burn rehab Flashcards
superficial 1st degree burn
epidermis
partial thickness 2nd degree
epidermis and dermis
full thickness 3rd degree
epidermis, dermis, subcutaenous layert
superficial thickness
- dry, no blisters, blanches
- red, bright pink
- painful
-epidermis only
-3-7 days, may peel
NOT includewd in TBSA %
superficial partial thickness
- blistered, weeping
-bright red
-very painful
-epidermis, pap dermis
-7-21 days, minimal to no scarring, pigment change unlikely
deep partial thickness
-pseucochar
-motted white to pink
-blanching indicates healing
-pain= healing, no pain= deep burn
- epidermis, pap and reticular
- 21-35 days, may develop severe hypertrophic scarrin
full thickness
-dry, leathery, charred
-mixed white, waxy, pearly, khaki
-no pain, hair pulls out easily
-epidermis, dermis, subcuteanous and beyond
-skin grafting- wont heal on its own
Lund and Browder
most accurate method of determining total body surface area (TBSA)
-necessary to calculate fluid resuscitation requirements
-most critical time for injury is first 24-48 hours
rule of 9’s
-body divided into 11 segments
9% or multiples of 9 but 1% for perineum
thermal burns
scald
flame
friction
scald
-hot liquids and grease
-common in kids and older
-patterns
flame
may involved inhalation injury
friction
road rash usually
electrical
-contact points might be small, internal damage more severe
- follows pattern of least resistance
- can see entrance spot but dont always know depth of injury
chemical
-treat by massive dilution
-attempts to chemically neutralize the burn can have adverse effect
-
radiation
sunburn
-radiation therapy
nectrotizing fasctisiis
-bacterial infection : Group A strep
-progresses quickly: red, warm, severe pain, fever
- antibiotics and daily surgical debridement necessary
- complications: sepsis, organ failure, life or limb, scarring
SJS and TEN
SJS= <10%, TEN= >30%
-epidermis
-allergic reaction to a drug
-life threatening when it gets to gut
frostbite
-hennepin score
-t-PA protocol, bone scan, rewarming
-time is of the esscence
renal system
-hypovolemic shock
marked fluid loss in organs increases HR , decreases urine and BP
escharotomy
fluid accumulates in extracellular space
-burn/eschar acts as torniquet
-ischmeic, compartment syndromw
mesh graft
run graft through a mesher
- interstices allow for wound drainage
-expanded over large area
- less durable than sheet grafts
-waffle like appearne
sheet graft
-graft unaltered
-more cosmetic
-requires large donor site
-watch for bleeders
cultured epidermal autograft
pts with large TBSA >30%
-skin biopsies taken and grow in the lab
