Severe burns are a worldwide problem especially in rural areas. Aside from the immediate loss of life, the potential for long-term disability is great. In sub-Saharan Africa, young children under the age 15, lose seven times the number of productive years from fires than from war.
"He makes wars cease to the ends of the earth; he breaks the bow and shatters the spear, he burns the shields with fire. Be still, and know that I am God." Psalm 46:9-10
In South Asia, more years of healthy life are lost for people between the ages of 0-29 due to fire (burn injury) than from TB, malaria, or HIV/AIDs. In this region, as distinct from the rest of the developing world, women are disproportionally more affected than boys, with almost 72% of these burn injuries afflicting young girls and women.
Patient 1: A 3 year old boy who burned the palm of his hand over a year earlier when he grabbed a hot pot. The burn was not life-threatening, but due to lack of treatment, his fingers are now contracted and literally stuck into his palm- this child’s hand is essentially useless.
It doesn’t take fancy equipment or special skills to prevent these terrible outcomes.
- Application of splints while the burn wounds are healing will help to prevent contractures. You want to keep the hand and fingers in neutral position (wrist in slight extension, MP joints in flexion, and IP joints straight).
- In addition, regular physical therapy during the healing process will keep the joints mobile. Encourage the patient/patient’s family to help them exercise their fingers several times a day.
- And particularly for burns that cross joint creases, early excision of the burned tissue followed by skin grafting can prevent or lessen the disability than can results from these injuries.
Source: Practical Plastic Surgery
