To the Editor,
Burn wounds are categorized among the most severe injuries an individual can experience1. These are one of the major health problems worldwide. Even in case of small burn it causes high economic burden on the family and the society. In burns, early recovery is considered as an integral part of the treatment, which is not in terms of healing wound only, but it is an overall process retrieval including physical activities, decreasing psychological problems and focus on cosmetic issue. It is evident that treatment must begin immediately after the injury and last up to months or even years2. Lack of emphasis on physical rehabilitation of burns patient is a source of concern and here I would like to draw your attention to the problems in case proper rehabilitation does not commence.
In Pakistan, most of the patient’s experience burn injuries due to domestic violence, lack of firefighting system and terrorist blast activities. According to an estimate 195000 deaths are reported every year due to burns in which majority of cases belong to low socioeconomic class of our country3. Limited epidemiological studies data is available on burns patients but no work has been documented on the aspect of rehabilitation.
Plastic surgeon plays a major role in treating the burn patient but unfortunately team work is not given its significance; which is again an important milestone of burn management. Internationally, management of burn patient is divided into three phases. An interdisciplinary team approach including Physical and Occupational Therapist involvement is essential in all three phases of rehabilitation4. Different methods can be used like stretching, mobility, ongoing skin assessment, scar management, education, balance, endurance, Range of Motion (ROM) and stretching with techniques, positioning and respiratory conditioning by the rehabilitation team members to resume the patients in their normal daily activities.
Lack of awareness and improper handling is one of the major constraints experienced by almost every tolerant in our country. In Pakistan, lot of efforts are required to address the complications like failure of grafts, contractures, scar formation, infections and cardiopulmonary issues of burn patients to provide them better opportunities to live a healthy life, and to fulfill the requirements of normal living. It is necessary that every tertiary care hospital should focus on the above-mentioned aspects of rehabilitation. Physiotherapy should be given due importance as it plays a vital role in rehabilitation of the burn’s patients.
Dr. Muhammad Usman Khan
Senior Lecturer (BPT, PPDPT)
Ziauddin College of Physical Therapy
- Loyd JR, Imamoglu K, Thermal injuries. In: Walt AJ, Wilson RF, Editors. Management of Trauma: Pitfalls and Practice.Philadelphia: Lea and Febiger, 2005;438-59.
- Sowemimo GOA. Burn injuries in Lagos. Burns 2002:9;280-83
- Burns Fact sheet N° 365 May 2012.Available from: http://www.who.int/mediacentre/factsheets/fs365/en/index.html
- Burn in Children: Encyclopedia. Brigham and Women’s Hospital. Department of Rehabilitation Services, Physical Therapy.2013 Available from: http://healthlibrary.brighamandwomens.org/Library/Encyclopedia/90,P01887