Burn Rehab Flashcards
Describe the Rule of Nines
head and neck- 9%
each UE- 9%
each LE- 18%
front trunk- 18%
back trunk-18%
perineum- 1%
What is the lund browder chart
More accurate description of TBSA
erythema
redness
Describe a superficial burn
- superficial epidermis
- short-term, mod pain with no blistering, dry, and min erythema
- 3-7 day healing
-no scar potential
Describe superficial partial-thickness burn
- epidermis and upper dermis layers
-significant pain, weet blistering, erythema - 1-3 week healing,
- min scar potential
Describe deep (partial thickness) burn
- epidermis and deep dermis layers, hair follicles, sweat glands
- severe pain
-erythema with or without blistering
-high risk of turning into full thickenss burn
-3-5 week healing
-high scar potential
Describe a full-thickness brun
-epidermis, dermis, hair follicles, sweat glands, nerve endings
-no sensation to light touch except at deep partial thickenss borders
-pale and non blanching
-requires skin graft
extremely high scar and contracture potential
Describe a subdermal burn
- Full thickness with damage to fat, muscles, and bone
-Charring present
-significant peripheral nerve damage
-surgical intervention or amputation
-scarring and contracture potential extremely high
What are the mechanisms in which burns can occur
-thermal
-chemical
-electrical
-radiation
How long is the emergent phase?
0-72 hrs after injury
What are the focuses of the emergent phase?
-sustaining life
-controlling infection
-managing pain
What are the concerns during sustaining life in emergent phase
- risk of dehydration
- hypo/hyperthermia
- fluid resucitation
- cardiopulmonary stability
- escharotomy and fasciotomy
What types of wound dressing are used to control infection
-Topical antibiotics
-Xenografts
-Allografts
-Nonbiological skin substitutes
How long is the Acute Phase
72 hours and until wound is closed
- can last days or months
What are the main focuses of the acute phase
- Infection control
- pain management
- proper nutrition and hydration
-Cardiopulmonary stability
How is infection controlled in the acute phase
nonsurgically though wound care maintenance
OR
Surgically through escharotomy and debridment or skin grafts
Describe an autograft
transplant of person’s own skin
Describe a split thickness skin graft
full epidermal and partial dermal layers taken
What is the gold standard skin graft
split-thickness skin graft
describe a full-thickness skin graft
full epidermal and dermal layers and some fat layers
mesh vs sheet graft
mesh- graft is meshed and stretched to cover greater area
sheet- graft is removed and laid down as is
when would skin substitutes be used rather than skin grafts
when there is not enough donor skin to cover all of the affected area with an autograft
When is the rehabilitation phase of burn rehab
6 months - 2 years
what are the focuses during the rehab phase
- psychosocial monitoring and management
-scar maintenance
Describe the physical components of the OT eval
-burn etiology, pmh, 2 dx
-assess wounds
-ROM and strength
-sensation
-functional use
-pain, edema, tight eschar
Describe the areas of occupation components during OT eval
-hand dominance
-previous injuries or conditions
-ADL and leisure participation
-psychological status, cognition, social support
