1. Nursing Instruction
  2. Overview
  3. Plastic and Reconstructive Surgery
【Major Points】
  1. For wound care, clean the healed wound with pH-neutral soap, and protect any blisters if occur.
  2. Apply baby oil or lotion to healed skin.
  3. For itchiness, use local ice compression or gently pat the skin. Avoid scratching directly.
  4. Ensure the injured area is maintained in a functional position.
  5. Wear a pressure garment 24 hours a day to improve the flexibility and elasticity of the scar.
Why do patients with burns need home care?
Patients with deep second-degree burns require home care to avoid healing wound reinfection and prevent scar hyperplasia.

What supplies do I need to prepare?
  1. Use pH-neutral soap to wash the healed wound at least once a day.
  2. Apply baby oil, moisturizing lotion, or petroleum jelly to the skin to aid healing, soften cuticles, and alleviate itching.
  3. Wear breathable, sweat-absorbent cotton clothing to prevent sweating, stuffiness, and heat, which could increase itchiness.

How do I proceed?
  1. Wear the pressure garment as ordered by physician. It should be worn daily, except bathing, for around six months to two years.
  2. Gently massage the scar in a circular motion using the heel of your palm or thumb, at least three times a day for at least 15 minutes each session. Continue this practice until the scar becomes softer or lighter in color. This may take six months to two years.
  3.  Maintain the injured area in a functional correct position:
    1. Face: Use facial expressions, such as whistling or chewing gum, to activate facial muscles.
    2. Neck: Keep the neck tilted back while lying in bed to stretch the neck muscles or joints.
    3. Armpits: Engage in activities that stretch the arms, such as dressing yourself, shooting a basketball, or swimming.
    4. Fingers: Perform exercises like making a fist, stretching fingers, and pressing buttons.
    5. Arms: Use a pillow to support the elbows in a horizontal or elevated position.
    6. Hips: Keep the hips in an abducted position.
    7. Knees: Maintain a slightly bent posture of 5 to 10 degrees.
    8. Ankles: Place the soles of feet against the bed board and keep the ankles at a 90-degree position to avoid foot drop.
    9. Lower limbs: Engage in movements such as lifting the legs, riding a bicycle, and climbing stairs.
    10. Trunk: Perform exercises to stretch the muscles and skin, such as deep breathing and chest expansion exercises.
  4. If the injury involves a joint, perform rehabilitation exercises daily to reduce stiffness and scar contracture. Aim for 2 to 4 sessions per day, moving the joint about 15 to 20 times each session. Gradually increase exercise time and frequency based on individual tolerance.

What should I pay attention to?
  1. If blisters appear on a healed wound, take care to prevent them from bursting. If a blister does burst, change the dressing as directed by medical and nursing personnel.
  2. For itchy skin, apply local ice compression or gently pat the area. Avoid scratching to prevent skin rupture and potential infection.
  3. Prepare 2 sets of pressure garments for ease of changing and washing. Regularly modify them to ensure they provide adequate pressure.
  4. Soak pressure garments in cold detergent and wash them by hand only—do not use a washing machine. After washing, dry them in the shade and avoid direct sunlight.
  5. If blisters less than 2 cm appear after wearing pressure garments, cover them with povidone iodine-sterilized gauze and continue wearing the garment. If blisters break or show signs of infection, discontinue use and seek medical attention promptly.

References
  1. Chung, B. Y., Kim, H. B., Jung, M. J., Kang, S. Y., Kwak, I. S., Park, C. W., & Kim, H. O. (2020). Post-burn pruritus. International Journal of Molecular Sciences, 21(11), 3880. https://doi.org/10.3390/ijms21113880
  2. Palackic, A., Suman, O. E., Porter, C., Murton, A. J., Crandall, C. G., & Rivas, E. (2021). Rehabilitative exercise training for burn injury. Sports Medicine , 51(12), 2469–2482. https://doi.org/10.1007/s40279-021-01528-4
  3. Schaefer, T. J., & Nunez Lopez, O. (2023). Burn resuscitation and management. In StatPearls. StatPearls Publishing
  4. Zhou, J., Fu, C., Yang, W., & Gu, W. (2022). A method that precisely pressurizes the local limb. Journal of Burn Care & Research : Official publication of the American burn association, 43(1), 240–248. https://doi.org/10.1093/jbcr/irab089
    Quiz
    Please answer the following questions:
    Nursing Instruction Satisfaction
    The statistical results are not open to the public.
    Please log in to rate
    Next
    Location
    1. Nursing Instruction
    2. Overview
    3. Plastic and Reconstructive Surgery
    Category
    Self-care / Home Care
    a601fc58a124a8d8547ddedd0043dcca.png
    Taipei Veterans General Hospital 
    No.201, Sec. 2, Shipai Rd., Beitou District,  3e72dadb9904d06fa0fb3744e4ed2612.png
    Taipei, Taiwan 11217, R.O.C.
    Tel: +886-2-2871-2121 #04
    • Smoking and chewing betel nut significantly induce oral cancer. Obesity will potentially increase the risk of breast cancer and colorectal cancer. Please control body weight and keep away from tobacco and betel nut.
    • Information provided above can’t overcome physician's treatment and replace physician patient relationship.
    © Copyright 2020 by Taipei Veterans General Hospital Nursing Department.
    All rights reserved.