FIG Education

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BURNS By Shelene Giles, FIG Education, Inc. CEO Author, Teacher, Mentor Chronic Complications (continued) These garments are usually recommended to be worn twenty-three hours per day for one to two years post-burn. Full compliance in wearing customized compression garments twenty-three hours per day is unlikely due to the restriction, uncomfortableness, potential claustrophobia, and weight fluctuations that may cause the garment to fit improperly. Silicone gel sheeting is another first line treatment for scar management available to burn patients. Marjolin ulcers are a rare and aggressive type of skin cancer that grow from burns, scars, or wounds that are not healing properly. A Marjolin ulcer develops at the damaged area of the skin. They grow slowly and may take thirty plus years to develop into cancer. However, once a Marjolin ulcer becomes cancerous, it can spread to other parts of the body, including the brain, liver, lungs, and kidneys. These ulcers are treated by excision or Mohs surgery. Surgery entails removing a thin layer of the cancerous layer of skin in a progressive fashion, while simultaneously examining the newly removed skin until there are no further signs of cancerous cells. If the cancer has spread, chemotherapy, radiation, or amputation may be required for treatment of the Marjolin ulcer and subsequent cancer diagnosis. Studies show burn survivors are at a slightly higher risk of skin cancer. The question is whether or not the heightened risk is due to the burn process or sequalae following the acute burns. Burn survivors are cautioned to avoid sun exposure and take precautions with sunscreen and U-V protectant clothing.   #nurses #ot #pt #crc #doctors #casemanagement #legalnurseconsultant

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TRIVIA THURSDAY! What is a common complication and related recommendation for chronic pain? ANSWER: Complications from chronic pain can be psychosocial and deconditioning. A chronic pain survivor may avoid use/activity/movement of the affected area – hoping to lessen the pain. This downward spiral leads to deconditioning and deterioration – which creates additional medical concerns (muscle atrophy, contractures, weight gain, overuse syndrome, etc.). Recommendations to include in the Life Care Plan, Medical Cost Projection, and Medicare Set-Aside can be therapeutic evaluations and modalities (OT, PT, psychological) for assessment and development of a therapeutic regimen. To learn more – https://lnkd.in/g2jPpZvc. #nurses #ot #pt #crc #doctors #casemanagement #legalnurseconsultant

WISDOM WEDNESDAY! Expanding Your Wings #nurses #ot #pt #crc #doctors #casemanagement #legalnurseconsultant

TIDBIT TUESDAY! BURNS By Shelene Giles, FIG Education, Inc. CEO Author, Teacher, Mentor Chronic Complications • Integumentary • Hypertrophic & keloid scarring • Marjolin ulcers • Skin cancer (heightened risk) • Pruritis (severe itching) • Pigmentation changes • Skin fragility • Ingrown hair & nails • Alopecia • Syndactyly • Sun exposure (intolerant) • Temperature regulation • Amputation (most common with electrical injury) The scarring maturation phase in burn injuries is typically between twelve and eighteen months, depending on the depth of the burns. Ongoing debridement and infection, as well as a compromised immune system can create acute complications and may delay the scar maturation phase into years. The rule of thumb is to begin counting the scar maturation calendar once the burn patient has been discharged from the hospital. As the burn wound heals, dense masses of granulation tissue form to create scarring. Keloids or hypertrophic scarring sometimes develop when healing takes place over a large burn area or on skin grafted sites. Hypertrophic scarring is defined as excessive amounts of collagen, which causes the scar to rise above the scar boundaries. Keloid scars are also comprised of excessive amounts of collagen that raise and extend beyond the scar boundaries. Keloid scarring is referred to as scarring that doesn’t know when to stop growing. Hypertrophic and keloid scarring may cause itching and may have an undesirable cosmetic effect. Scarring can be minimized by wearing custom compression garments, splinting, and applying moisturizing lotions and creams to prevent skin maceration. Compression wraps and garments are used immediately after the wounds are closed. The initial purpose of the wraps is to resolve and prevent edema. Once the scarred area assumes a more stable shape, a custom-made pressure garment is fitted. #nurses #ot #pt #crc #doctors #casemanagement #legalnurseconsultant

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FUN FRIDAY! Sequelae of Electrical Injuries By Shelene Giles, FIG Education, Inc. CEO Author, Teacher, Mentor Excerpt JNLCP Current research describes more common neuromuscular defects, including: * altered sensation, numbness * headache * weakness and muscle fatigue * memory changes * attention/concentration difficulties * new learning/word finding problems * pain with activity (Fish, Theman, & Gomez, March/April 2012). Psychological symptoms secondary to neurological symptoms and reported in 71% of survivors. They include: * depression * PTSD * anxiety * nightmares * insomnia * loss of self-confidence * feelings of anger * flashbacks (Singerman, Gomez, & Fish, September/ October 2008; Theman, Singerman, Go- mez, & Fish, November/December 2008). Electrical injury survivors perceive their trauma as a near-death experience. This experience, coupled with flashbacks and nightmares, produces long-term emotional challenges (Stergiou-Kita, et al., November/December 2014). Piotrowski notes emotional distress among EI tends to be a dominant feature influencing the long term outcomes of electrical injury survivors (Piotrowski, et al., May 2014). #nurses #ot #pt #crc #doctors #casemanagement #legalnurseconsultant