Burns Flashcards
rule used to estimate the total body surface area that has been burned for adults
rule of 9’s
rule used to estimate the total body surface area that has been burned for children and infants
Lund-Browder chart
burn that involves the superficial epidermis; pain is minimal to moderate with no blistering or erythema; healing time is 3-7 days (1 week)
superficial (first degree) burn
burn that involves the epidermis and upper dermis layer with significant pain and wet blistering and erythema present; healing time is 1-3 weeks
superficial partial-thickness burn (superficial 2nd degree burn)
burn that involves the epidermis and the deep dermis layers, hair follicles, and sweat glands with severe pain even to light tough; erythema present with or without blisters; high risk for turning to full thickness burn due to infection; grafting considered; may have impaired sensation and high potential for hypertrophic scar; healing time is 3-5 weeks
deep partial-thickness burn (deep 2nd degree burn)
burn that involves the epidermis and dermis, hair follicles, sweat glands, and nerve endings; burn is pain free and no sensation to light touch; burn is pale and non blanching and requires skin graft; extremely high potential for hypertrophic scar
full-thickness (3rd degree burn)
full-thickness burn with damage to underlying tissue such as fat, muscles, and bones; charring present; if electrical, nerve destruction along pathway; surgical intervention for wound closure/amputation; extremely high potential for hypertrophic scar
subdermal burn
mechanism of burn that results in tissue necrosis rather than direct heat production
chemical burn
what type of chemical burn is the worst
alkali burn > acid burn
what type of electrical burn is the most dangerous because of the greater degree of muscle contraction and which makes it difficulty to voluntarily control muscles for release
low-voltage alternating current > direct current
how long does the emergent phase of a burn last
0-72 hours
type of biological dressing that is bovine skin or processed pig skin
xenograft
type of biological dressing that is human cadaver skin
allograft
how long does the acute phase of burn management last
72 hours until the wound is closed (days or months)
transplantation of the persons own skin from an unburned donor site to the burned receiving site
autograft
type of skin graft where the full epidermal and partial dermal layer are taken from the donor site with a high chance of graft survival
split-thickness skin graft
type of skin graft that includes the full thickness of the epidermal and dermal layers plus a percentage of fat layers taken from the donor site with lower change of graft survival; outcome is functionally and cosmetically better if there is graft adherence
full-thickness skin graft
when the donor graft is stretched to cover a greater area of the receiving area
meshed graft
when the donor graft is removed and laid down on the receiving area as is
sheet graft
what is the role of OT in the emergent phase of a burn
splinting and anti-deformity positioning
how long is the immobilization period after a skin graft
3-10 days
should ROM be initiated if there are exposed tendons
no
to avoid pooling of fluid and blood in the lower extremities in dependent of standing positions, what can the therapist do
apply compression wrapping
how long is the immobilization period of the donor site after a skin graft
2-3 days
when is ambulation resumed after grafting in the LEs
5-7 days
after the immobilization period of a skin graft, what type of ROM should be initiated
gentle AROM
should be performed several times a day in the rehabilitation phase to prevent dry skin from splitting because of shearing forces or over stretching during movement and exercise
skin lubrication
can be used to desensitize a hypersensitive grafted site or burn scare; can reduce shearing forces and prevent splitting of immature or problematic scar tissue
skin massage
what type of compression is useful for the fingers
coban
how long can a scar take to mature
1 to 2 years
what psychosocial disorder is common with burns
PTSD
when is a scar most apparent
6-8 weeks after closure
when is a scare most active
initial 4-6 months
how to prevent a hypertrophic scar
early compression therapy
persistent itching that can lead to skin maceration and reopening of the wound; can be alleviated by cold
pruritis
what is the standard splinting position for the hand if there is a circumferential hand burn
volar hand splint
what precautions should be taken with dorsal hand butns
Boutonniere precautions- no composite flexion until integrity of dorsal hood confirmed
what type of edema measurement is contraindicated for open wounds
volumeter
what type of burn typically results from a chemical burn
full thickness
what type of burn typically results from an electrical burn
subdermal
rule of 9’s: percentage for front back of head
9%
rule of 9’s: percentage for arms
9% each (18% total)
rule of 9’s: percentage for legs
18% each (36% total)
rule of 9’s: percentage for chest/back
18% each (36% total)
rule of 9’s: percentage for genitals
1%
when can ROM be initiated when no graft is needed
72 hours
when would an intrinsic plus splint not be used for the hands
volar surface burns (extension)
what type of splint should be used for a web space burn
C-splint
bed positioning consideration for burns
no pillows under the head or knees
what type of modalities should not be used for burns
heat
how should ROM be initiated initially in the acute stage
each joint separately decreased the chance of rupture
