Question about burn scars (research)

[Kogarashi]

Ok, so someone else's research question seemed okay here, and my Google Fu is failing me, so I figured I'd ask here.

I've got a character in a story with a lot of burn scars on his upper torso and arms from magic gone awry, and was wondering what sort of long-term side effects or complications I could expect to have him deal with. The setting is high fantasy, but there's magic (including magical healing, though he didn't have ready access to it while learning his fire spells, hence all the scarring). No fancy advanced medical facilities, though.

I tried looking up complications with burn scars, but everything I found talked about complications at the time of the burn injury itself, not long-term effects from the scars.

[KiaKat]

Check out Nienie (www.nieniedialogues.com/) for some reference points. She was burned over some very high percentage of her body, years ago, and is only just now healthy enough to resume a semblance of her life. It's fascinating, everything she has to go through because of the scars and the remaining pain from nerve damage.

[kpzra]

Limited mobility in joints from the skin being tighter, they react differently to the sun, there can be numb areas depending on the severity, and are generally shiny even if they are textured. Even 28 years later I still get the nerve endings acting up and all firing at once, making it feel like I'm being burned again. The site KiaKat linked caused my computer to bork so I didn't look at it. For the most part, after they were healed they were like normal skin, just thicker in parts, thinner in some, and it burns easier in the sun. There is no hair in the 3rd degree spots even now.

[KiaKat]

I'm not surprised it caused problems - it's an image heavy blog.

[kpzra]

I figured. I fried my laptop so I'm stuck on the toughbook. 600MHz processor...yeah

[Kogarashi]

Awesome, guys. Thanks for the reference info.

[Seshat]

I've been told - though this is secondhand info - that if the burn damage is extensive enough, temperature regulation can be messed up.

[kansasgal]

The scars take time to stretch, so there is tightness over the burn area. Random shocks of pain happen daily, and sometimes hot water in a bath will make them feel like the burn is happening all over again. Discoloration when normal, and they don't tan. Since they are on the top of my foot, pain when a shoe is worn even when it is tied or buckled lightly if the shoe is worn too long. Mine were second and (a small area) third degree.

[PepperElf]

plus the healing itself can be hell.


warning - minimal images but the ones they do have are NOT pretty.
http://www.vuburncenter.com/downloads/WoundCare.pdf


It's a bit dry for reading material, but I do remember once reading that you WILL be hurt while healing cos don't forget - part of healing is abrading the skin to get it cleaned out. (shudder!)

and of course remember this is how trained medical professionals treat burns. in a sci-fi realm you don't always have the same kind of care.

[Kogarashi]

Thanks very much for the information, guys. Some of this stuff I knew already but a lot of it I didn't know before, so this is perfect. I'd hate to be one of those people who just sort of "wings it" and gets everything completely wrong. I hate reading stories and thinking, "But that's not how it works at all!" So thanks for the info!

[Parrothead]

Not reading the second link, but Back In The Old Days (TM), they abraided wounds with Maggots. From other readings there ate two types, one which burrows into the wounds and causes boatloads of damage and another which eats all the dead stuff and falls off I can't remember right now which is which, but if you need it, I can look it up.

*icky stuff is whited out.*

[kpzra]

I believe it's only screw worm fly maggots that eat live flesh, but I could be wrong. They still use them in modern hospitals. They do a great debridement job with less damage than a scalpel. I've heard they tickle a bit.

[Cia]

A friend of mine's little sister was burned over a quarter of her upper body when she was a young child. As she grew and went through puberty, she had to have surgeries since some of the scar tissue was on her chest and as she developed breasts the scar tissue wouldn't stretch and caused her some problems.

[Kogarashi]

A friend of mine's little sister was burned over a quarter of her upper body when she was a young child. As she grew and went through puberty, she had to have surgeries since some of the scar tissue was on her chest and as she developed breasts the scar tissue wouldn't stretch and caused her some problems.

I'll have to remember that part. I noticed on the Nienie Dialogues link that she needed similar treatments for when she got pregnant (or so it looked?) for the same reason: lower abdominal tissue wasn't going to stretch properly otherwise.

[Sapphire Silk]

I've been told - though this is secondhand info - that if the burn damage is extensive enough, temperature regulation can be messed up.

Only during the acute phase of the burn, typically. Once healing has occured, this usually isn't a problem.

The biggest problem with burns is infection, which can lead to sepsis and death. However, for the OP's character, the biggest challenge is going to be eschar and contractures. As the skin heals, it tightens and can pull extremities into twisted shapes, and the person loses full range of motion over the affected area. This can result in distortions in the face as well, or the ability to stand up straight.

Surgery to release the tightened skin helps this (escharotomies). Scarring in such cases is usually pretty extensive, and takes a long time to heal. This character likely has to use lotions and other products to soften the skin, and do frequent range of motion exercises to maintain mobility.

Some problems the character would face would include body image disturbances (talking in Hero System terms, a Distinctive Feature Disadvantage), the contractures would represent a Physical Limitation, anxiety over appearance a Pysch Lim, and the use of lotions for the skin a Quirk (in GURPS terms). The lotion might also leave the person with a distinctive smell (a Quirk or possibly Distinctive Feature).

Chronic pain might also be another issue to deal with. Also, weakness of an extremity depending on the severity of the burn.