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Burns 7-21-11

QuestionAnswer
Burns are direct contact with or exposure to any. Thermal, Chemical, Electrical or Radiation
Severity Of Burns Risk of Infection, Mortality, And cosmetic or functional disability.
Factors that Influence Severity depth, %TBSA, Location, age, general Health, Mechanism of injury
Burn Size %TBSA, est. helps predict the severity of physiological response
Rule of Nines (burn size) divides body into 11 segments.. Each 9% and 1% for genitals
Lund & Browder Standard table based on the parts of body burned according to age
Incidence Males more than females, except of 70 years
Thermal Flames, Hot liquids, Steams semisolid, hot objects.
Chemical contact with or ingestion, inhalation or injection
electrical electrical energy as it passes through the body
radiation least common, caused by radioactive source
Risk Factors for Burns 75% result from actions of injured person usually in home
Who is at highest risk? Children under 3 years, and elderly over 70years.
Other Risk factors rural location, mobile home, occupation, lack of smoke detectors, fireworks, and misuse of cig smoking
Amount of skin destructed depends on. temp to which skin exposed, length of time of exposure, and type of injury
A tremendous amount of heat is not required to cause.. Damage
below 111*F (44*c) no damage, unless prolonged exposure
111*F-124*F (44*C-51*C) Rate of cellular death doubles with each degree in temp rise.
>124*F (51*C) exposure time is brief for damage
SUPERFICIAL (1ST DEGREE) Epidermal Burn, Cell damage only to the epidermis skin, mild-severe erythema, blanching, surface is dry, no blisters, minor swelling, painful, skin will heal with out scaring, 3-7days
PARTIAL THICKNESS (2nd DEGREE) Superficial Partial Thickness & Deep Partial Thickness
SUPERFICIAL PARTIAL THICKNESS VERY PAINFUL, INTACT BLISTERS(COMMON SIGN), EPIDERMIS IS DESTROYED, SUPERFICIAL DERMIS MIN DAMAGE, MODERATE EDEMA, BLANCHING, HAIR & SWEAT GLANDS PRESERVED, COMPLETE HEAL 14-21 DAYS, LITTLE OR NO SCARING
DEEP PARTIAL THICKNESS DESTRUCTION OF EPIDERMIS & DOWN TO RETICULAR LAYER OF DERMIS, INJURY TO NERVE ENDINGS, HAIR FOLLICLES, AND SWEAT DUCTS; SENSITIVE TO COLD AIR, MIXED RED OR WAXY WHITE; WET SHINY AND WEEPING BROKEN BLISTERS; EDEMA; MAY REQUIRE SKIN GRAFT; HEAL 27+DAY
DEEP PARTIAL THICKNESS-- 2 SCARS HYPERTROPHIC & KELOID SCAR
FULL THICKNESS BURN (3RD DEGREE) ALL EPIDERMAL AND DERMAL LAYERS ARE DESTROYED, SUBCUTANEOUS FAT LAYER DAMAGED
ESCHAR DEVITALIZED TISSUE CONSISTING OF DRIED COAGULUM OF PLASMA AND NECROTIC CELLS -FEELS DRY, LEATHERY, & RIGID --TAN OR YELLOWISH-BROWN COLOR OR BLACK
FULL THICKNESS BURN (CONT) NO BLANCHING, DESTRUCTION OF HAIR FOLLICLES AND NERVE ENDINGS (NO PAIN), DECREASED SENSATION, DAMAGE TO PERIPHERAL VASCULAR SYSTEM, SKIN GRAFT
ZONE OF COAGULATION IRREVERSIBLE DAMAGE, SKIN DEATH!, SKIN GRAFT NEEDED TO HEAL, INCREASED RISK OF INFECTION
ZONE OF STASIS INJURED CELLS (DILIGENT TREATMENT OR CELL DEATH WITHIN 24-48HOURS) TOO TIGHT SPLINTS/COMPRESSION BANDAGES WILL DAMAGE
ZONE OF HYPEREMIA MINIMAL CELL DAMAGE
CLINICAL MANIFESTATIONS LOCATION INFLUENCES SEVERITY
PULMONARY COMPLICATIONS HEAD, NECK & CHEST
CORNEAL ABRASIONS fACE
PERMANENT PHYSICAL/VOCATIONAL DISABILITY HANDS/JOINTS
EMERGENT TIME OF INJURY UNTIL RESTORATION OF CAPILLARY PERMEABILITY
RESUSCITATION PERIOD INITIATION OF FLUIDS AND ENDS WHEN CAPILLARY INTEGRITY RETURNS TO NEAR-NORMAL & LARGE SHIFTS HAVE DECREASED
ACUTE PHASE OF RECOVERY HEMODYNAMICALLY STABLE, CAPILLARY PERMEABILITY RESTORED & DIURESIS BEGINS
REHABILITATION PHASE FINAL PHASE- MAX FUNCTIONAL RECOVERY
MOST COMMON AND LIFE THREATENING COMPLICATION INFECTION
OFTEN FATAL COMPLICATION INHALATION INJURY WITH MAJOR BURNS AND STAPHYLOCOCCAL SEPTICEMIA
COMPLICATIONS OF CARDIOVASCULAR & PULMONARY MULTIPLE ORGAN DYSFUNCTION SYNDROME AND DEATH
WOUND CLEANING GOALS REMOVE DEAD TISSUE, PREVENT INFECTION (STERILE), PROMOTE REVASCULARIZATION &/OR EPITHELIZATION
DEBRIDEMENT REMOVAL OF DEAD TISSUE
SHARP DEBRIDEMENT USE OF SURGICAL SCISSORS OR SCALPEL & FORCEPS; BLEEDING KEPT TO MINIMAL
HYDROTHERAPY WITH DISINFECTANT IN WATER TEMP 98*f -102*F, TOPICAL MEDS OR DRESSING APPLIED
PRIMARY EXCISION REMOVAL OF ESCHAR
AUTOGRAFT PTS ON SKIN USED TO COVER A BURNED AREA, PERMANENT COVERAGE
ALLOGRAFT (HOMOGRAFT) SKIN TAKEN FROM AN INDIVIDUAL OF THE SAME SPECIES; USUALLY CADAVER SKIN, TEMPORARY
XENOGRAFT (HETEROGRAFT) SKIN FROM ANOTHER SPECIES, USUALLY A PIG, TEMPORARY
BIO SYNTHETIC GRAFTS (SKIN SUBSTITUTIONS) CULTURED AUTOLOGOUS SKIN, GROWN IN A LAB, HIGHLY SUSCEPTIBLE TO INFECTION
DERMATOME INSTRUMENT FOR REMOVAL OF SKIN FOR GRAFTING
SPLIT-THICKNESS CONTAINS EPIDERMIS & ONLY SUPERFICIAL LAYERS OF DERMIS, ADHERES BETTER
FULL-THICKNESS CONSIST OF FULL DERMAL THICKNESS, LOOKS BETTER
DONOR SITE SITE FROM WHICH SKIN GRAFT IS TAKEN, THIGHS, BUTTOCKS AND BACK
SHEET GRAFT WITHOUT ALTERATIONS, FOR FACE, NECK AND HANDS
MESH GRAFT ABLE TO EXPAND BEFORE APPLICATION
PROCEDURES TO ELIMINATE SCAR CONTRACTURES SKIN GRAFTS, Z-PLASTY (LEGTHENS SCAR Y INTERPOSING NORMAL TISSUE IN LINE OF SCAR)
POSITIONING DECREASE EDEMA, PREVENT TISSUE DESTRUCTION, MAINTAIN SOFT TISSUE IN AN ELONGATED STATE
SPLINTING PREVENT CONTRACTURES, MAINTAINANCE OF ROM, CORRECTION OF CONTRACTURES, PROTECTION OF JOINT OR TENDON
ACTIVE OR PASSIVE EX PROGRESS 2 STRENGTHENING
AMBULATION AS EARLY AS POSSIBLE
SCAR MANAGEMENT PRESSURE DRESSING, VASCULAR SUPPORT OF SKIN GRAFTS/DONOR SITES, TO CONTROL EDEMA AND SCARRING; MASSAGE TO ASSIST WITH ROM EX.
HIGHER MORTALITY RATE FOR CHILDREN 4 & UNDER AND ELDERLY OVER 65YEARS
SURVIVAL RATE FOR ELDERLY 70%
FACTORS THAT INCREASE COMPLICATIONS & MORTALITY IN ADULTS OBESITY, ALCOHOLISM, CARDIAC DISORDERS (PVD)
Created by: 1215657031