[Psychological management and after-care of severely burned patients]

Skin damage resulting from severe burn injuries is often widespread and quite deep. In addition to the organ lesion, there is also psychological damage. Subsequent scar stigmatisation and reduced function, for example of the hands, neck and the facial area, and amputations lead in individual cases not only to increased stress at work, but to significant physical, emotional and social stress as well. In some cases, this results in drastic changes of lifestyle, even resulting in severe post-traumatic stress reactions. Psychological treatment begins as early as the intensive care period, at a time when the patient is trained to be off the respirator, or when the patient is fully awake, during preparation for the transfer to the normal or "aftercare unit", as well as the time when the patient leaves the hospital. Treatment is understood primarily as "crisis interventions"--and proceeds in accordance with everybody involved in therapy, including the consultant psychiatrist, the physiotherapist, the occupational therapist, the clergyman and the social worker. The aim of psychological treatment is to offer a patient specific help in his/her current situation and is a part of the whole multi-disciplinary rehabilitation concept. Additionally, it is also intended to prevent severe short- and long-term post-traumatic stress syndromes. Thermic accidents at work or at home, including suicide attempts, in most cases involve patients who are already suffering from psychoses or neurotic personality disorders, patients with high alcohol intake, medication and drugs abuse, or conflict situation in their social and working environments (burn prone personality).(ABSTRACT TRUNCATED AT 250 WORDS)