Burns are a Chronic Disease

Dear Editor, The US National Center for Health Statistics defines a chronic disease as “lasting 3 months or more.”1 And while the Centers for Medicare and Medicaid Services does not list burns as a potential chronic illness, facets of burn recovery require persistent attention and management, as well as conditions impacting quality of life that extend well beyond 3 months duration. Over 90% of burn survivors struggle with at least one chronic condition 10 years postinjury, including contractures, joint pain, chronic open wounds, and scarring.2 Stiffness, pain, and weakness lasting longer than 3 years duration are corroborated by research.3,4 These conditions are treatable by rehabilitation therapies, but adequate research in the outpatient burn therapy domain is lacking, as studies that describe burn rehabilitation needs emphasize inpatient care. From these, non-contracted patients receive 1-h treatment time on 80% of their length-of-stay days.5 For hands, tissue elongation was completed in only 36.4% of therapy sessions, despite spending an average of 38.7 min on this task alone.6 These findings, and the chronicity of burn morbidities, suggest substantial volumes and long durations for effective outpatient burn rehabilitation.