Fire-Related Injuries
About Burns
How Burns Affect the Body
Burns totally destroy homeostasis, or the body's ability to regulate
its processes. The worst pain from a burn comes with second degree
burns because the nerve endings are left exposed, and this results
in throbbing, intense pain. Third degree burns are worse but actually
hurt less, since protective sensation has been interrupted by the
burn. Patients with severe burns undergo daily debridement (removal
of dead tissue and cleansing) and wound care, which also causes
extreme pain.
The three major problems confronting burn patients are:
- High risk of infection (skin is the body's barrier against infection),
- Fluid loss
- Body heat regulation
Burns cause a massive immune system response to the trauma. The
loss of skin also means that the patient's metabolism skyrockets
as the body tries to stay warm. This takes tremendous energy and
calories--energy gets generated, but calories and fluids are used
beyond a person's ability to take them in. A burn of a little as
6 percent of the total body surface area is enough to be fatal to
both children under 6 and older adults.
A person with a larger percentage body burn (referred to by their
total body surface area) or severe, combined thermal and inhalation
injury often do not retain conscious memory of this early phase.
Scarring
Burns that will heal by primary intention (without surgery) generally
do so within two to three weeks. The longer the wound takes to heal,
the more scarring may develop afterward during the collagen formation,
remodeling and remolding phase of healing. Also, some cultural/racial
groups scar worse than others (genetics is thought to be the culprit).
People of African, Celtic and Mediterranean descent scar worse than
other groups. They develop more hypertrophic (raised) scarring and
keloid scarring. This group may or may not be helped by cosmetic
surgery following/during late phases of recovery.
More about scar healing and recovery
Psychological effects of burns 
Information courtesy of Ann Burkhardt,
OTR/L,
a fellow of the American Occupational Therapy Association
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