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HealthInfo Canterbury

Specialist care for your burn

FDP patient in hospitalPeople with serious burns need to be cared for in hospital. The first step in treating a bad burn is to check the person's breathing and circulation are stable. Burns can cause a lot of fluid and heat loss. Medical staff will try to reduce the amount of fluid lost, replace fluids and stabilise the person's circulation and body temperature.

Pain relief is important. The pain relief you (or the person you are caring for) will get depends on the amount of pain you or they are feeling.

Exactly how hospital staff manage the burns will depend on where they are, how deep and large they are (what percentage of the body is affected), and the age and health of the person who is burned.

There is always a risk of infection, so the wounds and their dressings need to be cared for carefully. Some people may need antibiotics.

Another risk is that the skin around the scar will pull together or tighten, restricting movement around the burned area. This is called a contracture. To avoid this hospital staff will use careful positioning, splints and physiotherapy.

Who will look after me or my relative?

If you or your child has had a serious burn, a team of health professionals, all with different areas of speciality, will be involved in your care. If you're not sure who to ask what, start with your nurse.

Plastic surgeons are the doctors who specialise in burns care, though a paediatrician or anaesthetist may also help to look after you. Physiotherapists, occupational therapists, dietitians and social workers may also be involved with your care.

Where are people with burns looked after?

For most burns you will be treated in Christchurch, which is a regional burn centre.

If you or your relative has a very serious burn you may need treatment in the Intensive Care Unit (ICU). Otherwise you may be in the Ward 20, the plastic surgery ward. If you are under 16 you will be in the Child Health Department (Wards 21 and 22).

See the recommended links below for information about burns in children.

For some severe and complex burn injuries you may be flown to the National Burn Centre in Auckland. This patient and family information booklet gives more information about the National Burns Unit.

Surgery for burns

Sometimes an operation, or several operations, are needed to manage burns. Plastic surgeons specialise in operations to treat burns. Sometimes people need emergency operations, some other operations may be planned (elective).

Some operations are done with local anaesthetic (numbing the immediate area), some are done with regional anaesthetic (like an epidural or a nerve block) and some are done with general anaesthetic (when you go to sleep). You will need to talk to your surgeon and anaesthetist about the type of operation and anaesthetic you are having. You can read more about Having an anaesthetic.

If your child is having an operation, you might like to watch the video If you need an operation with them (at the bottom of the page).

Common procedures are:

Debridement: This means removing dead or damaged tissue that could delay healing. The tissue may have lost its blood supply, it could be infected, or there could be foreign objects within the wound that need to be removed.

Skin grafts: People with third-degree burns (deep dermal or full thickness burns) often need skin grafts. Sometimes people with second-degree burns (mid-dermal, or partial thickness burns) need skin grafts. A skin graft may be done to improve or speed up healing. It may be done to help function, for example to treat contractures (where the skin around the scar has become too tight). Or it may be done to make the wound look better (cosmetic). Sometimes it is done soon after the burn, sometimes further down the track.

You can find out a lot more information about skin grafts in this section.

Scar Management Specialist Service

Burn scars can cause problems by restricting movement, and can be disfiguring. An occupational therapist (OT) who specialises in scar management is available through the Christchurch Hospital Plastic Surgery Unit to help you with these issues and minimise any effects of scaring.

If you need this service, you may see the OT soon after your injury, and will continue being seen as an outpatient. Treatments vary, depending on what each person needs.

If you have a scar that is worrying you and you're not already using this service, talk to your surgeon and ask for a referral.

Coping and emotional recovery

Burns can have a major emotional impact, for you and your caregiver or parent. Talk to any of the team caring for you or your relative and please do ask if you'd like extra support. There are some specialist services you can be referred to. The support groups in the more information page can help too.

  HealthInfo recommends the following pages

Written by HealthInfo clinical advisers. Approved by clinical director, Plastic Surgery Department, Canterbury DHB. Reviewed June 2017.

See also:

Caring for your burn at home

Sources

Page reference: 101211

Review key: HIBUR-30143