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October 22, 2001

Physical Therapists Continue Healing Process for Burn Patients From World Trade Center and Pentagon

 (SafetyAlerts) -  The men and women who sustained burn injuries from the terrorist attacks on the World Trade Center and the Pentagon on September 11 are taking the first steps toward recovery -- a rehabilitation process that may take years, says the American Physical Therapy Association (APTA).

Approximately 25 patients were treated at New York Presbyterian Hospital. Most of these men and women had third-degree burns covering 25 to 90 percent of their bodies. For these people, physical therapy began immediately.

The immediate concern was to assess the patients' range of motion and function, begin exercises to prevent muscle atrophy and contractures, and manage inhalation injuries. Hope Laznick, PT, assistant chief of physical therapy at New York Presbyterian Hospital, said, "For those people who were able, we encouraged them to sit, stand up, or even walk. They were encouraged to perform active and active assistive exercises to help prevent muscle atrophy and to control the formation of scar tissue. Physical therapists also intervened by putting patients in positions to minimize potential contractures. This was achieved by the use of positioning devices and splinting."

"We also helped teach patients deep breathing exercises and performed chest physical therapy in order to reduce the dangers of pneumonia that can result from inhaling toxic air," Laznick explained.

After the immediate danger had passed, physical therapists focused on scar management. Depending on how severe the burn injury is, scar management usually begins after the wounds are closed. The entire scarring process could take a year -- or longer," said physical therapist Heather Hunter, PT, assistant professor at New York University's School of Physical Therapy.

"The techniques of scar management are used to normalize collagen and blood flow to the affected area," Hunter explained. Scarring is fundamentally a prolonged inflammatory response. Physical therapists apply therapeutic massage combined with stretching to reduce the effect of scar formation. Pressure garments, often made of elastic materials and silicon, are designed and worn specifically to support the newly scarred area. Some patients may wear these garments for at least a year.

Ron Lassiter, PT, director of burn rehabilitation at Washington Hospital Burn Center, is working with patients with burn injuries from the Pentagon tragedy. Lassiter is providing scar management for his patients.

"Both massage and pressure garments combat the hypersensitivity of the scar. Pressure garments also control scar hypertrophy," Lassiter explained. "Any touch on the skin can be extremely uncomfortable. We use skin conditioning techniques so patients can tolerate touch."

Physical therapy is crucial to minimizing the extent to which the scar contracts. "A contracted scar, especially a large one, can severely interfere with the functioning of the affected limb or area," said Hunter. "This process begins in the earliest stages of treatment, by splinting and positioning the areas of the body to enable the skin to stretch as much as possible. Splinting is also crucial after skin graft surgery, where the area needs to be completely immobile for at least five days," Hunter added.

Long-term recovery for many burn patients may take years after the initial medical danger has passed. During this phase, physical therapists perform scar massage and therapeutic exercise to maintain a patient's range of motion, flexibility, strength and endurance.

"These patients need as much support as humanly possible from health professionals, families, friends, and the larger community," Hunter said. "We've been humbled by the overwhelming support we've witnessed to date."

Source: PRNewswire.

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