What are the common complications of healing from burns?

Burns are injuries to the skin, subcutaneous tissue and even deep bones and muscles caused by heat, including hot liquids, flames, steam, incandescent liquids or solid metals. Depending on the depth and location of the burn, some of the following complications may occur after the wound heals. First, hyperpigmentation, shallow Ⅱ degree and some shallow deep Ⅱ degree burns, due to the injury of local melanocytes located in the epidermis layer in the process of injury repair metabolism abnormalities, the production of a large number of melanin vesicles, gathered in the trauma site resulting in hyperpigmentation, the deepening of the skin color in light brown or brownish-red, seriously hampering the aesthetics. Figure 1 pigmentation Second, scarring after burns Deep second-degree burns and some small area of third-degree burns may have scar formation after healing. And according to the growth characteristics of the scar is divided into proliferative scar, atrophic scar, keloid. Proliferative scars are characterized by an irregular shape, unevenness, redness, congestion, and toughness, but they only proliferate on the original burn wounds and do not expand to the surrounding area. Atrophic keloid scars have no obvious proliferation, are wrinkled, pale red or grayish in color, and may be accompanied by varying degrees of hyperpigmentation or depigmentation. Keloid scars are now considered to be benign tumors with abnormal proliferation of connective tissue, often caused by burns or minor skin injuries. The most notable difference from the first two types of keloid scars is that they can grow invasively beyond the scope of the original skin injury. Figure 2 Hyperplastic scar Figure 3 Atrophic scar Whether hyperplastic scar, atrophic scar, keloid scar will have a serious impact on the patient’s appearance; if it involves the joints and other functional parts, it will also limit the patient’s limb activities, and the scar that involves the joints of the children, if it is not corrected and treated in time, it will also have an impact on the development of their bones and muscles, resulting in deformities and developmental disorders of the limbs. In addition, as the regenerated nerve endings are more disorganized during the healing process of deep burns and are encircled by scar tissue, itching and pain sensations will occur; due to the lack of hair follicles and sweat glands in the scar tissue, it will lead to the patient’s limited sweating function. Figure 4 Scar contracture deformity after burn injury Third, psychological problems. Burn patients’ injuries mostly occur suddenly and produce characteristic appearance changes, patients can not accept the changes in their face and body in a short period of time, and suffer great pain, often resulting in serious depression, fear, low self-esteem and other psychological, and even some patients have negative anorexia. Especially for pediatric patients, due to the change of appearance after burns, they are easily made fun of by their surrounding peers, which leads to the unwillingness of these children to contact and communicate with others, irritability, low self-esteem, which has a great impact on their psychological health development. In addition to timely physical and surgical treatment, corresponding psychological intervention and counseling is of vital importance.