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Click here to view the Reconstructive Make-Up Program Brochure
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Discharge Planning
The burn team will begin planning for discharge soon after admission. Case managers see patients during their stay in the ICUs and intermediate care floors and assist patients and families with coordinating discharge plans. Rehabilitation or visiting nursing services may also be needed to ensure recuperation. Some burn patients require a stay in a rehabilitation hospital before returning home. There are several parts of a discharge plan, including medication, diet, activity, home care supplies and equipment, wound care, potential complications, return appointments and referrals. Please feel free to ask the burn team questions about any part of the discharge plan.
Medications:
Burn patients may be discharged home with several different medications. Review how and when to take these medications, what the drugs are used for, and any possible side effects before leaving the hospital. A patient should not drink alcoholic beverages, drive, or operate vehicles or machinery while taking pain medications. A patient should finish any prescription for antibiotics, even if he/she is feeling well. If there is any concern of an allergic reaction, please call the doctor.
Diet:
A well-rounded, nutritious diet with plenty of fluids is important in the healing process. Patients should start with small, frequent meals. Diet restrictions on discharge vary from patient to patient, and will be reviewed with the patient before discharge.
Activity:
Activity is important for increasing the circulation, preventing loss of muscle strength, and improving general well-being. A patient should follow the guidelines set up by the burn team. Feelings of fatigue and weakness will gradually improve. Taking naps and engaging in light activity will help. Patients should avoid strenuous activity, driving, heavy lifting, and contact sports, until cleared by the doctor at the follow-up visit. Some burn patients may have physical or occupational therapy home visits to assist in their recovery.
Home Care Supplies and Equipment:
During recovery, patients may need equipment such as crutches, a wheelchair, or a shower seat. The burn team and case manager will work with the patient to ensure that the patient has the necessary equipment for discharge. The costs of some supplies may be covered by insurance.
Wound and Bandage Care:
The incision should be kept clean and dry. The patient (or a designated person) should gently cleanse the skin around the incision daily with mild soap and water. Steri-strips can be allowed to fall off on their own. Check with the doctor about when to start showering or bathing. All instructions for more specialized wound care will be provided by the nurse or doctor.
Outpatient Follow-Up Appointments
Patients will be told how often they’ll need to be seen for follow-up appointments after discharge. Please write down any questions or concerns for the doctor and bring the questions with you. Make sure to ask about returning to work and normal activities like driving.
To schedule an outpatient follow-up appointment, call (617) 726-3712.
After Discharge (Caring for Your Burn at Home)
Dressings or bandages are an important part of burn care and a part in which you play a large role. If you are unable to change your dressings, a visiting nurse or a family member should do it. This section will teach you the right way to change your dressing. As you read the information on this site, you will probably think of questions. Write them down. Don't hesitate to call the Burn Associates office (617-726-3712) to find the answers.
Frequently Asked Questions:
Burns and Dressings:
What do the dressings do?
- Protect the wound from injury such as bumps and scrapes
- Keep medicines — usually ointments or creams — on the wound to fight infection (such as Neosporin or bacitracin)
- Catch any fluids that are drawn out of the wound
How long will the wound need a dressing?
The length of time varies depending on how large the burn is and how fast you heal. We will tell you when you may remove the dressing.
How often should the dressing be changed?
The number of dressing changes can vary. We will tell you exactly when you should change your dressing.
Will the dressing changes hurt?
Yes, you will experience some pain. The pain you will experience should be neither much more or less than taking tape off normal skin. It is a good idea to take your pain medication 30 minutes before you change your dressing.
back to faq top Medications
What kinds of medications are used?
A variety of infection-fighting medicines are used. Generally they are put on the wound in the form of ointments or creams. Remember, NEVER use any other creams or take any other medicines that were not prescribed.
Will the medications interfere with medicine being taken for other problems?
There should be no conflict with other medications you are taking. However, be sure to tell us if you are taking other medications.
What about allergies?
Be sure to let us know if you have any allergies.
back to faq top Diet/Exercise
Should I follow a special diet?
You should eat a healthy, balanced diet. This means each meal should include meat, fowl or fish, a vegetable, dairy products and a fruit.
Should I exercise?
Your dressing should not limit your movement. You should participate in regular activities or your joints will get stiff. All joints — normal or injured — become stiff if not moved.
Can I shower or take a bath?
We will tell you when you can shower or bathe. Remember to keep the water lukewarm.
What are the warning signs of complications?
You should contact us if you have any of the following:
- Increased pain in the wound
- Odor from the wound
- Increased warm feeling from the wound
- Bleeding from the wound between dressing changes, unless there has been
an injury (but remember that bleeding at the time of dressing change itself may
be expected)
- Increased swelling in the injured part of the body
- Redness in the normal skin around the wound
- Fever: You should check your temperature daily and if it is more than 101 degrees, contact your doctor
- Complete loss of appetite or other changes from normal conditions
back to faq top Appearance
Will the injury leave a scar?
All burns, except first-degree burns, leave some kind of scar.
What do visible scars look like?
When you no longer need dressings, your wound will continue to change for a long time until that area of your body is healthy. At first the wound will be red for several weeks or months after the injury. The area is usually a little sensitive to use or touch. It may itch or tingle as it heals, but this indicates that the wound is improving.
Slowly, the wound will become increasingly pale. In a deep injury, the skin may never return to the way it was before the burn.
What causes scars?
Scars are caused by changes in the skin. When it is burned, the skin loses part of its structure. The skin is then thinner and irregular. Some of the injured tissue is replaced not by normal tissue but by scar tissue. The thinness,, the irregular structure and the scar tissue are visible and make up what we call a scar.
Feelings
The healing of a burn may take a long time, and the more severe the original burn, the longer the injury will take to heal. It is normal to feel sad sometimes, and angry that it happened. It is perfectly all right to have these feelings. Please talk with us. We can help you.
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Other Tips
- Blisters: Don't pop them, because the fluid inside them protects the wound
- Red spots in the skin of the wound: These are glands forming beneath the surface of the skin, instead of on top, where they should be. Don't pop or pinch them, but report this to us.
- Change of color of burned arm or leg: If you have to keep an arm or leg relatively immobile, the blood flow into it changes. Blood will collect and the limb will appear darker than normal. Don't worry, this will go away; elevate limbs when sitting or lying.
- Skin sensitivity: Sometimes the wound is more sensitive to cold than is normal. Wrap up more than usual; the wound is also more sensitive to injury and sometimes little open breaks will appear in the skin. Please report them to us. We will tell you how to treat them.
- Sun exposure: It is very important to protect your skin from the sun and heat;
wear light clothing and hats and use sunscreen (at least SPF 45 sunblock) for at least a year.
- Dry skin: You may experience dry skin temporarily; use a moisturizing lotion
a minimum of four to five times a day.
- Massage: Each time you moisturize, you should massage the area, especially areas that are slightly raised. Massage helps with scarring and also aids a decrease in sensitivity to touch.
back to faq top Changing Dressings
General Instructions
- Have someone help you: It is much easier to change the dressing on your burn if you have someone to help you.
- Preparation: Be organized. Carelessness can result in infecting your wound. Have a place where you store all the supplies you will use.
- Have a specific area where you always perform the dressing change:
For example, the area could include part of a kitchen table carefully covered with
a towel.
How to change a dressing
Be sure you have all the supplies you need spread out neatly. Be sure you have a clean area to use.
Equipment
- Normal saline (we can give you a prescription for normal saline)
- Sterile sponges (called sterile pads)
- Gauze bandage (e.g., Kerlix)
- Bandage tape
- Cream or ointment (prescribed by us)
Instructions for changing the dressing
- Wash your hands with soap and warm water.
- Put on gloves.
- Remove old dressings.
- Place them in a small plastic bag. Seal the bag.
- Remove gloves.
- Wash your hands again.
- Put on a second pair of gloves.
- Place the number of sterile sponges you need in the saline.
- Wring them out.
- Gently clean your wound. (Note: If you are using silvadene on your wound, make sure you remove all of it before applying more.)
- Gently pat dry.
- Apply the cream or ointment we have prescribed for you. (This can be done with your fingers, a Q-tip or a tongue depressor. You can also put the cream or ointment on a dry sterile spongue then place on the wound.)
- Take the gauze bandage and wrap the dressing. Start wrapping at the point farthest away from the heart. For example, if your calf is burned, wrap from the ankle to the knee. The wrap should be snug, but not tight. It is too tight if you feel tingling or
lose sensation.
- Tape the wrap in place.
- Clean the equipment.
- Remove gloves.
- Wash your hands.
Reconstructive Make-Up Program
View Reconstructive Make-Up Program brochure.
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Potential Complications
Call us at (617) 726-3712 if any of the following symptoms occurs:
- Increase in pain, redness, or swelling in or around the wound(s)
- Sudden increase in wound drainage, especially if drainage has pus or a foul odor
- Chills or fever greater than 101F (or 38.3C)
- Persistent vomiting or diarrhea
- Heavy bleeding (soaking the bandage)
- Persistent, significant pain
- Lower leg pain and/or swelling
- Sudden shortness of breath
- Persistent headaches and/or dizziness
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