Inpatient Care

The Burn Center wants to provide burn care to any and all citizens of North Carolina who have suffered a burn injury, regardless of ability to pay. Anyone can make a referral to the Burn Center, but once a patient has been hospitalized elsewhere, the physician or his representative must arrange for the transfer.

Reasons you should be seen at the Burn Center:

  • second and third degree burns greater than 10% total body surface area (TBSA) in patients under 10 or over 50 years of age
  • second and third degree burns greater than 20%TBSA in other age groups
  • second and third degree burns involving the face, hands, feet, genitalia, or major joints
  • third degree burns greater than 5% TBSA in any age group
  • electrical burns, including lightning
  • chemical burns
  • burn injury with pre-existing medical disorders that could complicate treatment and prolong recovery

Some patients are with us for a short period of time, while others may be with us for an extended period depending on the size and depth of burn and other complicating factors.

On arrival, the Burn Team evaluates your immediate needs including breathing and circulatory status. Simultaneously, they determine the size and depth of your burn wounds and look for other injuries. Fluid loss through the burn injury is greatest in the first 48-72 hours. Large IVs will be inserted to replace the amount of fluids lost through the burn wound; we will continually monitor your fluid loss.

We evaluate your airway for injury from smoke, chemicals, or heat and support your breathing with oxygen or a breathing tube and ventilator if necessary. Pain is assessed and pain medications are given to help you be more comfortable. After we have stabilized your immediate airway, breathing, and circulatory needs, we clean and cover the wounds with an antimicrobial dressing and settle you in your room.

Skin Grafts and Donor sites

Some burn wounds heal naturally, and some will need surgery. The Burn Surgeon will determine the best path to healing for your burn wounds.

If the wounds are deep second degree or third degree burns, they may need to be removed and cleaned in the operating room, where the dead tissue is removed and new skin from another place on your body called a donor site is placed over the wound. This is called a graft. Both the graft and the donor site will then heal faster in a shorter period of time than a burn wound.

All wounds including the grafts and donor sites will need daily care. The nursing staff will remove the old dressings each day, gently clean the wound, and put a new dressing on. The dressings provide antimicrobial activity against any bacteria or fungus trying to contaminate the wound.

Pain is controlled using a number of medications and methods. The Burn Team works very closely with each patient to ensure the highest comfort level possible.

Therapy

Movement of the burn injury is very important to maintain function. Our occupational and physical therapists specialize in burn injuries and help patients gain strength and maintain maximum function. By working with patients each day, they can easily monitor progress.

Recreational therapists also work with patients to assist with the many options for pain control in addition to the medications we administer. In addition, all therapists work with burn injured children to ensure they maintain the expected developmental level.

Nutrition

Good nutrition promotes proper healing. A nutrition expert works with patients individually to find out their food preferences and establish a diet that is palatable and ensures the appropriate nutritional requirements, protein and calories, to support wound healing. As patients progress, families are encouraged to bring in their favorite foods to promote good calorie intake.

Chaplains and Peer Support

The Burn Center has two chaplains who specialize in the needs of patients with burn injuries and are always ready to assist patients or their families in their time of need. In addition, they provide a family support group in the conference room of the Burn Center once a week. Before discharge, you may visit with another burn survivor who has healed from burn injuries and is willing to talk to you and answer any questions you have. They have wonderful tips to offer since they have already been through what you are experiencing. They are definitely in the know!

Social Work/Case Manager

We have many resources available for patients and their families during a stay in the Burn Center. Our social worker/case manger can help a patient and family meet needs that include but are not limited to resources needed for parking, meals, clothes, housing and other needed items and services.

School

School progress is maintained throughout hospitalization in the Burn Center to keep education on track. In addition, we provide support when it is time for a child to return to school.

Discharge

From the moment of admission, our goal in the Burn Center is to promote patient independence. A patient is considered ready for discharge when everyone on the Burn Team, as well as the patient and family, determine the wounds are closed enough that the patient and family can manage them at home, pain is controlled and manageable, and the patient is able to move about safely and assist in wound care with the help of a family member.

Before discharge, the patient and family need to:

  • demonstrate appropriate wound care procedures
  • demonstrate pain management
  • manage changes in self-image and body image
  • review nutrition requirements for wound healing

On or before the day of discharge, patients are provided with supplies to care for their wounds until they come back to burn clinic, pain medication prescriptions and education, any other medication prescriptions and education needed, a reminder for their first burn and therapy clinic appointment, and support telephone numbers should they need help once they get home. An expert burn nurse is available 24/7 for any questions they may have. After leaving the hospital, it is important to keep appointments at the Burn Clinic because we need to see how the burns are healing.