burns

Question 1

Superficial thickness burn (1st degree)

Answer 1

• Epidermis
• Dry, no blisters, blanchable
• Red, bright pink
• Heals in 3-7, may peel

Question 2

Partial thickness (2nd degree) - Superficial partial

Answer 2

epidermis, dermis - papillary

 Blistered, weeping, bright red
 Heals in 7-21 days by re-epithelialization
 Minimal to no scarring or change in pigment

Question 3

Partial thickness (2nd degree) - deep partial

Answer 3

epidermis, dermis - reticular

 Pseudoeschar
 Mottled white to pink
 Blanching indicates healing
 Pain indicates healing, no pain indicates deep burn
 Epidermis, papillary, and reticular dermis
 Heals in 21-35 days
 May develop severe hypertrophic scarring

Question 4

Full thickness (3rd degree)

Answer 4

• Epidermis, dermis, subcutaneous layer
• Dry, leathery, charred
• Mixed white, waxy, pearly, khaki
• No pain, hair pulls out easily
• Healing requires skin grafting

Question 5

Renal system impact

Answer 5

o Hypovolemic shock
 Marked fluid loss
 Decrease BP and urine output
 Increase HR

Question 6

cardiovascular system impact

Answer 6

o Tachycardia
 Hypovolemia

o Bedrest/deconditioning
 Loss of plasma volume
 LV atrophy

Question 7

allograft

Answer 7

• Cadaver skin
• A/PROM okay after 24 hours

Question 8

autograft

Answer 8

• Split thickness skin graft (STSG)
  o Sheet graft, mesh graft
  o Dermatome .007-.16 inches thick
• Full thickness graft (FTSG)
  o Entire thickness of skin down to subcutaneous tissue
• Protection
  o Immobilize grafts that cross joints at all times until POD5
   If good graft take and AROM
  o Gentle PROM 5-7 days after

Question 9

Preventing contractures

Answer 9

• Use a splint at rest and at night
• Position of comfort = position of contracture

Question 10

Scar management

Answer 10

• Massage and stretching
• Compression (silicone + foam)
• CO2 laser therapy
• Z-plasty