Ms Liz Capell¹, Ms  Helen Scott¹

¹Alfred Health, Melbourne, Australia

Abstract:

This presentation will describe the management of a 34yo female admitted to the Victorian Adult Burns Service at the Alfred Hospital. This patient sustained a 7% TBSA flame burn to the right side of her face chest and right upper limb with significant axilla involvement while cooking over a gas stove. The patient required debridement and autograft, including sheet grafts to right hand and right breast and meshed to all other areas.

This patient had the trifecta of risk factors for developing hypertrophic scarring as she was female gender (Gangemi et al, 2008), young age (Gangemi et al, 2008) and Malaysian ethnicity with dark pigmented skin (Gabriel, 2011). A collaborative approach was adopted between allied health disciplines including Physiotherapy, Occupational Therapy and Orthotics, as well as the burns surgeons, nursing team and the patient. It was decided to implement all possible treatment options to achieve the best outcome for this patient. The initial interventions commenced less than a week post grafting and included a customised aeroplane splint, in conjunction with shoulder range of motion exercises. Once the grafts were healed, the team utilised a toolbox of treatment options including the custom compression garments with silicone fabric lining worn 23hrs a day, hydration with moisturiser, home exercise program and scar management education.

The patient has achieved full range of movement and return to all function 18months following her burn injury due to her commitment and a collaborative team approach to her burns recovery.

References:

Gabriel, V. (2011). ‘Hypertrophic scar’. Phys Med Rehanil Clin N Am, 22(2), 301-310.

Gangemi, E.N., Gregori, D., Berchialla, P., Zingarelli, E., Cairo, M., Bollero, D., Stella, M. (2008). ‘Epidemiology and risk factors for pathologic scarring after burn wounds’.  Arch Facial Palst Surg, 10(2), 93-102.

Biography:

Liz Capell is the acting Burns Allied Health Team Leader and a senior burns Physiotherapist at the Alfred Hospital in Melbourne. Helen Scott is a senior burns Occupational Therapist at the Alfred Hospital in Melbourne and an accredited Hand Therapist as awarded by the Australian Hand Therapy Association.