Burns - Wound Healing

Factors that affect healing:

• Burn location – burns on the face, hands, feet and genitalia are serious due to the possible loss of function
• Burn configuration – oedema due to circumferential burn which can slow or stop circulation to extremities
• Pre-existing medical conditions – disorders that can impair peripheral circulation, e.g. diabetes, PVD, chronic alcohol abuse
• Other injuries - that were sustained at the time of the burn
• Patient’s age
• Pulmonary injury – inhaling smoke or superheated air damages lung tissue

Wound Healing

Superficial burns – heal by re-epithelialisation from epidermal cells.

Superficial dermal burns - – heal by a mixture of granulation, contraction and epithelialisation.

Deep dermal and full thickness burns – deep burns destroy most of the adnexal structures and, therefore, can’t heal by re-epithelialisation. Wound contraction reduces the surface area of the burn and the edges will eventually meet. Gross contractures may have occurred. Therefore, it is better to resurface the wound with a skin graft. (Dealey, 2005)

Escharotomy

Escharotomy is the incision through deep circumferential burns of the limbs or trunk in order to relieve the tourniquet effect. Careful observation must be made of the burn for loss of circulation, coolness, pale colour, loss of pulses and numbness (Zhang & Hughes, 2019).