Adult thermal burns

Abstract

Adult burn injuries are heterogeneous in their aetiology and in their severity, and in the many ways in which they affect the burns patient. Treatment should be initiated promptly, ensuring that other life-threatening injuries are dealt with, and that expert burn care is delivered to the patient. First aid followed by emergency management of the patient, fluid resuscitation, and specialist wound care ensures the patient is given the very best opportunity for full recovery and survival. The burn wound may be managed non-surgically, but for deeper and more severe injuries, surgical debridement and wound cover with grafts, cell suspensions, dermal matrices, or flaps is required. Areas of special attention include the face, hands, and perineum—all functionally and aesthetically important, and each with specific dressing needs and surgical techniques that optimize good outcomes. Scar management and physiotherapy are crucial components of adult burn care, with many therapies applied concurrently to ensure good functional and aesthetic recovery. For those patients with ongoing scar and contracture difficulties, scar therapies and reconstructive burns surgery offer the chance of better function and appearance even many years after the original burn. The journey to recovery would not be complete, however, without important psychosocial input for the burns patient, as the psychological scars are often just as painful as the physical ones.