232 chapter 28
Ways to help burns heal faster and better
Skin grafts
Large deep burns heal very slowly
and form ugly, stiff scars. Healing
can be faster and scarring reduced
by using ‘skin grafts’. A very thin
layer of skin from another part
of the body is stretched over the
burn. Usually this is only done by
a surgeon (although some village
health workers have been taught
how to do it).
Placenta or afterbirth
broken ‘bag
of waters’
(amniotic sac)
Also, to speed healthy healing, you
can use the fresh ‘bag of waters’ or
transparent membrane that comes
out with the placenta after childbirth.
But use it only if you are certain the
mother does not have HIV.
This sac must be kept clean. Wash it
in boiled and cooled, slightly salted
water, and put it on the burn as soon
as you take it out of the water.
RANGE-OF-MOTION EXERCISES
As soon as burns are covered with new skin or by a scar, gently begin range-of-
motion exercises. Slowly straighten and bend the affected joint—a little more each day.
For exercise details, see Chapter 42. If scarring is
severe, you may need to continue range-of-motion
exercises for years after burns are healed. Scar tissue
does not grow and stretch like normal skin.
Skin contractures often form and may slowly get
worse—sometimes even with exercises.
Before beginning exercises, it helps to rub body oil
or cooking oil into the healed burn (but never into a
fresh burn). Reports from several parts of the world
claim that fish oil on healed burns helps prevent thick
scarring and skin contractures.
SURGERY
When joints are scarred down or severe
contractures form after burns, ‘plastic surgery’ may
be needed. Sometimes skin is taken from another
part of the body and used to add more skin over the
joint area (a skin transplant).
In case of severe burns that have destroyed fingers
or thumb, special ‘reconstructive’ surgery may help
to return use of the hand. (This surgery is very costly
and usually can only be done by special surgeons in
larger hospitals.)
For example, if
the thumb has
been destroyed,
sometimes a
finger (or toe) can
be attached to the
end of the stump
so that the child
can grasp things
better.
index finger moved to
form thumb
PREVENTION of burns is important:
Keep small children away from fires.
Where there are open fires, be sure an
older child or someone else watches
the young children carefully.
Disabled village Children
Keep matches and
explosives out of reach of
children.
Turn handles of pans on
stove so that the small
child does not pull them.