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wound care exam 2 > Burns > Flashcards

Burns Flashcards

1
Q

Deep partial thickness s Sx

A

Thick, rubbery scar
Poor hand/arm function
Poor skin integrity

Grafting better cosmetically and funtionally

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2
Q

Surgical burn management

A

Autograft: deep partial/full thickness-permanent

Allograft: temporary

Xenograft: pig skin-temporary

Skin substitute: temporary, special protocols

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3
Q

Split thickness skin graft (STG)

A

Advantages: durable, limits contraction, cosmetic

Disadvantages: difficult adherence

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4
Q

STSG mesh

A

Advantage: donor skin covers more of burn, better for irregularities or if wound bed contaminated

Disadvantages: less durable, contracts more

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5
Q

STSG donor site

A

Thigh, leg, back, buttock
Heals by re-epitheliazation.(7-14 days)

Can be harvested 3-4 times
treat as partial thickness wound

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6
Q

Graft recipient area requirements

A

Adequate vascularity
Complete contact
Adequate immobilization
Few bacteria

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7
Q

ACE wrap for burns

A

Supports graft/burn, promotes circulation, prevents hemorrhage

Figure 8 or spiral

No sleeping in ACE wrap

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8
Q

LE burn and ambulation

A

Apply compression: progressively dangle legs, walk immediately on stance

If grafted, progressively dangle: start at 1 min and observe for color change, bleeding, etc.

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9
Q

Contraindications to ex for burns

A

Exposed joints, tendons of PIP
DVT
Compartment syndrome

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10
Q

Position of contracture

A

Usually position of comfort

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11
Q

Facial complications of burns

A

Ectropion of eye: excessive tear production, conjunctivitis, keratitis

Ectropion of mouth: difficulty managing secretions, liquids

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12
Q

Shoulder complications of burns

A

Flexion or add contracture

Limited chest wall expansion

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13
Q

Burn numbers

A

500k a year
Males 16-40 most common

Children 1-5: 2* to scalds
Adolescents: 2* to accidents with flammable liquids

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14
Q

Superficial (First degree)

A 
Sunburn
No blisters, bright red or pink.
Epidermis only, blanches under pressure.
Tender to touch
Spontaneous healing in 2-3 with no scar
No edema
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15
Q

Superficial Partial Thickness

A 
Epidermis and papillary dermis.
Intact blisters c inflammation
Blanches under pressure.
Painful/sensitive.
Heals s surgical intervention in 7-10 days c minimal scarring
Immediate capillary refill
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16
Q

Deep partial thickness

A 
Epidermis and dermis down to reticular layer.
Mixed red/waxy apperance.
Significant edema.
Heals in 3-5 wks, STSG usually required
Hypertrophic scarring common
Sluggish capillary refill
17
Q

Full thickness burn

A

Epidermis and dermis, possibly subQ
Covered c eschar
STSG necessary
Edema

Beyond PT scope

18
Q

Escharotomy

A

Swelling c circumferential burn

Decreases pressure, restore blood flow, save limb

19
Q

Subdermal burn

A

Destruction from dermis through subQ tissue, muscle, bone
Prolonged contact
Charred or mummified appearance
Extensive sx/therapy

20
Q

Rule of 9’s

A 
Head: 9%
Anterior trunk: 18%
Posterior trunk: 18%
Leg: 18% each
Arm: 9% each
Balls: 1%
Palm: 1% each
21
Q

Types of burns

A

Thermal: direct contact: contact time, temperature, type of insult

Chemical: acids/bases: alkali>acid, contact time, concentration, amount

Electrical:AC>DC, contact time, voltage

22
Q

Electrical burn

A

Destructive
Entrance and exit wounds
Cardiac arrhythmia, respiratory arrest

23
Q

Inhalation injury

A

Increases morbidity/mortality: 60% of fire related death
Prolonged ventilation and bed rest

No smoke detector increases risk of death by 60%

24
Q

Stevens Johnson Syndrome/TENS

A

Immune complex hypersensitivity

Skin and mucous membranes

Drugs, viral, infection.

Tens=greater than 30% of body

25
Q

Complications of burns

A 
Shock: hypovolemia, TBSA >30%
Pulmonary: inhilation injury
Hypermetabolism
Thermoregulation
Infection
26
Q

Resuscitive phase

A

Nothing by mouth first 24 hrs
IV for fluid loss
Cardiopulm complications

27
Q

Wound coverage phase

A

Excision/debridement
Dressings
Grafting

28
Q

Dressings for burns

A 
Siladene: non-graft or donor site
Acitcoat: impregnated c silver
Collagenase: deeper burns c slough/eschar
Bacitracin: grafts/donor sites
Sulamylon: grafts with poor adherence

wound care exam 2 (4 decks)

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