Psychological and Physiological Complications of Post-Burn Patients in Pakistan

Abstract

Pakistan has a burn mortality rate of 6.5%, with a considerable percentage of survivors suffering from long-term complications due to lack of rehabilitation. The aim of this review is to outline the important physiological and psychological after-effects of burn injuries. Relevant articles were included by conducting a comprehensive search between 20th March and 25th May 2020. Psychological complications of burns include depression, post-traumatic stress disorder, anxiety, sleep disturbance, phobias, guilt, suicidal thoughts, and personality changes. Physiological complications include scarring, contractures, pain, muscle wasting, and hypothermia. Other complications include infections. The review revealed a scarcity of literature regarding the prevalence and impact of long-term complications in post-burn patients. Our findings include a lack of rehabilitative services and high rate of post-burn complications in Pakistan. Rehabilitation of burn patients should be a continuation of active treatment and should begin from the day of admission, to reduce the morbidity and improve the quality of life of burn patients.
 Keywords: Burns; physiology; psychology; rehabilitation; quality of life.

Risk factors for burn contractures in a lower income country: Four illustrative cases

“…Burns are a global problem, and most frequently occur in LMICs; 27 – 29 it follows that contractures are also likely to affect many LMIC burn survivors, although data on actual prevalence and severity of contractures in LMICs are lacking. 11 Contractures cause not only profound human suffering, diminished function, disfigurement, and social isolation, 2 , 5 , 7 , 30 but also result in ‘catastrophic expenditure’ on healthcare (>10% annual expenditure 31 ) for many of the families affected. In the study population from which these illustrative cases were drawn, 22 the costs of care incurred by the participants, even before any reconstructive surgery, ranged from 3 – 125 times the annual family income.…”

Researches on cognitive sequelae of burn injury: Current status and advances

“…The fully developed PTSD syndrome has a delayed onset, but individual symptoms of PTSD developed earlier in postburn patients. The presenting symptoms include those that fulfill PTSD criteria C (i.e., emotional numbness and avoidance symptoms, such as an inability to recall events and estrangement from people) and PTSD criteria D (i.e., increased arousals such as heightened irritability and hypervigilance) (Giannoni-Pastor et al, 2016;Ali and Ali, 2022). A recent systematic review has shown predictive factors for PTSD in burn victims, such as the risk of life threat, severe pain, unmarried status, intrusive symptoms, substance abuse, depression, anxiety, previous mental diagnosis, and poor economic conditions (Giannoni-Pastor et al, 2016).…”

Effects of acupressure on sleep quality and anxiety of patients with second- or third-degree burns: a randomized sham-controlled trial

“…Following burns, patients experience different physiological problems (e.g., contractures, scarring, infection, chronic inflammation, pain, and hypothermia). Besides, behavioral and psychological complications are prevalent among burn survivors, including but not limited to post-traumatic stress disorder, personality changes, phobias, depression, anxiety, and sleep disturbances [ 10 ]. Among these, anxiety is a common annoying problem, often due to patient’s concerns about their appearance, the painful nature of therapeutic procedures (i.e., wound debridement, wound dressing change, and repair surgeries), and monetary and occupational problems [ 11 – 13 ].…”