Burns Flashcards
burns can be : (3)
chemical, thermal, or electrical
Burn depth:Superficial (1st degree)
sun burn, heals spontaneously in 3-5 days, red/pink, painful, epidermis damaged
Burn depth:Partial thickness (2nd degree)
superficial, deep, epidermis and dermis are damaged, 2 types!!! Superficial partial and deep partial- Superficual=red, blisters, moist, healing in 10-14 days, painful, minimal scarring, pigment changes, blanches- deep= 3-6 weeks spontaneous heling, whitish, red, less moist, not as painful, skin grafted, scarring, slow to branch
Burn depth: Full thickness (3rd degree)
epidermis and dermis destroyed, subcutaneous tissue damage,dry, white, leathery, sometimes cherry apple red in children, insensate, does not blanch, requires skin grafts
Burn depth: Subdermal (4th degree)
damages fat, mmuscle, bone, tendon, ligaments, muscle flaps for coverage, usually electrical
total body surface area (rule of 9’s)
The rule of nines assesses the percentage of burn and is used to help guide treatment decisions including fluid resuscitation and becomes part of the guidelines to determine transfer to a burn unit. You can estimate the body surface area on an adult that has been burned by using multiples of 9.
Phases of wound healing
(inflammatory, proliferation, maturation, scar formation)
Phases of Healing: (1) Inflammatory
5-7 days, Initial response to trauma,Cardinal signs: redness,edema,warmth,and pain, Monocytes attack bacteria in the wound (phagocytosis)
Phases of Healing: (2)Fibroplastic / Proliferative
6-8 weeks, Also known as collagen or reparative phases, Re-epithelialization at surface, Skin buds develop (granulation tissue) and create vascular beds for new skin layer, Fibroblasts are migrating and proliferating deep in the wound (synthesize scar tissue), Causes contraction of burn wound, Poor tensile strength, Scar formation is worst 3-4 months post injury
Phases of Healing: (3) Maturation
Up to 2 years, Decrease in the number of fibroblasts, Tensile strength increases as collagen remodels, Vascularity decreases, Scar softens and flattens, Mature scar is resistant to stretch, flat, minimally vascular and pliable.
Phases of Healing: (4)scar formation
hypertrophic scar-Enlarged, red, raised, rigid scar, Stays within the boundaries of the original wound.
keloid scar-Large, firm scar, Extends beyond the boundaries of the initial wound, More common in African Americans and Asian Americans.
Fluid Resuscitation
in acute care management
Fluid Resuscitation
Compartment syndrome: interstitial pressure becomes severe and compresses blood vessels, tendons, or nerves and can cause secondary tissue damage
Ischemia: restriction of blood flow
Escarotomy: cutting through the necrotic burn tissue to restore blood flow to distal tissue stopping at fascia
Fasciotomy: Cutting through fascia
eschar
a dry, dark scab or falling away of dead skin, typically caused by a burn, or by the bite of a mite, or as a result of anthrax infection.
heterotopic ossification HO
is the abnormal growth of bone in the non-skeletal tissues including muscle, tendons, or other soft tissue. When HO develops, new bone grows at 3 times the normal rate resulting in jagged, painful joints.
split-thickness skin graft (STSG)
Split-thickness. A split-thickness skin graft (STSG) is a skin graft including the epidermis and part of the dermis. Its thickness depends on the donor site and the needs of the person receiving the graft.
