Apart from disfigurement, other psychosocial issues Richard might face include but are not limited to sleep disorder, fear and anxiety around open flames, depression, loose of self-esteem and PTSD. Additional precaution needs to be taken to make sure Richard maintains some functions in his burnt fingers. Some of these precautions should be occupational therapy and physical therapy. Due Richard was burnt in the face, other systems may be compromised.
The systems that could be affected are the respiratory system (because his nose could be burnt), the digestive system (because if his mouth is affected, then his ability to eat, chew or drink might be impeded. ) and ofcourse his nervous system as the nerves in his face will be dead. Based on the fact that Richard is losing a lot of body fluid his nutritional needs are high protein food, water, high calorie drinks, fruits and vegetable, and fatty food because fat is a readily available source of energy.
Partial thickness burn is extremely painful because most of the nerve endings which detect and interpret pain and sensation are located in the dermis where partial thickness burn occurs. Partial thickness burn would heal faster because it is not as deep into the skin and therefore skin rejuvenation is more possible. Functions compromised by the burn on Richard’s skin are the ability to secret sweat, the ability to convert sun to vitamin D, ability to protect against infection, ability to regulate temperature and the ability to protect against infection.
Other skin functions that should be a concern to the medical staff is that Richard’s skin will lose the ability to store blood and there will be no tissue growth. His skin will also lose the ability to maintain water and salt balance. It is unlikely for Richard to grow hair to cover the scars on his chest because his hair follicles in the burnt area are damaged and there can be no more hair growth because of this. Also the scar tissue is covering the pores from which hair sprouts. During the first phase of wound healing, inflammation takes place first. Blisters orm on the outer edges of the burns as the wounds begin to form scabs. Formation of granulation tissue will not lead to normal appearing/ formation of skin as Richard heals. This is because granulation tissue is scar tissue and scar tissue does not appear normal or allow hair growth or normal skin function. Some long term consequences include the inability to regulate temperature and feel pain because of the dead nerve endings at the site of the burn. Numbness may occur, his body will not be able to secret sweat and he might gain weight because of this.