intensive care unit (BICU) or hospitals specifically dedicated to treating burns. In many cases, smaller hospitals and even hospitals with a Level I trauma center are not equipped to handle the long-term treatment of burn victims. Whenever possible, people with serious burns may be transported via medical flight to a burn center once they are initially stabilized.

Specialized burn centers remain invaluable in the treatment of burn injuries, especially for widespread burns. Although pain and disfigurement are important when considering burn injuries, the severity of these injuries is extensive. Some of the major considerations include the role of the skin. The skin is important in protecting major organs from pathogens, regulating body temperature, and helping maintain electrolyte balance. With severe burns, all of these necessary body functions are compromised, making serious burns difficult to treat.

Burn Rehabilitation

The rehabilitation associated with burn treatment can be arduous and may occur over many months or years. Burn victims typically receive daily removal of dead skin (debridement) and changes in their dressings until the areas have healed. The management of extensive pain and itching are also an important part of rehabilitation. Other components of rehabilitation may include physical manipulation of the joints and soft tissues to keep them movable as the skin heals.

As the burned skin heals, scar tissue may form and skin can contract making it difficult to move the burned area. Regular physical therapy can minimize scar tissue and reduce mobility limitations. In some cases, surgical repair of contractures are necessary. Rehabilitative aspects may extend beyond burned skin. Depending on the exact type of burns and severity, other damage may occur. For example, smoke inhalation could be another complication, causing problems with breathing and/or speech. Extensive damage to muscles, nerves, and other soft tissues may require rehabilitation to help the patient regain lost functions.

Skin Grafting

Large burned areas may not heal or it may take so long to heal that the underlying tissues could become necrotic. In some cases, the burn victim may be able to donate their own skin to treat areas (autograft). For example, unaffected skin on their back may be sliced off by using a dermatome to cover a burned area on their leg. The skin donor may also be someone different than the patient (allograft). In this case, the skin is matched as closely as possible to the recipient to minimize the incident of rejection and to help the skin graft blend in with the skin color of the recipient.

Fortunately, other skin grafting techniques have been developed for use when traditional autografts and allografts cannot be used. One such example is the use of the burn victim's skin cells to create sheets of skin. A cultured epithelial autograft (CEA) is a thin, fragile sheet of skin grown in the laboratory from skin cells. Much like a traditional autograft, rejection of the donated tissue is not a concern, but a successful graft is not guaranteed. The concern of CEA use surrounds its fragility. Movement of the burned area is important of prevent skin tightening, but this is not possible with CEA. The CEA can tear easily if it has not healed before moving the area. Since the patient must keep the area still to minimize damage to the CEA, rehabilitation can be a slower process.

With specialized care and resources for the treatment of serious burns, the outcomes of these injuries have vastly improved. Additionally, with newer techniques for skin grafting, more patients are recovering faster and achieving a better cosmetic result. 

For more information about burn treatment and other medical emergencies, contact a health clinic near you.