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7313/7333 Bringman > 1.20 Burns 4 > Flashcards

1.20 Burns 4 Flashcards

1
Q

contamination vs. infection

A
  • any wound bed will be contaminated because it’s an open sore
  • doesn’t mean it’s infected
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2
Q

How do you know if a wound bed is infected?

A
  • take a culture (flush with saline, swab wound bed)

- count of bacteria is 10^5 or higher to be considered infected

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3
Q

s/s of infection

A
  • change in amount/color of discharge
  • fever (systemic)
  • odor (must irrigate, then smell)
  • increased redness
  • fatigue/general malaise
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4
Q

What are the complications of burns?

A
  • infection
  • pulmonary
  • metabolic
  • cardiovascular
  • heterotopic ossification
  • pathological scars
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5
Q

metabolic complications of burns

A
  • takes a crap ton of calories to heal a wound (burn/pressure ulcer)
  • body spends a lot of energy healing
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6
Q

What are some of the cardiovascular complications of burns?

A
  • hypovolemia (loss of plasma)
  • BP plummets, HR increases (trying to increase stroke volume
  • can go into shock at any time
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7
Q

pulmonary complications that arise because of burns

A

inhalation injury

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8
Q

burns and heterotopic ossification (where, who, picking up on it)

A
  • typically occurs in the joints
  • can occur in spinal cord injury and TBI as well as burn victims
  • harder to pick up on in burn patients
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9
Q

normal scar characteristics

A
  • stay in the borders of the original wound

- flat/close to flat with our normal anatomy

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10
Q

hypertrophic scars

A

grows slightly beyond wound borders (height)

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11
Q

keloid scars

A
  • keep remodeling and adding more collagen
  • scar moves outside the borders
  • takes over tissue adjacent to original wound
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12
Q

Who commonly gets keloid scars?

A

people of color (due to melanin content of skin)

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13
Q

scar management: what should you do if you notice even a hypertrophic scar? implications to PT?

A
  • begin management and possible referral to plastic surgeon to keep it from progressing
  • can create contractures
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14
Q

PT’s role with burn patients

A
  • prevent contractures
  • appropriate positioning (within MD’s guidelines)
  • exercise when we can
  • patient education on skin care
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15
Q

exercising a burn patient

A
  • always monitoring grafts
  • don’t want to do too much and make the graft fall off
  • keep other complications from happening
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16
Q

big complications a PT should worry about when exercising a burn patient

A
  • bedsores
  • PE
  • DVT
  • pneumonia
17
Q

severe burn patients: Wolff’s law

A
  • form follows function

- tissue laid down following lines of stress

18
Q

severe burn patients: maturation phase

A

6 months to 2 years

  • constantly addressing ROM and scars
  • apply low pressure long duration
19
Q

severe burn patients: How do we apply low pressure for long duration to address scars?

A
  • compression garments (stress) to be worn every day (23 hours)
  • at least 12-18 months
20
Q

fibrous band of scar tissue: how to address?

A
  • may do taping to pull fibers in certain directions

- MD will do a z-plasty if taping doesn’t work (middle portion of the z bisects the band)

21
Q

How often to burn patients need to put lotion on?

A

1-2x per day

22
Q

PT education on skincare for burn patients: amounts

A

if they put too much on, the skin won’t absorb and it will become macerated

23
Q

PT education on skincare for burn patients: type?

A
  • unscented, hypoallergenic, plain soap
  • no smelly lotions, generic
  • vitamin e, lubriderm, aquaphor, etc
24
Q

graft: skin from your own body

A

autograft

25
Q

graft: same species, cadaver tissue

A

allograft

26
Q

graft: different species

A

xenograft

27
Q

graft: skin substitutes

A

biosynthetics

  • can take a sample, send it to a lab, and they manufacture pieces of the person’s own skin
  • time is a factor
  • use temporary porcine graft
28
Q

To use autograft, the burn cannot be

A

covering the whole body

29
Q

autograft: thickness?

A

usually split thickness

30
Q

autograft: Why is this the best type if available?

A

body sees it as its own tissue and grows quickly

31
Q

How does the body heal with allograft tissue?

A
  • gives our body a matrix to grow into

- not revascularized as well » peels off by the tim our bodies re-epithelialize

32
Q

Most xenografts come from

A

pigs

33
Q

Why would xenografts be used?

A

if there are no donors readily available

34
Q

benefit to biosynthetic grafts

A
  • can create specialized shapes (i.e. gloves)

- made from the person’s own skin cells

7313/7333 Bringman (56 decks)

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