Frequently Asked Questions

1) Why does my donor site hurt worse than my actual burns when I move?

The skin that is harvested from a donor site is 1 ½ layers deep. This leaves the lower layers intact which is where the nerves that transmit pain are located. Essentially, these nerves are exposed. The burn, which may have been painful prior to surgery, is now covered with the harvested skin, and is probably not as painful.

2) What is the purpose of wearing a splint?

Splinting of a joint or multiple joints over a burn area of skin is used to prevent contractures, prevent deformities, and apply pressure/stretch to the burn areas for scar control. For a burn survivor the position of comfort is also the position of contracture.

3) How often do I have to wear my ace wraps?

Ace wraps are worn with a lower extremity burn or skin graft or donor site whenever the patient is out of bed or when the legs are in a dependent position (hanging off the side of the bed, sitting in a chair, standing).

4) When can I stop worrying about my burns forming a contracture?

Forming a contracture is a concern when dealing with burns. The length in which one should worry about a contracture can very from person to person. A contracture could form with a couple of days without stretching anywhere from 12 - 24 months. During this time, one should complete the home exercise program for scar control and contracture prevention.

5) How often do I have to do my stretches and exercises?

It is physically impossible to do too many stretches if you have a burn injury. Ideally you should spend about five minutes of each waking hour performing stretches to maintain range of motion.

6) What can I put on my grafts to keep them from scarring?

Although scarring can't be prevented, the hope is to make the scar as functional as possible by increasing its elasticity. This can be done with correct positioning, using prescribe a splint, using an abduction wedge, wearing pressure garments, wearing tubigrip as prescribed and with ace wraps.

7) Why do I have to wait three days after getting a skin graft on my leg to get out of bed?

There will be 3 days of bed rest following a lower extremity skin graft in order to give the graft time to adhere to the area. Keeping pressure off of the affected leg and avoiding friction to the graft maintains an ideal healing environment.

8) Will I pull my staples out when I am going through my stretches and exercises?

No. When it comes to staples and performing stretches, most patients are apprehensive about damaging the graft as a result of pulling the staples. Your therapist will assess your graft in order to determine when it is appropriate to resume active range of motion. Range of Motion following a skin graft is typically resumed on post operative day # 3. If your doctor decides to leave the staples in place, then your therapist will make accommodations to your range of motion regime as needed.

9) How will compression garments help my scars?

Garments will provide complete and even pressure to aid in smooth scar formation and prevent hypertrophic scarring.

10) Can I wash my ace wraps and/or tubigrip?

Yes. You may wash both of these items with a mild detergent. Because the ace wraps and tubigrip contain an elastic material, it is recommended that you let these garments air dry.

11) Why is positioning so important when it hurts to lie like that?

The position of comfort is the position of contracture. Contractures lead to functional limitations which make even the easiest daily task difficult.

12) Why does it feel like my arms/legs are burning when I stand or let my arms hang down?

This occurs as a result of blood/fluid rushing to these areas. This fluid accumulation in these areas presses on the nerve endings creating a sensation of burning and or tingling.

13) What happens if I leave my ace wraps on all night?

Leaving ace wraps on at night can lead to the following:

1. You are not giving your legs exposure to any air (no time to breathe!)
2. Your ace wraps could roll and tighten, creating a tourniquet, which could prevent adequate circulation.
3. You could cause your burn, graft site, or donor site to become “soupy” due to collection of exudate or drainage

14) Why is being active so important following a burn injury?

1. During the process of recovery from a burn your body will require a lot of energy in order to repair damaged tissue and replace the muscle that was utilized as fuel. The body uses fat and muscle reserves in order to heal the burn resulting in a build up of muscle ‘waste’. This muscle ‘waste’ may cause you to feel more fatigued. As a result, you may find that even a simple walk to the mailbox leaves you feeling exhausted. By gradually increasing your level of activity you will recover much faster although, depending on the extent of your burn, it may take more than a year before you feel back to normal.
2. One of the other reasons for increasing activity is to maximize the function of your burned extremities. Remember, that it is very important to not only stretch as prescribed by your OT/PT but to also engage yourself in everyday activities such as bathing, dressing, self feeding, light housework and mobility (walking).

15) Why can’t I use a walker or crutches to help me walk since my legs hurt so badly?

It is not recommended that you use an assistive device to help with walking, especially if you did not require one prior to the injury. Using an assistive devices allows your arms to assist to unweight your legs during ambulation. Fully bearing weight through your legs will help with circulation, therefore speeding the healing process. Walking without an assistive device will help promote the regaining of your normal functional mobility skills. Lastly, walking without an assistive device will help to prevent the loss of muscle mass.