Burns

Question 0

Zone of coagulation

Answer 0

Center of burn
Greatest damage
Eschar

Question 1

Functions of skin

Answer 1

Vitamin D synthesis
Temperature regulation
Protection
Sensation
Excretion
Immunity
Blood reservoir

Question 2

Zone of stasis

Answer 2

Surrounds zone of coagulation

Marginally viable tissue

Question 3

Zone of hyperemia

Answer 3

Outermost area

Heals rapidly

Question 4

What characterizes electrical burns?

Answer 4

Entrance & exit wounds

Question 5

Chemical burns significantly alter..

Answer 5

Tissue pH and metabolism

Pulmonary and metabolic complications

Question 6

Rule of nines

Answer 6

Body sections for area of burn

Question 7

Medical care necessary for following burns:

Answer 7

Inhalation injury
Chemical
Electrical
Partial thickness >10% TBSA
Face, hands, feet, genitalia, major joints
3rd degree burns
Burns with preexisting medical conditions
Burns with trauma
Burns on children in hospital w/o qualified specialist

Question 8

1st degree superficial burn

Answer 8

Pink/red
Blanches
Sensation intact
Epidermis only
Intact skin
With/without edema
Painful

Question 9

2nd degree moderate partial thickness burn

Answer 9

Pink to mottled red with edema
Blanches slowly refills
Blisters
Superficial dermis injured
Very painful

Question 10

2nd degree deep partial thickness burn

Answer 10

Pink to ivory
Dry with blisters
May blanch
Decreased sensation 
Painful
Deep dermis w/ hair follicles/sweat glands intact
Scar formation likely

Question 11

3rd degree full thickness burn

Answer 11

Entire dermis or fat,muscle, bone (4th degree)
White, red, brown, black
No blanching
May blister
Insensate
Depressed wound 
No pain

Question 12

How long does it take burns to heal

Answer 12

Superficial 1st degree: 3-5 days by epithelialization

Moderate partial thickness 2nd degree: 5 day-3 weeks by epithelialization

Deep partial thickness 2nd degree: 3 weeks- months by granulation tissue formation (scars)

Full thickness (3rd & 4th degree): not able to regenerate

Question 13

Phases of burn care:

Answer 13

1. Resuscitative (72 hours)- fluid infusion over 48 hours, prevent infection, dry dressings to minimize risk oh hypothermia/radiant heat, opioids for pain, rinsed/lavaged/debrided (escharotomy/fasciotomy)
2. Reparative phase (weeks to months)- scar management

Question 14

Keloid scar

Answer 14

Extends beyond boundaries of primary wound…raised scar

Question 15

Hypertrophic scar

Answer 15

Stays within boundaries of primary wound

Question 16

Heterograft/xenograft

Answer 16

Temporary graft from animal

Question 17

Allograft

Answer 17

Autograft of unburied skin cultured in lab

Question 18

Autograft

Answer 18

Permanent Surgical harvesting of pts own skin from a donor site

Question 19

Homograft

Answer 19

Temporary cadaver graft

Question 20

Proper joint positioning for burn pt:

Answer 20

Neck- extension
Shoulder- 90 deg abduction, ER, horizontal flexion 10 deg
Elbow- extension with supination
Wrist-neutral/slight extension
Hand- functional position (dorsal burn) or finger & thumb extension (palmar burn)

Trunk- straight
Hip- neutral, slight abduction
Knee- extension
Ankle- neutral/slight DF

Question 22

Phases of wound healing

Answer 22

Inflammatory: 3-5 days, neutrophils/macrophages, clotting/platelets, increased blood flow
Proliferation: fibroblasts–> new tissue, form scar, wound contraction, angiogenesis, reepithelialization, day 3-20
Maturation: 9 days up to 2 years, scar tissue remodeling, epithelial cells continue differentiating to collagen type I, red–>pink–>white,