Introduction

Postoperative care of the burned patient must fall to a team of health care workers who have been trained and are experienced in the management of this challenging clinical problem. Care is most appropriately given by a committed team which includes, amongst others, surgeons, anaesthetists, physicians, psychiatrists, pathology services, nurses, physiotherapists, occupational therapists, dieticians, medical social workers and chaplains. Wherever possible, the patients family must be involved in the care and rehabilitation.

The care must be afforded in a purpose-built unit in which temperature and humidity can be controlled, and where patients can be easily isolated if necessary. The unit must have the facility to receive patients and nurse them in a range of areas from one prepared for the whole spectrum of critical care to low dependency nursing areas.

Post-operative management begins in the pre-operative period. If it is at all possible to communicate with the patient, they must be informed prior to going to the operating theatre of what will be done (informed consent) and what to expect regarding dressings and discomfort. Without being untruthful, this must be done with tact and in a reassuring manner. If it is planned to move the patient to another ward area in the post-operative period the patient and any family must be informed. Preoperative visiting by the anaesthetist and by the recovery room staff must be mandatory.

Postanaesthetic recovery (PAR)

Admitting the patient to the PAR and later discharging the patient to the ward is the responsibility of the anaesthetist.