Burns and rehabilitation

Necessary principles of rehabilitation for burn patient are based on empirical findings recently corroborated by discoveries about healing pathophysiology. Risks are assessable immediately from the extensive, depth and situation of the burns, problems appear only if the dermis is affected: retraction, hypertrophy and losses of substances. To cutaneous problems it is necessary to add those linked to the prolonged immobilization and to complications of the resuscitation. To be effective, re-education has to be precocious, continuously suited to cicatricial processing and to the different therapeutic steps: resuscitation, surgical treatment, processing in a re-education and rehabilitation center, steady at home and processing of the sequelae. The processing rests on the repressive cloth port 23/24 hours during more of a year, the port of orthesis of immobilization and segmental posture (to stretch the dermis permanently) and the mobilization of articulations to avoid their stiffening. The cooperation of the patient is essential, it needs the share of therapies as well as the totality of problems and difficulties met by the patient, that they are physical, psychological, social, family or occupational. The steady has to be insured by a pluridisciplinarity team during at least the two necessary years for the cicatricial maturation.