Preventing Scars and Contractures
Preventing scars after a burn
Scars are thickened marks left after a burn has healed. Most second- and third-degree
burns cause some degree of scarring. Physical therapists will work with your child
to prevent or reduce scarring.
Wearing pressure garments can minimize scarring and help reduce pain. Children with
deeper burns need pressure garments, which are tight-fitting clothes to be worn over
burned areas to reduce scarring. These must be worn 23 hours per day (taken off only
for bathing) for up to 2 years after the burn.
Your child should have at least 2 sets of pressure garments so one can be worn at
all times while the other pair is being washed. Hand wash the pressure garment, rinse,
squeeze gently on a towel, and hang to dry. Don't use bleach or put the pressure garment
in the dryer because this will damage the garment. As your child grows, they many
need to have new, larger garments.
Vitamin E ointments and honey may help decrease scarring from second-degree burns.
But there hasn't been a lot of research on how well these work.
Preventing contractures after a burn
Contractures occur when the burn scar matures, thickens, and tightens. This can prevent
movement. It usually occurs when a burn occurs over a joint. A contracture is a serious
complication of a burn. If your child gets a contracture, they will not be able to
move the scarred area normally. For example, your child may have trouble doing normal
things like dressing, walking, eating, or playing—depending on where the scar contracture
is located. It's important that you let your child do things for themself regardless
of how long it might take or how hard it might be. This will help prevent contractures
and help your child become independent and confident.
Most second- and third-degree burns do cause some degree of scarring. But several
things can be done to minimize scarring and reduce contractures. They include:
Wearing a splint. Sometimes, after a child has been burned, they will need to wear a splint on the joint
to keep it in a stretched position and to help prevent a contracture. Splints should
be worn on top of the pressure garment.
Doing range of motion exercises. Range of motion (ROM) exercises help keep the muscles and joints of the burned limbs
flexible. A physical therapist (PT) will teach you and your child how to do ROM, so
you can help in the healing process. The types of exercises and how often to do them
will be determined by the PT. But they should be done several times a day.
Exercising. Do the special exercises given by your child's PT with your child faithfully. Exercises
are very important to keep the scar area stretched and prevent a thick, hard, tight
contracture. Exercises must be done even if your child doesn't like them. You may
want to reward your child for doing a good job at the end of the exercises. If pain
affects their ability to exercise, talk with their healthcare provider about how to
ease the pain.
Promoting independence. Have your child do daily activities for themself as much as possible. For example,
let your child eat, brush teeth, brush hair, and dress. Even if it is a little difficult
for your child, let them do these activities and resist the temptation to help. The
movement that occurs during daily activities will help keep the scar area stretched.
Your child should do daily range of motion exercises as directed by the PT or your
child's doctor. When appropriate, consider having your child attend a support group
or a camp for burn survivors. Emotional support and encouragement from peers can make
a positive difference in your child's recovery.