Burns

Question 1

Mention zones of immediste cellular injury in burns & their fate

Answer 1

Central zone of coagulation: eschar & separation
Intermediate zone of stasis: viable either die within 48 hrs or remain viable
Outer zone of hyperemia: recover within 7 to 10 days or become infected

Question 2

List factors of poor prognosis in burns

Answer 2

Depth, extent (50% TBSA=50% mortality), type (high voltage worst), site (face is worst), infection (septicemia), associated injury

Question 3

Describe management of electric burns

Answer 3

As any burn+
1. Forced alkaline diuresis to prevent tubular necrosis
2. Fasciotomy if needed
3. DC shock in VF

Question 4

Mention factors that are sus for inhalation injury

Answer 4

Fire in a closed space, presence of facial burns, hoarseness of voice, carbonaceous sputum or soot, presence of singed nasal hair & eyebrows

Question 5

The most common cause of death 4-7 days postburn

Answer 5

Infection

Question 6

List early local complications of burn

Answer 6

Infection, suffocation, constricting eschars, compartmental $

Question 7

Mention late local comp of burn

Answer 7

Contractures, scarring (hypertrophic scar, keloid), malignant transformation, pigmentary skin changes

Question 8

In burn patients
The rate of IV fluid administration should be…..
CVP should be…
Adequate urine output should be…..

Answer 8

50-70 cc/hr
10 cmH2O
1-1.5 cc/kg/hr

Question 9

Indications of hospitalization in burn

Answer 9

1. 3rd deg burn >5% in any age
2. 2nd deg burn >10% in extremes if age
   3.2nd deg >20% in adult
3. Electrical burn
4. Burn of imp area (face, perineum, hand)
5. Circumferential burns
6. Chemical burn with serious threat to function or comesis

Question 10

Mention indications of Theirsch graft

Answer 10

Cover:
1. Large areas of granulation tissue
2. Deep burns
3. After malignancy resection