Burns

Question 1

pathology of extensive burns

Answer 1

Haemolysis due to damage of erythrocytes by heat and microangiopathy

Loss of capillary membrane integrity causing plasma leakage into interstitial space

Extravasation of fluids from the burn site causing hypovolaemic shock (up to 48h after injury)- decreased blood volume and increased haematocrit

Protein loss

Secondary infection e.g. Staphylococcus aureus

ARDS

Risk of Curlings ulcer (acute peptic stress ulcers)

Danger of full thickness circumferential burns in an extremity as these may develop compartment syndrome

Question 2

healing pathology

Answer 2

Superficial burns: keratinocytes migrate to form a new layer over the burn site

Full thickness burns: dermal scarring. Usually need keratinocytes from skin grafts to provide optimal coverage.