The physical and mental impact of burns
ANITA (not her real name) had recently delivered her child when tragedy struck. She suffered scalding burns on the lower part of her body and legs after slipping and falling into a basin of hot water.
Four days after the incident, she sought specialist care at a hospital because the burns had become infected. She needed several cleaning procedures in the operating theatre and regular wound dressings.
Her burns were termed “neglected” as they showed signs of infection, with some slough covering it. The infection became worse since the area of injury was around the anus. This type of burn is different from others as it involves the genitalia.
Wound care is more difficult around this area as dressing isn't easy, compounded by the fact that the dressing gets soiled each time the patient urinates or defecates.
The concern was that if the burns worsened and the infection spread, she would require skin grafting, which essentially means using skin from other parts of the body to cover the burns. This would lead to an even longer hospital stay, larger wounds, and a longer recovery.
The aim was to treat her wounds aggressively so she could avoid skin grafting. Thankfully, the wounds showed signs of healing after regular treatment. After a week, she was discharged from hospital, but still had to see her doctor twice a week to change her dressings. She was advised to rest as much as possible and not lie on her back for prolonged periods. It took about two weeks for her to recover.
Common Causes of Burns and First Aid Tips
Household accidents are among the most common causes of burn injuries, says Bukit Tinggi Medical Centre (BTMC) consultant plastic surgeon Dr Harwinder Singh.
Bukit Tinggi Medical Centre (BTMC) consultant plastic surgeon Dr Harwinder Singh
Contact with hot objects (liquids or solids), such as hot water or drinks, are often the cause. Objects such as hot irons can also cause serious burns, he says.
What to Do Immediately After a Burn
When a burn happens, it’s important to place the affected area under running room-temperature water for at least 20 to 30 minutes.
What Not to Apply on a Burn
“Do not apply toothpaste or ketchup. Running water will help to limit the extent of the burns. Afterwards, a bandage may be used to wrap the area.”
If a bandage is unavailable, cling wrap can also be used but be sure to remove any tight clothing or jewellery around the affected area, advises Dr Harwinder.
Understanding Burn Classifications
Burns are generally classified according to the depth of their effect on the skin’s three layers: epidermis (topmost layer), dermis and hypodermis.
First-degree burns only involve the epidermis and are termed superficial burns, and second-degree burns, also called partial thickness burns, affect the dermis.
Third-degree burns affect all layers and are called full thickness burns.
“Each stage of burns is managed differently. Generally speaking, first-degree burns do not require admission to hospital. Dressing is not required in most cases and your doctor will just prescribe an ointment or soothing lotion,” says Dr Harwinder.
Sometimes painkillers are required if a large area of the body is affected.
Second-degree burns might or might not require hospital admission depending on the total body surface area affected.
Second-degree burns can be divided into superficial partial thickness or deep partial thickness burns.
Dr Harwinder says superficial partial thickness burns will require dressings that need to be changed every few days.
In deep dermal burns, the dermis is affected till almost its deepest part. Surgical removal of dead skin is likely needed, and skin grafting is performed.
Third-degree or full thickness burns also require surgery to remove dead tissue followed by skin grafting.
Why Psychological Support Matters for Burn Victims
Bukit Tinggi Medical Centre consultant psychiatrist Dr Siti Zaheera Ahmad Zam Zam says psychological support is crucial for burn victims.
Bukit Tinggi Medical Centre consultant psychiatrist Dr Siti Zaheera Ahmad Zam Zam
Burn injuries often result from traumatic events, such as fires, motor vehicle accidents or violence.
The recovery from burn injuries can be prolonged and involves serial surgeries and procedures, which require strong mental strength and resilience.
How Mental Health Support Aids Recovery
“Victims may also feel alienated and face strong stigma due to their appearance, which leads to mental health issues and loneliness,” she says.
Therefore, effective psychological support is vital to help victims build resilience, cope with trauma and improve their self-esteem.
Psychological support through counselling, psychotherapy, psychiatric care and support groups help improve healing outcomes.
This would ultimately support a patient’s mental, emotional and physical recovery and reintegration into society.
Link: Berita Harian
