On arrival at hospital, the patient will be cared for by a team of specialists. If the burns are deep and cover a large surface area, the patient will be treated initially in the intensive care unit. Often patients are put into an artificial coma in order to reduce pain and suffering and help with resuscitation.
Pain relief is one of the team's priorities. It is not unusual for morphine or its derivatives to be employed to alleviate suffering.
As soon as the patient is stabilised, they will be moved from intensive care into "Medium Care", where they may stay for several weeks. At this stage, volunteers can play a part in their recovery.
The healing process
It isn't easy to outline the typical path a patient will follow, because each person can react differently to treatment. But in general, here are the major steps in the healing process.
1. The burn is dressed with gauze and burns cream. This layer is then protected with bandages and adhesive plaster to hold it in place. This allows the dead cells to be detached from the healthy ones.
2. The bath. Patients are "showered" as part of their treatment: this is a far from pleasant process. All bandages need to come off, (they often stick to the skin) and the dead skin must be removed to allow new skin to form. Bandages and cream are then reapplied. This can be done under general anaesthetic, or patients also can use the Meopa® facial mask. This has a green ball on one side, and a little aeroplane on the other with moveable red propellers. Meopa® is a gas mixture which relaxes patients and helps them to cope with the discomfort of treatment.
In the case of deep burns where the damaged skin cannot renew itself, an operation involving a skin graft may be necessary.
3. The doctor will perform a skin graft under anaesthetic. Healthy skin is taken from a part of the body not affected by burns. The skin is treated to stretch it, which gives it a mottled appearance. It is then put in place.
4. After several days, the patient is bathed to make sure the skin graft has taken and to prevent infection. In the case of infection, the patient is put into isolation.
5. Once the graft has taken, the patient will undergo a twice daily session with a physiotherapist to help mobilise and stretch the scar.
6. After several weeks, the patient will be able to return home, but will need to return for consultations at the hospital to monitor progress.
7. Compression clothes and/or silicone sheets will complete the treatment. These help compress the lumpy red scars by reducing oxygen flow to the peripheral blood cells. Skin becomes more flexible, less itchy and smoother.
Patients can be protected by isolation to reduce the risk of infection.
Patients have unrestricted freedom within their rooms.
All visitors, including the care team, must wear protective clothing to avoid bringing in germs from the outside. An apron, mask, hat and gloves are available in the entrance to the room. On leaving the room, visitors and care staff throw away their protective clothing.
If the patient can leave the room, they will need to put on protective clothes in order to avoid infection from the outside. Accompanying carers do not need to be protected outside the room.
On return to the room, the patient will throw away the protective clothing.
Plants and flowers
To prevent the spread of germs, plants and flowers are not allowed into the burns unit. Visitors are encouraged to substitute their floral gestures by bringing alternative gifts (sweets, chocolates...)
Thanks are due to Dr Jennes, head of the burns unit, as well as to Thibaut Deprez and Els Vandermeulen, psychologists, for their invaluable advice during the creation of this document for the general public.