Brian Shirley with patient

Brian Shirley, NP, JMS Burn Center at Doctors
Hopsital treats a pediatric patient

During the wound healing process, the body’s cells naturally reform. With third and fourth degree burns, however, the cells don’t reorganize normally and thus, noticeable scarring results. Aesthetics aside, burn scars can seriously inhibit normal movement, which is why extra attention must be given to treating burn scars in children whose bodies are still growing.

Brian Shirley, a nurse practitioner with the JMS Burn Center at Doctors Hospital, specializes in treating the skin’s regrowth and works closely with the surgeons and therapists. “Scar tissue tends to contract, so much so that serious limitations in movement can occur depending on the location of the burn. This is a particular concern when the burn patient is a child who is still growing and maturing,” he says.

According to Shirley, the location and severity of the burn both have implications for how that child will fare later in life. “Often we can repair lacerations or do skin grafts to minimize scarring—we can’t stop all scars—but full thickness burns on the palms, soles of the feet, neck and armpit can seriously affect range of movement later in life because of how much the skin will tighten as it heals. Scar tissue doesn’t stretch or flex.”

When the burn is severe and occurs across a joint, the child can lose the motion of the joint. For example, when full thickness burns occur on the palm of the hand, commonly associated with stove tops and oven doors, irons and children’s hands getting caught in treadmills, eventually the child won’t be able to open his hand unless there is intervention during the healing process. Because the child is still growing, Shirley says that palm burns in particular have more severe implications for children than in adults.

“Although function is the most important part of treating scars, we do our very best to address the cosmetic nature of scars as well. We are highly sensitive to the emotional toll an altered appearance can have on a child,” Shirley says. “Some parents choose to homeschool their children to spare them the stares and comments that might occur.”

He adds that the Georgia Firefighters Burn Foundation sponsors Camp Oo-U-La®, a camp specially designed for burned children, where kids can go and be themselves because they’re surrounded by other children that look like them and have had similar experiences in their recovery. For more information about the camp, you may visit