Physiotherapy in the Rehabilitation of Burn Injuries

Introduction

• Thermal injuries are a common occurrence,

which are accompanied by a high risk of
mortality and morbidity amongst all age
groups.
 Epidemiology
• Total of 4,563 hospital admissions for burns
between 1993 and 1997 o 25.3 per 100,000
population  The Bradford Burn Study (Khan
et al 2007) o Studied all burns admissions
(n=460) for a full year at a single A&E in the
UK o Children of <10 years accounted for 36%
of admissions o Wrist and Hand burns
accounted for 36% with upper limb burns
constituting a further 21% (DORAS 2001)
 Mechanism of Injury
• (DOH, Western Australia 2009; Ever et al 2010;
Hettiaratchy and Dziewulski 2004)
•  May be thermal or non-thermal 1. Flame
burns – 50% 2. Scalds from hot liquids, e.g.
boiling water, cooking oil – 40% 3. Contact
burn, e.g. stoves, heaters, irons, 4. Electrical
burn, e.g. electrocution 5. Chemical Burns, e.g.
Hydrofluoric Acid 6. Friction burn 7. Radiation
burn
 Review of the Skin
•  Cutaneous membrane which covers the surface of the
body  Largest organ of the body in terms of weight and
surface area  Epidermis o Superficial layer o Composed of
epithelial tissue o Avascular o Deepest layer (Stratum
Basale) contains ‘Stem cells’  Capable of regeneration 
New skin cannot regenerate if injury destroys a large portion
of this layer  Dermis o Deeper, thicker layer o Connective
tissue o Contains blood vessels, nerves, glands and hair
follicles  Subcutaneous layer o Areolar and adipose tissue o
Storage for fat/ insulation o Contains large blood vessels o
Attaches to underlying facia  Connective tissue overlying
muscle and bone