Skip to main content

Long term consequences of burn injuries

  • Chapter

Abstract

Data from the National Burn Repository of the American Burn Association [2], has revealed that between the years of 1998 – 2009, more patients are surviving large burns despite multiple complications. The mortality rate for all burn injuries is 4%. The average length of stay declined during this time period from 11 days, in the decade prior, to 9 days. This is just over one day of hospitalization per 1% burn. As a result, these patients are being discharged with multiple, long term physical and psychological challenges, such as scarring, contractures, amputations, pain and poor psychological adjustment. In the past, most of the literature on burn injuries was devoted to the acute phase of hospitalization, particularly resuscitation efforts and surgical interventions. In recent years, issues associated with long term adjustment have been recognized as a priority for research and clinical practice.

Keywords

  • Obstructive Sleep Apnea
  • Body Image
  • Coping Style
  • Allostatic Load
  • Post Traumatic Growth

These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

This is a preview of subscription content, access via your institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   119.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   159.00
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Abdullah A, Blakeney P, Hunt R, Broemeling L, Phillips L, Herndon D N et al (1994) Visible scars and self-esteem in pediatric patients with burns. J Burn Care Rehabil 15(2): 164–168

    CrossRef  PubMed  CAS  Google Scholar 

  2. American Burn Association (2010) National burn repository: Report of data from 2000–2009, from http://www.ameriburn.org/2009NBRAnnualReport.pdf?PH PSESSID=c2099c30cd05c31bd5b13650c95b4677

    Google Scholar 

  3. American Psychiatric Association (1994) Diagnostic and statistical manual of mental disorders, 4th edn. American Psychiatric Association, Washington, DC

    Google Scholar 

  4. Ancoli-Israel S, Roth T (1999) Characteristics of insomnia in the United States: Results of the 1991 National Sleep Foundation Survey I. Sleep 22(2): S347–S353

    PubMed  Google Scholar 

  5. Bauer K, Hardy P, Van Sorsten V (1998) Posttraumatic stress disorder in burn populations: A critical review of the literature. J Burn Care Rehabil 19: 230–240

    CrossRef  Google Scholar 

  6. Beck A, Steer RA, Brown G (1996) BDI-II manual, 2nd edn. The Psychological Corporation, San Antonio, TX

    Google Scholar 

  7. Bianchi TL (1997) Aspects of sexuality after burn injury: outcomes in men. J Burn Care Rehabil 18(2): 183–186; discussion 182

    PubMed  CAS  Google Scholar 

  8. Boeve SA, Aaron LA, Martin-Herz SP, Peterson A, Cain V, Heimbach DM et al (2002) Sleep disturbance after burn injury. J Burn Care Rehabil 23(1): 32–38

    CrossRef  PubMed  CAS  Google Scholar 

  9. Bryant R (1996) Predictors of post-traumatic stress disorder following burn injury. Burns 22: 89–92

    CrossRef  PubMed  CAS  Google Scholar 

  10. Calhoun LG, Tedeschi RG (1999) Facilitating posttraumatic growth: a clinician’s guide. Lawrence Erlbaum Associates, New Jersey

    Google Scholar 

  11. Christian LM, Graham JE, Padgett DA, Glaser R, Kiecolt-Glaser JK (2006) Stress and wound healing. Neuroimmunomodulation 13(5–6): 337–346

    CrossRef  PubMed  CAS  Google Scholar 

  12. Cordova MJ, Cunningham LL, Carlson CR, Andrykowski MA (2001) Posttraumatic growth following breast cancer: a controlled comparison study. Health Psychol 20(3): 176–185

    CrossRef  PubMed  CAS  Google Scholar 

  13. Dauber A, Osgood PF, Breslau AJ, Vernon HL, Carr DB (2002) Chronic persistent pain after severe burns: a survey of 358 burn survivors. Pain Med 3(1): 6–17

    CrossRef  PubMed  Google Scholar 

  14. Difede J, Barocas D (1999) Acute intrusive and avoidant PTSD symptoms as predictors of chronic PTSD following burn injury. J Trauma Stress 12(2): 363–369

    CrossRef  PubMed  CAS  Google Scholar 

  15. Difede J, Ptacek JT, Roberts J, Barocas D, Rives W, Apfeldorf W et al (2002) Acute stress disorder after burn injury: a predictor of posttraumatic stress disorder? Psychosom Med 64(5): 826–834

    CrossRef  PubMed  Google Scholar 

  16. Edwards RR, Magyar-Russell G, Thombs B, Smith MT, Holavanahalli RK, Patterson D R et al (2007) Acute pain at discharge from hospitalization is a prospective predictor of long-term suicidal ideation after burn injury. Arch Phys Med Rehabil 88[12 Suppl 2]: S36–42

    CrossRef  PubMed  Google Scholar 

  17. Ehde D, Patterson D, Wiechman S, Wilson L (2000) Post-traumatic stress symptoms and distress one year after burn injury. J Burn Care Rehabil 21(2): 105–111

    CrossRef  PubMed  CAS  Google Scholar 

  18. Ehde DM, Patterson DR, Wiechman SA, Wilson LG (1999) Post-traumatic stress symptoms and distress following acute burn injury. Burns 25: 587–592

    CrossRef  PubMed  CAS  Google Scholar 

  19. El hamaoui Y, Yaalaoui S, Chihabeddine K, Boukind E, Moussaoui D (2002) Post-traumatic stress disorder in burned patients. Burns 28(7): 647–650

    CrossRef  Google Scholar 

  20. Fauerbach J, Lawrence J, Haythornthwaite J, Richter D, McGuire M, Schmidt C (1997) Pschiatric history affects post trauma morbidity in a burn injured adult sample. Psychosomatics 38: 374–385

    CrossRef  PubMed  CAS  Google Scholar 

  21. Fauerbach J, Spence R, Patterson D (eds) (2006) Adult burn injury. Lippincott Williams and Wilkins, Philadelphia, PA

    Google Scholar 

  22. Fauerbach JA, Heinberg LJ, Lawrence JW, Bryant AG, Richter L, Spence RJ (2002) Coping with body image changes following a disfiguring burn injury. Health Psychol 21(2): 115–121

    CrossRef  PubMed  Google Scholar 

  23. Fauerbach JA, Heinberg LJ, Lawrence JW, Munster AM, Palombo DA, Richter D et al (2000) Effect of early body image dissatisfaction on subsequent psychological and physical adjustment after disfiguring injury. Psychosom Med 62(4): 576–582

    PubMed  CAS  Google Scholar 

  24. Fauerbach JA, Lawrence JW, Munster AM, Palombo DA, Richter D (1999) Prolonged adjustment difficulties among those with acute posttrauma distress following burn injury. J Behav Med 22(4): 359–378

    CrossRef  PubMed  CAS  Google Scholar 

  25. Fauerbach JA, McKibben J, Bienvenu OJ, Magyar-Russell G, Smith MT, Holavanahalli R et al (2007) Psychological distress after major burn injury. Psychosom Med 69(5): 473–482

    CrossRef  PubMed  Google Scholar 

  26. Fleming MP, Difede J (1999) Effects of varying scoring rules of the Clinician Administered PTSD Scale (CAPS) for the diagnosis of PTSD after acute burn injury. J Trauma Stress 12(3): 535–542

    CrossRef  PubMed  CAS  Google Scholar 

  27. Foa EB (ed) (1995) PDS (Posttraumatic Stress Diagnostic Scale) Manual. Natl. Comput. Syst., Minneapolis

    Google Scholar 

  28. Folkman S, Lazarus RS (1980) An analysis of coping in a middle-aged community sample. J Health Soc Behav 21: 219–239

    CrossRef  PubMed  CAS  Google Scholar 

  29. Fukunishi I (1999) Relationship of cosmetic disfigurement to the severity of posttraumatic stress disorder in burn injury or digital amputation. Psychother Psychosom 68(2): 82–86

    CrossRef  PubMed  CAS  Google Scholar 

  30. Gottschlich MM, Jenkins M, Mayes T, Khoury J, Kagan R, Warden GD (1997 a) Lack of effect of sleep on energy expenditure and physiologic measures in critically ill burn patients. J Am Diet Assoc 97(2): 131–139

    CrossRef  PubMed  CAS  Google Scholar 

  31. Gottschlich MM, Jenkins M, Mayes T, Khoury J, Kagan R, Warden GD (1997 b) Lack of effect of sleep on energy expenditure and physiologic measures in critically ill burn patients. J Am Diet Assoc 97(2): 131–139

    CrossRef  PubMed  CAS  Google Scholar 

  32. Gottschlich MM, Jenkins ME, Mayes T, Khoury J, Kramer M, Warden GD et al (1994 a) The 1994 Clinical Research Award. A prospective clinical study of the polysomnographic stages of sleep after burn injury. J Burn Care Rehabil 15(6): 486–492

    CrossRef  PubMed  CAS  Google Scholar 

  33. Gottschlich MM, Jenkins ME, Mayes T, Khoury J, Kramer M, Warden GD et al (1994 b) The 1994 Clinical Research Award. A prospective clinical study of the polysomnographic stages of sleep after burn injury. J Burn Care Rehabil 15(6): 486–492

    CrossRef  PubMed  CAS  Google Scholar 

  34. Gottschlich MM, Khoury J, Warden GD, Kagan RJ (2009) An evaluation of the neuroendocrine response to sleep in pediatric burn patients. JPEN J Parenter Enteral Nutr 33(3): 317–326

    CrossRef  PubMed  Google Scholar 

  35. Holbrook A, Crowther R, Lotter A, Endeshaw Y (2001) The role of benzodiazepines in the treatment of insomnia: meta-analysis of benzodiazepine use in the treatment of insomnia. J Am Geriatr Soc 49(6): 824–826

    CrossRef  PubMed  CAS  Google Scholar 

  36. Holbrook AM, Crowther R, Lotter A, Cheng C, King D (2000) Meta-analysis of benzodiazepine use in the treatment of insomnia. Cmaj 162(2): 225–233

    PubMed  CAS  Google Scholar 

  37. Jaffe S, Patterson DR (2004) Treating sleep problems in patients with burn injuries: Practical considerations. J Burn Care Rehabil 25(3): 294–305

    CrossRef  Google Scholar 

  38. Kammerer B (2010) BEST program provides key to successful community reintegration. Burn Support News, Winter 1–4

    Google Scholar 

  39. Kiecolt-Glaser JK, Marucha PT, Malarkey WB, Mercado AM, Glaser R (1995) Slowing of wound healing by psychological stress. Lancet 346(8984): 1194–1196

    CrossRef  PubMed  CAS  Google Scholar 

  40. Kolman PBR (1983) The incidence of psycholopathology in burned adult patients: A critical review. J Burn Care Rehabil 4: 430–436

    CrossRef  Google Scholar 

  41. Kravitz M, McCoy BJ, Tompkins DM, Daly W, Mulligan J, McCauley RL et al (1993) Sleep disorders in children after burn injury. J Burn Care Rehabil 14(1): 83–90

    CrossRef  PubMed  CAS  Google Scholar 

  42. Lambert JF, Difede J, Contrada RJ (2004) The relationship of attribution of responsibility to acute stress disorder among hospitalized burn patients. J Nerv Ment Dis 192(4): 304–312

    CrossRef  PubMed  Google Scholar 

  43. Lawrence J, Fauerbach J, Eudell E, Ware L, Munster A (1998) Sleep disturbance following burn injury: A frequent yet understudied complication. J Burn Care Rehabil 19: 480–486

    CrossRef  PubMed  CAS  Google Scholar 

  44. Lawrence JW, Fauerbach JA, Heinberg L, Doctor M (2004) Visible vs hidden scars and their relation to body esteem. J Burn Care Rehabil 25(1): 25–32

    CrossRef  PubMed  Google Scholar 

  45. Lazarus RS, Folkman S (1984) Stress, appraisal and coping. Springer, New York

    Google Scholar 

  46. Luszczynska A, Mohamed NE, Schwarzer R (2005) Selfefficacy and social support predict benefit finding 12 months after cancer surgery: the mediating role of coping strategies. Psychol Health Med 10: 365–375

    CrossRef  Google Scholar 

  47. Madianos MG, Papaghelis M, Ioannovich J, Dafni R (2001) Psychiatric disorders in burn patients: a followup study. Psychother Psychosom 70(1): 30–37

    CrossRef  PubMed  CAS  Google Scholar 

  48. Malenfant A, Forget R, Papillon J, Amsel R, Frigon JY, Choiniere M (1996) Prevalence and characteristics of chronic sensory problems in burn patients. Pain 67(2–3): 493–500

    CrossRef  PubMed  CAS  Google Scholar 

  49. McEwen BS (1998) Protective and damaging effects of stress mediators. N Engl J Med 338(3): 171–179

    CrossRef  PubMed  CAS  Google Scholar 

  50. McEwen BS, Stellar E (1993) Stress and the individual. Mechanisms leading to disease. Arch Intern Med 153(18): 2093–2101

    CrossRef  PubMed  CAS  Google Scholar 

  51. McKibben JB, Bresnick MG, Wiechman Askay SA, Fauerbach JA (2008) and predictors in a sample with major burn injuries. J Burn Care Res 29(1): 22–35

    Google Scholar 

  52. Milam JE (2004) Posttraumatic growth among HIV/ AIDS patients. J Appl Soc Psychol 34: 2353–2376

    CrossRef  Google Scholar 

  53. Nowell PD, Mazumdar S, Buysse DJ, Dew MA, Reynolds CF 3rd, Kupfer DJ (1997) Benzodiazepines and zolpidem for chronic insomnia: a meta-analysis of treatment efficacy. Jama 278(24): 2170–2177

    CrossRef  PubMed  CAS  Google Scholar 

  54. Pakenham KI (2005) Benefit finding in multiple sclerosis and associations with positive and negative outcomes. Health Psychol 24(2): 123–132

    CrossRef  PubMed  Google Scholar 

  55. Partridge J (1997) When burns affect the way you look. Changing Faces, London

    Google Scholar 

  56. Patterson DR, Everett JJ, Bombardier CH, Questad KA, Lee VK, Marvin JA (1993) Psychological effects of severe burn injuries. Psychol Bull 113(2): 362–378

    CrossRef  PubMed  CAS  Google Scholar 

  57. Patterson DR, Finch CP, Wiechman SA, Bonsack R, Gibran N, Heimbach D (2003) Premorbid mental health status of adult burn patients: comparison with a normative sample. J Burn Care Rehabil 24(5): 347–350

    CrossRef  PubMed  Google Scholar 

  58. Patterson DR, Jensen M (2003) Hypnosis and clinical pain. Psychol Bull 129(4): 495–521

    CrossRef  PubMed  Google Scholar 

  59. Patterson DR, Ptacek JT, Cromes F, Fauerbach JA, Engrav L (2000) The 2000 Clinical Research Award. Describing and predicting distress and satisfaction with life for burn survivors. J Burn Care Rehabil 21(6): 490–498

    CrossRef  PubMed  CAS  Google Scholar 

  60. Patterson DR, Tininenko J, Ptacek JT (2006) Pain during burn hospitalization predicts long-term outcome. J Burn Care Res 27(5): 719–726

    CrossRef  PubMed  Google Scholar 

  61. Pruzinsky T, Cash T F (1990) Integrative themes in bodyimage development, deviance, and change. In: Cash TF, Pruzinsky T (eds) Body images: Development, deviance, and change. Guilford Press, New York, pp 337–349

    Google Scholar 

  62. Ptacek J, Patterson D, Heimbach D (2002) Inpatient depression in persons with burns. J Burn Care Rehabilitation 23(1): 1–9

    CrossRef  CAS  Google Scholar 

  63. Ptacek JT, Patterson DR, Montgomery BK, Ordonez NA, Heimbach DM (1995) Pain, coping, and adjustment in patients with severe burns: Preliminary findings from a prospective study. J Pain Symptom Manage 10: 446–455

    CrossRef  PubMed  CAS  Google Scholar 

  64. Robertson CF, Zuker R, Dabrowski B, Levison H (1985) Obstructive sleep apnea: a complication of burns to the head and neck in children. J Burn Care Rehabil 6(4): 353–357

    CrossRef  PubMed  CAS  Google Scholar 

  65. Rose M, Sanford A, Thomas C, Opp MR (2001) Factors altering the sleep of burned children. Sleep 24(1): 45–51

    PubMed  CAS  Google Scholar 

  66. Rosenbach C, Renneberg B (2008) Positive change after severe burn injuries. J Burn Care Res 29(4): 638–643

    CrossRef  PubMed  Google Scholar 

  67. Sheikh AI (2004) Posttraumatic growth in the context of heart disease. J Clin Psychol Med Settings 11: 265–273

    CrossRef  Google Scholar 

  68. Smith MT, Perlis ML, Park A, Smith MS, Pennington J, Giles DE et al (2002) Comparative meta-analysis of pharmacotherapy and behavior therapy for persistent insomnia. Am J Psychiatry 159(1): 5–11

    CrossRef  PubMed  Google Scholar 

  69. Spitzer RL, Williams JB, Kroenke K, Hornyak R, McMurray J (2000) Validity and utility of the PRIME-MD patient health questionnaire in assessment of 3000 obstetric-gynecologic patients: the PRIME-MD Patient Health Questionnaire Obstetrics-Gynecology Study. Am J Obstet Gynecol 183(3): 759–769

    CrossRef  PubMed  CAS  Google Scholar 

  70. Stanton AL, Revenson TA, Tennen H (2007) Health psychology: psychological adjustment to chronic disease. Annu Rev Psychol 58: 565–592

    CrossRef  PubMed  Google Scholar 

  71. Sterling P, Eyer J (1988) Allostasis: a new paradigm to explain arousal pathology. In: Fisher S, Reason J (eds) Handbook of life stress, cognition and health. John Wiley & Son, New York, pp 629–649

    Google Scholar 

  72. Suls J, Fletcher B (1985) The relative efficacy of avoidant and nonavoidant coping strategies: a meta-analysis. Health Psychol 4(3): 249–288

    CrossRef  PubMed  CAS  Google Scholar 

  73. Taylor SE, Stanton AL (2007) Coping resources, coping processes, and mental health. Annu Rev Clin Psychol 3: 377–401

    CrossRef  PubMed  Google Scholar 

  74. Tedeschi RG, Calhoun LG (1995) Trauma and transformation: growing in the aftermath of suffering. Sage Publications, Thousand Oaks, CA

    Google Scholar 

  75. Tedeschi RG, Calhoun LG (1996) The posttraumatic growth inventory: measuring the positive legacy of trauma. J Trauma Stress 9(3): 455–471

    CrossRef  PubMed  CAS  Google Scholar 

  76. Tedstone JE, Tarrier N (1997) An investigation of the prevalence of psychological morbidity in burn-injured patients. Burns 23(7–8): 550–554

    CrossRef  PubMed  CAS  Google Scholar 

  77. Thombs BD, Bass EB, Ford DE, Stewart KJ, Tsilidis KK, Patel U et al (2006) Prevalence of depression in survivors of acute myocardial infarction. J Gen Intern Med 21(1): 30–38

    CrossRef  PubMed  Google Scholar 

  78. Thombs BD, Bresnick MG, Magyar-Russell G (2006) Depression in survivors of burn injury: a systematic review. Gen Hosp Psychiatry 28(6): 494–502

    CrossRef  PubMed  Google Scholar 

  79. Ullrich PM, Askay SW, Patterson DR (2009) Pain, depression, and physical functioning following burn injury. Rehabil Psychol 54(2): 211–216

    CrossRef  PubMed  Google Scholar 

  80. Van Loey NE, Maas CJ, Faber AW, Taal LA (2003) Predictors of chronic posttraumatic stress symptoms following burn injury: results of a longitudinal study. J Trauma Stress 16(4): 361–369

    CrossRef  PubMed  Google Scholar 

  81. Walsh J, Erman M, Erwin C et al (1998) Subjective hpynotic efficacy of trazodone and zolpidem in DSMIII-R primary insomnia]. Hum Psychopharmacol 13: 191–198

    CrossRef  CAS  Google Scholar 

  82. Wiechman Askay SA, Patterson DR (2009) Psychological rehabilitation in burn injuries. In: Frank RG, Rosenthal M, Caplan B (eds) Handbook of rehabiliation psychology, 2nd edn. American Psychological Association, Washington, D. C.

    Google Scholar 

  83. Wiechman Askay SA, Stricklin M, Carrougher G, Patterson DR, Klein MB, Esselman P et al (2009) Using QMethodology to identify reasons for distress in burn survivors postdischarge. J Burn Care Rehabil 30(1): 83–91

    CrossRef  Google Scholar 

  84. Wiechman SA, Ptacek JT, Patterson DR, Gibran NS, Engrav LE, Heimbach DM (2001) Rates, trends, and depression following burn injuries. J Burn Care Rehabil 22: 417–424

    CrossRef  PubMed  CAS  Google Scholar 

  85. Williams EE, Griffiths TA (1991) Psychological consequences of burn injury. Burns 17(6): 478–480

    CrossRef  PubMed  CAS  Google Scholar 

  86. Williams RM, Patterson DR, Schwenn C, Day J, Bartman M, Engrav LH (2002) Evaluation of a peer consultation program for burn inpatients. 2000 ABA paper. J Burn Care Rehabil 23(6): 449–453

    CrossRef  PubMed  Google Scholar 

  87. Zigmond AS, Snaith RP (1983) The hospital anxiety and depression scale. Acta Psychiatr Scand 67(6): 361–370

    CrossRef  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Shelley Wiechman Ph.D. .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and Permissions

Copyright information

© 2012 Springer-Verlag/Wien

About this chapter

Cite this chapter

Wiechman, S. (2012). Long term consequences of burn injuries. In: Kamolz, LP., Jeschke, M.G., Horch, R.E., Küntscher, M., Brychta, P. (eds) Handbook of Burns. Springer, Vienna. https://doi.org/10.1007/978-3-7091-0315-9_2

Download citation

  • DOI: https://doi.org/10.1007/978-3-7091-0315-9_2

  • Publisher Name: Springer, Vienna

  • Print ISBN: 978-3-7091-0314-2

  • Online ISBN: 978-3-7091-0315-9

  • eBook Packages: MedicineMedicine (R0)