Burn scar management

true

burn scar management has the goal of achieving pliable soft scarring

t ro f

false

burn scar management has the goal of achieving resembling normal skin properties

t ro f

intrinsic factors

___ which inc risk of a hypertrophic scar includes being female, >30 yrs, darker skin pigment, and UE/body burns

external factors

___ whiich inc risk of a hypertrophic scar includes %TBSA burned, burn depth, surgery procedure, time to heal more than 14 days and complications

scar contracture

impairment due to replacement of skin w pathologic scar tissue of insufficient extensibility and length leading to a loss of motion or tissue alignment of an associated joint or anatomical structure

microstomia

an oral scar which leads to a contracture and the mouth being stuck in an open positions leading to issues w speaking, eating and drinking

positioning

helps w scar management involving placing the pt opposite to the direction of potential contracture in acute/early rehab stages but also later on in healing

90 deg abduction, external rotn

for burn scars the shoulder should be positioned in

supination

for burn scars the forearm should be positioned in

extension/hyperexension

for burn scars the neck should be positioned in

straight alignment

for burn scars the trunk should be positioned in

20 deg abduction

for burn scars the legs should be positioned in

dorsiflexion

for burn scars the ankle should be positioned in

scar massage and moisturization

using water based lotion 5x a day to ensure scar tissue is hydrated and helps to inc integrity and pliability for inc ability to do ROM and other treatments and dec pruritis and tightness

true

general and circular, zig zag, pinch and roll and anchor and pulling mobility are examples of scar massage techniques

t or f

false

general and circular, zig zag, pinch and roll and anchor and scrubbing mobility are examples of scar massage techniques

t or f

cutaneous functional units

the amt of skin involved in joint movement extended far beyond the immediate proximity of the joint skin creases themselves helping understand contractures

passive stretching

used to improve ROM and prevent contractures esp over areas of hypertrophic scarring over joints in acute care

blanche

when doing PROM want the scar to ____ or turn white to help indicate intensity of the stretch

splinting

used to prevent contractures, improve and maintain ROM as an early intervention, in those who cant do A/PROM and a deep burn crossing the joint

true

splints can be applied over wounds, skin grafts and dressings

t or f

true

splints are used all day and night in pts in acute care and switch to night only when in outpt rehab

t or f

false

splints are used only at night in pts in acute care and in outpt rehab

t or f

compression/pressure garments

induces a state of hypoxia and reduces expression pattern of scar growth after a burn by flattening the scar and preventing hypertrophy in addition to dealing with edema and pruritis

hard face mask

used to apply pressure to facial scars and minimizes hypertrophic scarring with silicone under it

silicone

used to hydrate and compress the scar to improve pliability, appearance and dec hypertophy of burn scar

true

silicone is applied to burn scars which have a high probability of forming hypertrophic scars

t or f

false

silicone is applied to hypertrophic scars already formed or on the whole burn wound

t or f

corticosteroid injections

used to reduce inflammation of a hypertrophic scar tissue and dec risk of further hypertrophy with several doses over time

laser treatment

use of a fractional CO2 laser makes microchannels in the scar allowing collagen rearrangement for healing with the use of local anesthesia every 4-8 weeks

self assembled skin substitutes

an autologous bilayered skin substitute grown from the pt stem cell grown in a lab to dec hypertrophic scar occurrance

reconstructive surgery

surgical procedure to release contractures that are not responding to more conservative treatments with aggressive mobilizations after to max ROM gains