Pain management, surgery, and support with physical recovery after a burn

Depending on the severity of a burn, strong pain medication and surgery may be needed. Some people we talked to also received support with physiotherapy and diet in their physical recoveries.

This section covers:

  • Pain management
  • Being placed in a coma
  • Having surgery
  • Support with physical recovery, including physiotherapy and nutrition

Pain management

Having and recovering from a burn injury can be a very painful experience. Most of the people we spoke to were prescribed painkillers such as paracetamol, ibuprofen, codeine, or morphine to help them cope with their pain. Helen X was given a morphine pump so she could self-administer her own pain relief.

When Chris Y and Amy’s son, William, was discharged from hospital, they were instructed to give him paracetamol and ibuprofen. He was still in a lot of pain so they were prescribed morphine as well.

Frazer, Charlotte and Mercy told us that one of their most painful experiences was when dressings were taken off their burns to allow oxygen to get to them. Others, such as Helen Y, found that standing up for the first time after being burnt was the most pain they had experienced.

Frazer told us that allowing his burn to oxygenate was “the worst bit”.

Helen Y said she was in “intense pain” when she stood up for the first time after being burnt.

Communication about pain and pain management from healthcare professionals was an important topic. Sabrina, who was aged 12 when she was burnt, said she didn’t really understand the different treatments she was having or “why you need to push through the pain” of them. Tara appreciated when doctors were honest about how painful a specific treatment would be.

Tara’s surgeon was honest about how painful treatment would be.

Sometimes a burn injury was not initially painful. When Helen first woke up after being burnt, she was in hospital but couldn’t remember why. She told us she did not believe the nurse who told her she had been burnt because “I had no pain”. Helen X found out that the reason she couldn’t feel any pain was because her burns were so deep that her nerves had been damaged. Marilyn shared a similar experience and told us “I couldn’t feel much pain and that made me realise how serious it was”.

Helen X couldn’t feel any pain at first because the burn had damaged her nerves.

Being placed in a coma

If a person has extensive burn injuries, they may be placed in an induced coma whilst their skin begins to heal. After Gary was burnt, he was placed in an induced coma for six weeks. He told us that when he woke up from the coma, he felt “quite scared and shocked in the hospital because I didn’t know why I was there”. Sinead’s daughter, Elizabeth, was also placed into an induced coma for around 2 months when she was burnt. Sinead said her daughter was “very, very ill”, but she felt like she was safe whilst she was in a coma.

Sinead’s daughter, Elizabeth, was in an induced coma for around 2 months.

Having surgery

Helen Y, Saffron, Gary and Raiche, among others, had undergone surgeries for their burns. These included skin grafts and plastic or reconstructive surgery. Sometimes people needed to be under anaesthetic for debridement (when unhealthy or dead skin is removed from the burn) and dressing changes. Surgery may be needed to release burn contractures (when the burns scar is pulled tightly and restricts movement). Helen Y had tissue expansion therapy to give more movement and stretch to the areas where she has burn scarring. Saffron, Raiche and Justyn had laser surgery to improve the appearance of scars and keloids (overgrowths of scar tissue).

A burns surgeon explains what scar contracture means.

Saffron, Gary and others we spoke to had experienced a number of surgeries at different stages of their recovery. Saffron was “in and out” of surgery for around 12 weeks after she was burnt. She told us that she had daily surgery for the first three weeks after she was burnt. Her surgeries included skin grafts, surgical debridement, and surgical dressing changes.

Gary had a free flap operation (a reconstruction surgery which involves the transfer of living tissue from one part of the body to another, along with the blood vessel that keeps it alive) on his leg stump as he had an ulcer which kept getting infected. Raiche also had flap surgery to stop the skin on her face from pulling as it made her unable to blink or close her eyes properly.

Gary had free flap surgery on his leg stump to help control infection.

Raiche told us about her experience having flap surgery and a fat transplant to help manage her burns.

Having surgery to manage a burn injury usually involves being placed under general anaesthetic. As part of this, India, who was a child when burnt, was intubated (when a tube is inserted down the throat or nose to hold the airway open) and this left some lasting damage. Saffron said going under general anaesthetic was always a “horrible” process.

Sinead’s daughter, Elizabeth, also underwent many operations to manage her burns. She explained that, as Elizabeth got older, she began to feel more anxious about her surgeries and would sometimes have a “fear of dying” about the operation. This added to Sinead worrying whether Elizabeth having the operations to improve movement was “doing the right thing or not”.

Sinead’s daughter, Elizabeth, had anxiety about her surgeries.

Sometimes anaesthetic can cause confusion for the person after they wake up. Tom told us that after he came from the anaesthetic, he “wasn’t really sure what was going on”.

Saffron had to repeat the process of going under general anaesthetic and then spending the day “coming round” for a period of three weeks.

Support with physical recovery, including physiotherapy and nutrition

Some people we spoke to, like Helen X, India, and Tom, had physiotherapy to help with their recovery after a burn. Charlotte and Saffron had physiotherapy to help them get out of bed and walk again. Rhian had physiotherapy to help her regain and strengthen the movement in her arm after she burnt her wrist.

Although physiotherapy could be “painful” and “intense”, some also said it was important as it helped them to regain mobility and flexibility. Sabrina, who was a child when burnt, recalled “not wanting to do” physiotherapy because it was “really painful” and she didn’t really understand how it might help.

As well as seeing a physiotherapist through the support of the charity The Katie Piper Foundation, Raffaella also saw an occupational therapist who helped her go out shopping for the first time since her burn and get back more independence.

Charlotte had physiotherapy to learn to walk again.

A few people, like Helen X, saw a dietician or had advice from other healthcare professionals about diet during recovery from a burn injury. They were told to eat high-protein diets to promote their skin’s healing. This is because the body will naturally lose protein as it produces extra energy for the healing process of the burn.

Holly’s son’s burn did not heal properly because he had a cow’s milk protein allergy.

Another key aspect of support after a burn injury for the people we spoke to was with their emotional recoveries and mental health. You can read more about the psychological impact and available support here.

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