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Select Practices in Management and Rehabilitation of Burns: A Survey Report

Holavanahalli, Radha K. PhD*; Helm, Phala A. MD*; Parry, Ingrid S. MS, PT; Dolezal, Cynthia A. PT, MLS*; Greenhalgh, David G. MD‡§

doi: 10.1097/BCR.0b013e31820aadd5
Original Articles

The purpose of this study is to document the organization and current practices in physical rehabilitation across burn centers. An online survey developed for the specific purposes of this study sought information regarding a) logistics of the burn center; b) inpatient and outpatient treatment of patients with burn injury; and c) specific protocols in the treatment of a few complications secondary to burn injuries. Of the 159 responses received, 115 were received from the United States, 20 from Australia, 16 from Canada, and 7 from New Zealand. The overall sample included responses from 76 physical therapists (PTs) and 78 occupational therapists. Seventy-three of those surveyed considered themselves primarily a burn therapist. Nurses (86%) were reported as primarily responsible for wound care of inpatients, followed by wound care technicians (24%). Ninety-seven percent of the therapists reported following their own treatment plans. The trunk and areas of head and neck were treated by both PTs and occupational therapists, whereas the lower extremities continue to be treated predominantly by PTs. Some common practices regarding treatment of a few complications secondary to burn injuries such as splinting to prevent contractures, treatment of exposed or ruptured extensor tendons, exposed Achilles tendons, heterotopic ossification, postoperative ambulation, conditioning, scar massage, and use of compression garments are described. Opportunities exist for 1) developing a common document for practice guidelines in physical rehabilitation of burns; and 2) conducting collaborative studies to evaluate treatment interventions and outcomes.

From the *Department of Physical Medicine and Rehabilitation, University of Texas Southwestern Medical Center at Dallas; †Department of Occupational and Physical Therapy and ‡Burn Division, Shriners Hospital for Children Northern California, Sacramento; and §Department of Surgery, University of California, Davis.

Supported by funds from the National Institute on Disability and Rehabilitation Research (NIDRR) in the Office of Special Education and Rehabilitative Services in the U.S. Department of Education

Address correspondence to Radha K. Holavanahalli, PhD, Department of Physical Medicine and Rehabilitation, UT Southwestern Medical Center at Dallas, 5323 Harry Hines Boulevard, Dallas, Texas 75390-9136.

© 2011 The American Burn Association