Burn rehabilitation is an essential component of successful patient care. In May 2008, a group of burn rehabilitation clinicians met to discuss the status and future needs of burn rehabilitation. Fifteen topic areas pertinent to clinical burn rehabilitation were addressed. Consensus positions and suggested future research directions regarding the physical aspects of burn rehabilitation are shared.

Burn rehabilitation has been a part of burn care and treatment for many years. Yet, despite of its longevity, the rehabilitation outcome of patients with severe burns is less than optimal and appears to have leveled off. Patient survival from burn injury is at an all-time high. Burn rehabilitation must progress to the point where physical outcomes parallel survival statistics in terms of improved patient well-being. This position article is a treatise on burn rehabilitation and the state of burn rehabilitation patient outcomes. It describes burn rehabilitation interventions in brief and why a need is felt to bring this issue to the forefront. The article discusses areas for change and the challenges facing burn rehabilitation. Finally, the relegation and acceptance of this responsibility are addressed.

Functional recovery and outcome from severe burns is oftentimes judged by the time required for a person to return to work (RTW) in civilian life. The equivalent in military terms is return to active duty. Many factors have been described in the literature as associated with this outcome. Hand function, in particular, is thought to have a great influence on the resumption of preburn activities. The purpose of this investigation was to compare factors associated with civilian RTW with combat injured military personnel. A review of the literature was performed to assimilate the many factors reported as involved with RTW or duty. Additionally, a focus on the influence of hand burns is included. Thirty-four different parameters influencing RTW have been reported inconsistently in the literature. In a military population of combat burns, TBSA burn, length of hospitalization and intensive care and inhalation injury were found as the most significant factors in determining return to duty status. In previous RTW investigations of civilian populations, there exists a scatter of factors reported to influence patient disposition with a mixture of conflicting results. In neither military nor civilian populations was the presence of a hand burn found as a dominant factor. Variety in patient information collected and statistical approaches used to analyze this information were found to influence the results and deter comparisons between patient populations. There is a need for a consensus data set and corresponding statistical approach used to evaluate RTW and duty outcomes after burn injury.

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A common complaint among patients with burns is their inability to grasp items while wearing compression gloves. Recent technological innovations permit the addition of grip-enhancing material to garment fabric. The purpose of this case series was to describe the course of development of compression gloves with enhanced grip modifications. Five different types of grip modifications were made during a period of 18 months. Five subjects who were prescribed compression gloves tested each type of glove. The gloves were fabricated with grip-enhancing material on the palmar surface in five ways: 1) rectangular rubber tabs; 2) honeycomb pattern silicone; 3) wave-like pattern silicone; 4) line pattern silicone beads; 5) line pattern silicone beads embedded into the fabric. Each glove was evaluated on a three-point Likert scale (0 = poor, 1 = moderate, 2 = good) for grip-enhancing qualities and durability. All five subjects reported similar experiences with each glove type: 1) the rectangular rubber tabs demonstrated poor grip and moderate durability; 2) the honeycomb pattern provided good grip but poor durability; 3) the wave pattern had good grip and moderate durability; 4) the silicone beads adhered to the fabric had moderate grip but poor durability; 5) the silicone beads embedded into the fabric had moderate grip and good durability. The wave pattern provided the best gripping capability and silicone embedded into the fabric demonstrated the best durability. A wave-like pattern silicone material embedded into the fabric seems to provide the best combination of grip and durability to enhance activities of daily living performance.

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