Burns rehabilitation is more than skin deep
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《英国医生杂志》
EDITOR—Edgar and Brereton discuss rehabilitation after burns injury in the ABC of burns.1 Burns rehabilitation is often challenging and has several other dimensions, entailing much more than the sole aim of preventing scarring.
Psychological factors such as sexuality and changed body image require careful management. One model frequently used is the PLISSIT model,2 which provides a framework for all health professionals to introduce sexuality and frank discussion into treatment comfortably and appropriately. Adaptation to long term disability should be integrated into the rehabilitation treatment plan as well as the assessment of post-traumatic stress disorder as the potential to develop this disorder exists owing to the often distressing nature of many of these injuries.3 The input of psychological services is an invaluable aspect of burns rehabilitation.
Although Edgar and Brereton addressed physical considerations, they did not include nutritional aspects of wound healing and recovery. Adequate evidence supports the need for good nutrition after burns, for initial wound healing and long term scar reduction.
In addition, reintroduction to society and work may provide several challenges to a burns survivor. Issues related to a full return to the community, and their solutions such as behaviour therapy, occupational rehabilitation, and adaptive equipment may be outside the limits of a brief paper. However, follow up recommendations, including a more comprehensive checklist of potential areas of need, may be helpful.
Monique Berger, clinical nurse consultant
mberger@stvincents.com.au Sacred Heart Rehabilitation Service, St Vincent's Hospital, 170 Darlinghurst Road, Darlinghurst, NSW 2010, Australia
Stephen Wilson, senior lecturer (conjoint)
Public Health and Community Medicine, University of New South Wales, Sydney, NSW 2052, Australia
Competing interests: None declared.
References
Edgar D, Brereton M. ABC of burns. Rehabilitation after burn injury. BMJ 20047;329: 343-5. (7 August.)
Whitehead TL. Sexual health promotion of the patient with burns. J Burn Care Rehabil 1993;14(2 part 1): 221-6.
Lawrence J, Fauerbach J. Personality, coping, chronic stress, social support, and PTSD symptoms among adult burn survivors. J Burn Care Rehabil 2003;24(1): 63-72.
Psychological factors such as sexuality and changed body image require careful management. One model frequently used is the PLISSIT model,2 which provides a framework for all health professionals to introduce sexuality and frank discussion into treatment comfortably and appropriately. Adaptation to long term disability should be integrated into the rehabilitation treatment plan as well as the assessment of post-traumatic stress disorder as the potential to develop this disorder exists owing to the often distressing nature of many of these injuries.3 The input of psychological services is an invaluable aspect of burns rehabilitation.
Although Edgar and Brereton addressed physical considerations, they did not include nutritional aspects of wound healing and recovery. Adequate evidence supports the need for good nutrition after burns, for initial wound healing and long term scar reduction.
In addition, reintroduction to society and work may provide several challenges to a burns survivor. Issues related to a full return to the community, and their solutions such as behaviour therapy, occupational rehabilitation, and adaptive equipment may be outside the limits of a brief paper. However, follow up recommendations, including a more comprehensive checklist of potential areas of need, may be helpful.
Monique Berger, clinical nurse consultant
mberger@stvincents.com.au Sacred Heart Rehabilitation Service, St Vincent's Hospital, 170 Darlinghurst Road, Darlinghurst, NSW 2010, Australia
Stephen Wilson, senior lecturer (conjoint)
Public Health and Community Medicine, University of New South Wales, Sydney, NSW 2052, Australia
Competing interests: None declared.
References
Edgar D, Brereton M. ABC of burns. Rehabilitation after burn injury. BMJ 20047;329: 343-5. (7 August.)
Whitehead TL. Sexual health promotion of the patient with burns. J Burn Care Rehabil 1993;14(2 part 1): 221-6.
Lawrence J, Fauerbach J. Personality, coping, chronic stress, social support, and PTSD symptoms among adult burn survivors. J Burn Care Rehabil 2003;24(1): 63-72.