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of cotton, abd’s and splints may be necessary to aid in this process. In large areas, such as the torso, the surgeon may ask for the anti-sheer wound cover dressing or towel gauze to lay over top of the interface and the petrolatum wound dressing. Petrolatum dressing and gauze rolls will also be applied to the donor sites, making sure to keep it separated from the grafted areas. Once all grafts are laid, hemostasis will be reached. The patient then will be ready to be extu- bated (if able) and taken to recovery. B E N E F I T S A N D R I S K S Assuring that the patient is stable enough to undergo anes- thesia is important, although the unsalvageable tissue needs to be debrided as soon as possible. Since burn patients have a weakened immune system, they are more prone to infec- tion, which can also lead to sepsis. Other disadvantages include blood loss and graft loss, but without surgery a patient can suffer from compartment syndrome, as well as infection. There also are cosmetic and life-altering disadvan- tages of meshing the graft; however, it allows the surgeon to use less donor tissue. Meshing also allows blood and body fluids to drain from under the skin grafts, preventing graft loss, and it allows the donor skin to cover a greater burned area because it is expanded. P O S T - O P E R A T I V E Rehabilitation begins with wound coverage to prevent burn scar contracture. Aggressive physical and occupational ther- apy with exercise and splinting in position of function are the keys to recovery. The use of pressure garments also has been shown to help with healing of wounds more rapidly, but evaluation of its cosmetic and functional advantages currently are still under examination. Plastic and recon- structive surgeons will need to be involved early in patient care for any future needs of contracture releases and related surgeries. 7 Other aspects that will need to be addressed are pain and wound management. Hydrotherapy is highly com- mon to aid in the treatment of a burn victim. Hydrotherapy involves the use of water for pain relief and treatment, using the temperature and pressure of the water to aid in therapuetic care as well as to help stimulate circulation. Patients find that while they are in hydrotherapy they are able to move more without as much pain. Burn victims who suffer from inhala- tion injuries also will need therapy to help treat their lungs. During treatment in a hyperbaric chamber, oxygen is admin- istered into the pressurized chamber. This greatly increases the amount of oxygen delivered to the tissues throughout the body, which stimulates wound healing, fighting infection and promoting new growth in blood vessels and arteries. 7 P A T I E N T C A R E – O U T S I D E T H E O P E R A T I N G R O O M Burn victims not only undergo changes in their personal health and appearance, but in their social life as well. Special training and education is needed for victims to overcome this transition phase in their life, as well as for the family members who assist the patients during this time. Burn cen- ters are highly recognized around the nation for not only their surgical intervention, but the holistic team approach of care that each and every burn patient receives. At St Joseph Hospital in Fort Wayne, Indiana, the medi- cal team (specialized in caring for burn patients) meets weekly and thoroughly discusses each patient and the plan of action for their care. During grand rounds, the surgeon (referred to as the bus driver in the care plan), an intensivist, a member from microbiology, trauma therapy (psychology), occupational therapy, respiratory therapy, nursing, as well as a case manager and chaplain are present to review each patient on a case-by-case basis. This approach gives each patient the most holistic and positive outcome possible, and helps assure that each area of their life is being addressed. In addition to the traumatic event itself, some patients are dealing with the loss of a loved one or personal belongings such as a home and may require assistance with the grieving process. The trauma therapy member will help the patient cope with changes that they will not only face in the present but in the future as well. The cosmetic change also can be a huge challenge for patients. Many times, a makeup artist will meet with the patient to help them adapt to the changes so they can find confidence in themselves again. In cases where the victim is a child, a nurse also can accompany them on | The Surgical Technologist | APRIL 2016 166 Burn centers arehighly recognized around the nation for not only their surgical intervention, but the holistic team approach of care that each and every burn patient receives.