Burns Flashcards
Superficial Burn
- Involves superficial epidermis
- Pain min-mod, no blistering or erythema (superficial reddening of the skin)
- Healing 3-7 days
Superficial Partial-Thickness Burn
- Involves the epidermis and upper dermis layers
- Pain is significant, wet blistering and erythema are present
- Healing 1-3 weeks
Deep Partial-Thickness Burn
- Involves the epidermis and the deep dermis layers, hair follicles, and sweat glands
- Pain is severe, even to light touch
- Erythema is present (with or without blisters)
- High risk of turning into full-thickness burn because of infection
- May have impairment of sensation
- High potential for hypertrophic scar
Healing 3-5 weeks
Full-Thickness Burn
- Involves the epidermis and dermis, hair follicles, sweat glands, and nerve endings
- Burn is pain free, no sensation to light touch
- Burn is pale and non blanching
- Requires skin graft
- Potential for hypertrophic scar extremely high
Subdermal Burn
- Full-thickness burn with damage to underlying tissue such as fat, muscles, and bone
- Charring is present, may have exposed fat, tendons, muscles
- Peripheral nerve damage is significant
- Requires surgical intervention for wound closure or amputation
Burn Emergent Phase
Splinting in antideformity positions
- Intrinsic plus for hands
- Extension for neck, elbows, and knees
- Shoulder in abduction and hip in extension
Intrinsic Plus Splint for hand burn
Wrist 30 degrees extension, MPs 80-90 degrees flexion
Burn Acute Phase
Splinting and positioning in antideformity positions, edema management, early participation in ADLs, and client and caregiver education
- ROM as tolerated
- NO P/AROM with exposed tendons or grafts (5-7 days)
Burn Surgical and Post-op Phase
- Immobilization 3-10 days post graft
- Anticontracture positioning
- Gentle AROM to avoid shearing of new grafts
Burn Rehab Phase
- Skin conditioning (skin lubrication)
- Skin massage to desensitize
- Compression therapy for both edema control and scar compression
- Stretching, resistive exercises, activity to tolerance, coordination activities
Contracture
Results from tight scar band, hypertrophic scar, or prolonged immobilization
Hypertrophic Scar
Scar is most apparent 6-8 weeks after wound closure, apply compression therapy early and continue 1-2 years
Heterotrophic Ossification
Formation of bones in abnormal areas, causes loss of ROM and pain is localized and severe
Pruritis
Persistant itching after a burn