Follow-Up Care for Burns
Follow-up care involves surveying patients with burns for signs of infection, scarring and contracture. To minimize further damage, infection is best managed in a hospital. Scarring and contractures connote long-term disfigurement and disability, both of which are indications for specialized care.
Follow-Up Intervals
Patients with burns who are being managed as outpatients should be seen again on the day after injury. At this visit, the level of pain can be assessed, pain medication can be adjusted if necessary, and competence in managing dressing changes can be assessed. Subsequent follow-up can then be performed on a weekly basis until wound epithelialization occurs. However, if pain control is insufficient or there are concerns about the ability of a patient or family members to provide proper wound care, the patient should be seen on a daily basis until complete epithelialization occurs.
If wound epithelialization has not begun after two weeks or if subsequent evaluations reveal the presence of a full-thickness burn more than 2 cm in diameter, the patient should be referred to a surgeon with expertise in burn care. Tiny opalescent islands of epithelium throughout the wound indicate epithelialization, with the wound typically healing completely in seven to 10 days.
After epithelialization has occurred, patients are seen every four to six weeks to assess for evidence of hypertrophic scar formation and to monitor coping mechanisms.
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