The American Burn Association estimates that roughly 450,000 people receive hospital and emergency room treatment for burns each year. While it’s a smaller population than other traumatic injuries, leaders in the field say it’s an injury that needs more attention from the medical and rehabilitation communities.
Brooke Murtaugh, OTD, OTR/L, CBIST, BT-C, the burn program leader at Madonna Rehabilitation Hospitals – Lincoln Campus, is the only therapist in Nebraska with an international certification from the American Burn Association. As a burn therapist at Madonna, she works with some of the nation’s most complex burn injury cases.
“Burn rehabilitation overall is a very specialized area, not only from a burn medicine perspective but also from rehabilitation for several reasons,” Murtaugh said. “It’s a very complex injury because you’re not just looking at the area that has scarring, but how the body moves overall.”
According to the American Burn Association, the survival rate of burn patients admitted to a burn rehabilitation center is 97.7%. While a high percentage of individuals who sustain burn injuries survive, the key to their longevity and quality of life is rehabilitation. Engaging in activity allows for a burn survivor’s skin, scars and underlying tissue to become increasingly mobile. Burn rehabilitation is also one of the most painful types of rehabilitation, as burn survivors are also many times dealing with open wounds, skin grafts and skin tightness as a result of scarring and immobility.
Murtaugh said, in most cases, beginning therapy with burn patients as soon as possible is key to long-term success. The worst scenario is too much bed rest, which can greatly delay how quickly patients can make functional gains.
“It’s really considered best practice to start therapies as soon after the injury as medically possible and appropriate,” Murtaugh said. “I can tell the patients who have been intensively mobilized in acute care on the burn unit versus the ones that are in and out of the operating room frequently and just don’t get that opportunity to participate in regular, intensive therapy the days and weeks after injury.”
The approach to burn rehabilitation goes beyond focusing on the affected area of the body, and instead must consider how the body, particularly the skin, moves together when performing an action. While rehabilitation of areas around joints can provide an increased range of motion, it’s also important to factor in what other parts of the body move when, for example, a person raises their arm.
Even more difficult, certified burn therapists are trained to identify what areas are most important to focus on in instances where a large portion of a person’s body has burns in order to help the patient regain as much functionality as possible.
“A key component of burn rehabilitation is identifying which areas of scars are going to cause you the most functional limitations, because not all scars are created equal,” Murtaugh said. “You really have to assess, at a micro level, which scars need to be aggressively treated because if you focus on all scars on somebody who has burns on 80% of their body, you’re never going to get anywhere. There’s just too many.”
Not only is burn injury complex, it’s expensive. The lifetime cost for treating a severe burn injury survivor can easily jump into the millions of dollars between surgeries, skin grafts, therapies and other treatments. Through a specialized, strategic rehabilitation plan, burn survivors can avoid more intensive interventions like reconstructive and scar release surgeries.
Because burn injury has lifelong effects on the survivor, psychological recovery is just as important as the physical one. There’s an incredibly high incidence of PTSD within the burn community, and Murtaugh often points survivors to peer resources like the Phoenix Society for invaluable support.
“Burn really is a lifelong injury,” Murtaugh said. “It’s one of those things where you don’t understand what that person is going through unless you’ve been through it yourself. Peer support and lifelong burn survivor resources are critical for long-term success and quality of life.”