Scar Therapies

Details

Title

Scar Therapies

Type

Stage Two

Module code

HPE411

Requirement

Compulsory

Module objective

By the end of this module, the Clinical Scientist in HSST will be able to apply their expert knowledge, skills and experience in the clinical setting to undertake a range of procedures in the therapeutic treatment of scars. This area is multidisciplinary and the Clinical Scientist in HSST will be working closely with a number of other healthcare professionals, including plastic and reconstructive surgeons, burns specialists, physiotherapists and occupational therapists, and wound care nurses. The clinical setting will include structured pre-treatment assessment, the use of direct therapies, psychological support and motivation offered to this vulnerable group of patients. The Clinical Scientist in HSST will also be able to manufacture and quality assure custom-made devices used in the treatment  of scars. They will be able to recognise and address the findings from initial clinical assessment and apply a detailed knowledge of management options available to the responsible clinician based on the  investigative findings, current evidence and best practice.

The Clinical Scientist in HSST will be able to critically evaluate the service performance consistently using the professional attributes and insights required of a Consultant Clinical Scientist in Reconstructive Science. The Clinical Scientist in HSST will be expected to be able to contribute to national guidelines on the treatment of burns and the therapeutic treatment of scars.

Knowledge and understanding

By the end of this module the Clinical Scientist in HSST will be able to analyse, synthesise, evaluate and critically apply their expert knowledge to scar treatment  and management, including:

• the anatomy of the skin, anatomy of the body surface, physiology and pathophysiology of burn injuries;
• microbiology of the skin, microbiological issues associated with burn injury;
• aetiology and specific characteristics of thermal injury, including flame, scald, electric, chemical, inhalation injury and non-accidental injury;
• governance issues related to scar therapies for adult and paediatrics, including protecting children and vulnerable adults from maltreatment, abuse, neglect, or exploitation (safeguarding) and consent;
• classification of scars and burn injuries and the importance of management and protocols;
• audit tools to measure and quantify, e.g. Vancouver scar scale;
• hypertrophic and keloid scar management;
• management of adult and paediatric burns;
• specific psychosocial issues related to burns injury;
• the role of MDTs in nursing, physiotherapy, OT, burns/wound care nurses and the Burns Networks;
• planning and prioritising treatment within an MDT setting;
• differing roles of burn facilities, units and centres;
• the role played by external factors in healing, e.g. diet.

The impact of a range of treatment options, including:

• surgical options in the treatment of scars, including skin grafting: split thickness skin grafting (SSG), full thickness skin grafting (FTSG) and reconstructive meshing;
• intralesional steroid therapy;
• splint therapy, both passive and active (pressure), and the importance of when to employ them;
• selection of splint materials and manufacturing techniques depending on location of injury and other patient factors;
• application of specialist occlusive dressings to manage and reduce scarring, e.g. silicone sheets;
• translation of various splinting techniques for keloid scars, including innovative designs and manufacture for flexible provision, e.g. very different parts of the body require different splinting designs to deliver the therapy;
• follow-up care in complex cases inlcuding the psychosocial reaction to scarring;
• micropigmentation as a therapy for the disturbance of scar formation and promotion of wound healing;
• laser treatment to promote normal healing processes:
  • laser safety, management, regulations;
  • laser type selection, power, type, evidence base;
  • patient monitoring and safety during treatment;
• National Burn Care Standards (NHS);
• British Burns Association Guidelines.

Technical and clinical skills

By the end of this module the Clinical Scientist in HSST will have a critical understanding of current evidence and its application to the performance and mastery of a range of technical skills and best practice in the design, manufacture and management of pressure therapy modalities for post burn or other scars.

They will be able to:

• use scar assessment scales;
• take impressions for scar splinting in difficult areas of the body and in difficult circumstances, e.g. face impressions that may compromise airways in adult and paediatric patients in theatre;
• use 3D photometry, scanning and computer aided design and manufacture to increase the performance of medical devices;
• adapt analogue patient casts to develop treatment moulds;
• produce thermoplastic splinting in a variety of settings and different equipment, e.g. hot bath or vacuum;
• produce complex splinting (demonstrating the use of directional pressure);
• treat, provide information, or refer for other treatment modalities, e.g. steroid injections;
• provide or refer for localised topical cosmetic skin camouflage to mask the site;
• use invasive devices such as laser and micropigmentation to treat scars.

By the end of this module the Clinical Scientist in HSST will be expected to critically reflect and apply in practice a range of clinical and communication skills with respect to Burns and Scar therapy. They will communicate effectively with patients, relevant clinicians and other healthcare professionals and will demonstrate the ability to:

• take pertinent focused history, including presenting complaint;
• examine the scar and make an assessment of treatment, synthesise this into a treatment plan;
• recall and coordinate joint reviews with OT and physiotherapy teams;
• provide detailed advice on the treatment pathway within the context of the relevant MDT;
• manage complex/large burns;
• plan and prioritise treatment within an MDT;
• provide input into a care pathway that supports an individual to successfully adjust to disfigurement. These include the patient being provided with information about their condition and its treatment and social skills training to manage other people’s reactions.