Seven days following Anna's admission to the burn unit, her vitals are stable, and kidney function is returning to normal. Anna's wounds have been rinsed daily with warm water and rebandaged. Her doctors are now preparing for surgery and skin grafting.
The following video demonstrates debridement and skin grafting of a burn.
WARNING: this video is graphic and may be upsetting if you just ate lunch or if you're starving. If you don't want to watch this video, you can get information about debridement and skin grafting in the links following the video.
View Debridement and Skin Grafting of a Burn video and answer the following questions:
- 26. What is debridement?
- 27. What methods can be used for debridement?
- 28. What is skin grafting?
- 29. What are the three classifications of skin grafts?
There was a lot of bleeding during the debridement process. Anna received 2 units of packed RBC's during surgery and an additional unit the following day.
Toxin products from the burn circulate in the blood and diminish RBCs. Anemia is a common problem in burn patients. Anna may need to continue to be treated for anemia for some time.
- 30. What are packed RBC's and why are they transfused instead of whole blood?
Two months after the accident, Anna returned home. She meets with a physical therapist daily who helps her increase mobility. She also meets with an occupational therapist that helps her learn to manage day-to-day living. Contractures are a common result from severe burns. Anna will have several more surgeries with plastic surgeons who will release contractures over joints, modify severe scarring, and continue to reshape severely burned areas of her head and neck. She will need to use creams such as lanolin daily to protect the burned areas from further drying and cracking. She is also meeting with a psychiatrist, to help her heal emotionally and learn to live a productive life, despite the disfigurement. A recovering burn patient experiences anxiety, terror, pain, sadness, and depression. Antianxiety medication and antidepressants are usually recommended to help the patient heal mentally. Psychotherapy allows the patient to heal mentally and learn coping skills to accept their new condition and learn to fully function.
Counseling is also provided to the patient's family. Anna's boyfriend continues to be supportive, in fact, they were recently married in a hospital wedding (all good stories must end as happily ever after)!