Burn Scars: Fighting the Effects

Abstract

Deep burns can occur in seconds, but the scars they leave can cause lifelong disfigurement and disability. Positioning, exercising, controlling bacterial invasion, and knowing how and when to apply pressure garments and splints are nursing strategies that can help minimize scarring and maximize function. The deeper the burn, the slower and less efficient the healing process. In superficial partial-thickness burns (first degree and some second degree), epidermal cells regenerate rapidly. These burns heal spontaneously within a few days to two to three weeks, leaving no scars. With other partial-thickness burns, such as superficial second degree burns, the epidermis and some of the dermis may be destroyed, but reepithelization still occurs quickly as cells arise spontaneously from undamaged cutaneous appendagesthe sweat glands, hair follicles, and sebaceous glands in the dermal layer. New cells also advance from the wound edge to resurface the burn. A partial-thickness burn that is kept clean and free from infection will heal with minimal to no scarring and only a transient discoloration to mark the area of injury. Deep dermal burns (deep second degree) also can close by reepithelization as long as they are kept well-protected and infection-free. Spontaneous healing may take several weeks, however, so surgeons often decide to debride and graft such burns in order to lower the risk