Caring for Those with Severe Burns

Family Caregiving January 06, 2012 Print Friendly and PDF

Did you know that, according to Journal of Critical Care Medicine, burn injuries account for 5 percent to 10 percent of combat casualties? During military operations, burn injuries are usually caused by explosive device detonations or refueling operations. Such burn injuries can be accompanied by severe complications, including shock, infection, electrolyte imbalance, and respiratory distress.

As a caregiver to a wounded warrior, you need to understand the recovery process and steps to take in the immediate aftermath of military burn injuries.

The recovery process

During the recovery process, a team of burn professionals, consisting of plastic surgeons, burn team nurses, counselors, social workers, and psychologists, helps your wounded warrior, you, and other family members.

According to British Medical Journal, the recovery of burn patients is a continual process that comprises three stages—the resuscitative or critical stage, the acute stage, and long-term rehabilitation.

  • Resuscitative or critical stage In this beginning stage of recovery, physical survival is the primary goal. Your wounded warrior may experience challenges, such as sleep disturbance, confusion, disorientation, and pain. Treatment may involve pain medication, suggestions for coping strategies, education, and support services.
  • Acute stage Your wounded warrior may become more aware and alert and have greater awareness of his or her physical appearance and the psychological impact of the injuries. During this stage, symptoms of depression and anxiety may take effect. Options for treatment may include drug management (for example, depression and sleep medications), counseling, and relaxation techniques.
  • Long-term rehabilitation: Reintegration is key during long-term rehabilitation. This stage begins when your wounded warrior is discharged from the hospital. He or she may experience the hassles and reality of daily activities, changes in body image, and the constant role of rehabilitation in his or her life. Treatment may consist of social skills training, peer counseling, vocational counseling, and support group participation.

Types of burns

Burns are categorized by degree of severity.

  • First degree This type of burn is rarely serious and may heal by itself within days. These burns usually occur as a result of exposure to sun (sunburn) or hot liquids.
  • Second degree Second degree burns require longer periods to heal and may result in permanent scarring. They can result from exposure to hot or scalding fluids or from flash or flame injuries.
  • Third degree This type of burn may require skin grafting, a surgical procedure in which a partial segment of noninjured skin from the patient’s body (referred to as the “donor site”) is grafted to the burn area.
  • Fourth degree Fourth degree burns can affect all layers of the skin as well as structures below the skin. They may result in permanent disability and require extensive rehabilitation.

Strategies for helping and coping

It's important to learn how to help your wounded warrior and yourself respond to your situation.

  • Always check with your wounded warrior’s doctors to learn about individualized treatment plans.
  • Learn how to minimize and prevent negative effects of prolonged bed rest, including debilitation and loss of muscle tone, strength, and condition.
  • Learn how to help your wounded warrior adapt to the environment and/or to equipment for enhanced independence.
  • Anticipate the need to apply skin lotion to prevent your wounded warrior from becoming too dry.
  • Control and prevent the formation of scars by applying pressure garments (garments worn after a burn to control scarring).
  • Maximize wounded warrior and family education.
  • Join a support group for caregivers who are experiencing similar wounded warrior situations. Locate such groups by contacting your local Army installation's Soldier and Family Assistance Center (SFAC).

Caregiver resources

For more information about severe burns and caring for a service member with severe burns, contact Brooke Army Medical Center (BAMC), the Defense Department’s leading burn center, at (210) 916-4141. Contact your local Army installation’s SFAC for information about support groups and caregiver support services. For additional information on caregiving, visit the VA Caregiver Support website.


  1. Burns.” MedlinePlus. 8 Oct. 2008. U.S. National Library of Medicine and the National Institutes of Health 3 Feb. 2010.
  2. Burn Rehabilitation.” United States Army Institute of Surgical Research. Nov. 2010. 3 Feb. 2011.
  3. Kauvar D.S., Cancio L.C., Wolf, S.E., Wade C.E., and Holcomb J.B.: Comparison of Combat and Non-combat Burns from Ongoing U.S. Military Operations. J. Surg. Res., 132: 195-200, 2006.
  4. Medical Care Guide.” Burn Survivor Resource Center. 2001. 3 Feb. 2011.
  5. Medical Care Guide-Types of Burns.” Burn Survivor Resource Center. 2001. 3 Feb. 2011.
  6. Severe Burns.” U.S. Army Wounded Warrior Program (AW2). Aug. 2009. 3 Feb. 2011.
  7. White, C., and Renz, E. 2008. Advances in surgical care: Management of severe burn injury. Critical Care Medicine, 36, 318-324.
  8. Wiechman, S., and Patterson, D. 2004. ABC of burns, Psychosocial aspects of burn injuries. British Medical Journal, 329, 391-393.

Photos provided by the U.S. Department of Defense.

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This work is supported by the USDA National Institute of Food and Agriculture, New Technologies for Ag Extension project.