Burn Complications & Prevention

Burn Complications: Infection

• Burn injuries compromise the skin barrier, increasing susceptibility to bacterial and fungal infections.
• Symptoms of infection:
  • Increased redness
  • Warmth
  • Purulent drainage
  • Fever
  • Worsening pain
• Severe infection can lead to sepsis, characterized by:
  • Hypotension
  • Tachycardia
  • Altered mental status
• Prevention:
  • Strict sterile technique during wound care and dressing changes to minimize contamination.
  • Use of topical antimicrobials such as silver sulfadiazine or mafenide acetate.
  • Systemic antibiotics if infection is suspected.
  • Early wound debridement and skin grafting to promote healing and reduce infection risk.

Burn Complications: Contractures

• Contractures result from scar tissue formation during the healing process of burns.
• Scar tissue is fibrotic and non-functional compared to normal skin; it lacks elasticity and malleability.
• Scar tissue leads to contractures that restrict movement and impair function.
• Burns over joints are particularly problematic because skin tightening limits range of motion, affecting the joint itself.
• Prevention and Management:
  • Early physical therapy and range of motion exercises to maintain flexibility.
  • Performing range of motion exercises during dressing changes under anesthesia for extensive burns to minimize pain.
  • Splinting joints in neutral positions to prevent joint deformities.
  • Surgical interventions such as skin grafting, performed accurately and early.
  • Repeated skin grafting may be necessary if contractures develop.

NCLEX Key Points

• Prioritize infection prevention through aseptic wound care.
• Recognize early signs of sepsis.
• Ensure patients are up-to-date with tetanus vaccination due to the risk of tetanus.
• Address contractures with early mobilization and physical therapy to prevent permanent disability.