Authors (including presenting author) :
Wong HY (1), Chan NY (1), Chan YK (1), Wong MC (2), Ng YT (2) Lam PL (2)
Affiliation :
(1)Physiotherapy Department, David Trench Rehabilitation Centre
(2)Physiotherapy Department, Queen Mary Hospital
Keyword 2: :
Scar Management
Introduction :
Queen Mary Hospital serves as a territory-wide tertiary and quaternary referral centre for many complex and advanced services including burns and reconstructive surgery. The designated burn unit manage cases with various injury mechanisms, including flame burns, scalding burns, chemical burns, electrical burns and contact burns. A dedicated team of professionals, comprising plastic surgeons, advanced practice nurses, physiotherapists, occupational therapists and clinical psychologist collaborate to provide comprehensive and holistic care for patients.
Objectives :
A recent case exemplifies an extensive and tailored rehabilitation services we offered. A 38-year-old male patient suffered from a scald injury by hot water and steam after industrial pressure cooker explosion one day before Christmas in 2024. This injury resulted him with 35.5% total body surface area 2nd degree burn involving face, anterior trunk and bilateral upper limbs. He spent 27 days in the Burn unit and underwent repeated debridement and skin grafts to close the large wounds. The pain from surgery, wound dressing, impaired mobility, scar itchiness, distorted appearance of limbs and worries about future seems never ending. The patient feels like life will never be normal again.
Methodology :
Our structured physiotherapy program is designed to address the need of patient in each step of the rehabilitation journey. From chest physiotherapy when patient is still intubated to early mobilization to prevent contracture of limbs, therapist-assisted stretching exercise to improve joint range of motion, pain relieving treatment such as superficial heat modalities, and scar management using modernized machine to smooth and soften the scar. Most importantly, listening to and celebrating together with the patient each small achievement he made.
Result & Outcome :
With efforts of a whole dedicated team, the patient achieved a well healed scar with minimal pain and itchiness, nearly full shoulder mobility and a subjective rating of 90% recovery. The most encouraging part was his successful return to work one year after injury and regain of confidence and self-esteem. Despite the complex nature of burn injuries, physiotherapist was missioned to walk along with every referred patient in their rehabilitation path. This case demonstrated the effectiveness of our tailored program for the patient to regain a meaningful living after a life-threatened injury. Specialised physiotherapists are integral to develop structured and patient-centred rehabilitation programs to support patient after a life-changing burn injury. By relentlessly refining our clinical practices, we strive to provide the highest standard of care for our patients.
