Burns Flashcards
Name the 4 layers of the Epidermis and their respective functions
1) Stratum Corneum: waterproofing characteristics
2) Stratum Granulosum: water retention
3) Stratum Spinosum: layer of protection
4) Stratum Basale: allows for regeneration of the skin
What is the Rete Peg?
the region of ‘interfacing’ between the epidermis and the dermis
**for those of you who don’t sew, interfacing goes between 2 layers of fabric to make a garment stiffer
Name the two layers of the dermis and their locations.
Papillary dermis is superficial
Reticular dermis is deep
**the dermis is 20-30x’s thicker than the epidermis
What are the functions of the skin?
waterproofing
first line of defence against infecton
Temperature regulation (sweating)
oil secretion
Vitamin D synthesis
Sensation
Cosmetic appearance
** the skin is the largest of the body: makes up about 15% of your body weight
Name the different burn classifications
Superficial Burn
Superficial Partial-Thickness Burn
Deep Partial-Thickness Burn
Full-Thickness Burn
Subdermal Burn
`Electrical Burn
Name and Describe each of the 3 Burn Wound Zones
**Coagulation: **irreversible damage + skin death
full thickness burn, needs a graft to heal
Stasis: Cells die withing 24-48 hrs w/o treatment
infection, drying, inadequate blood supply = nectrotic tissue
Hyperemia: minimal damage
What is the Rule of Nines?
the Rule of Nines divides the body into areas making up 9% (and multiples of 9) of the body’s total surface area. This allows for rapid estimation of Total Body Surface Area that’s been burned
Name some of the complications of Burns
Infection
pulmonary complications (from inhalation injuries)
metabolic complications
cardiovascular complications (due to hemodynamic changes)
heterotopic ossification
neuropathy
pathological scars
What’s one important thing to remember about burn healing?
The demis and the epidermis heal seperately
**epithelial healing can occur at surface IF the burn has ONLY affected the epidermis, OR if there are viable cells lining the skin appendages
this will NOT result in scarring
Name the 3 phases of Dermal Healing (they’re similar to the ones we already learned)
Inflammation: prepares wound for healing via hemostatic, vascular, and cellular means
lasts 3-5 days
characterized by redness, edema, warmth, pain, and decreased ROM
Proliferation: fibroblasts synthesize scar tissure
granulation tissue appears as new blood vessels form
wound contraction
Maturation: reduction in fibroblast #, decreased vascularity, collagen remodeling/breakodown
scars: should be pale, flat, and pliable
What is the difference between hypertrophic and keloid scars?
hypertrophic scars occur when healing exceeds breakdown of tissue
keloid scars appear when the firm scar tissue overflows the boundary of the wound
What are the very first steps of burn care?
establish/maintain an airway
prevent cyanosis, shock, and hemorrhaging
establish baseline data on the patient: depth/extent of burns
prevent/reduce fluid loss: most burn patients die of dehydration
clean patient and wounds
examine for other injuries
prevent pulmonary anc cardia complications
What is the main type of treatment for large burns?
Surgical
primary excision: surgical removal of eschar, then closed with a skin graft
Where can surgeons obtain the material used for skin grafts?
Autograft: skin taken from elsewhere on the patient (usually from the thighs, back or butt)
Allograft: skin taken from a cadaver
Xenograft: skin from another species (usually pig)
Cultured skin substitutes made in a lab
Name the different grafting procedures
Split-thickness: epidermis + some dermis
Full-thickness: dermal grafting
Sheet graft: just what it sounds like
Mesh graft: when limited skin is available
What happens if conservative treatments can’t prevent scar formation?
Z-plasty:
