Burns Flashcards
What is a thermal burn?
A burn caused by conduction or convection such as when coming in contact with a hot liquid, fire, or steam
What is an electrical burn?
burn caused by the passage of electrical current though the body which typically has an entrance and an exit wound and can cause significant cardiopulmonary or other organ damage
What is a chemical burn?
a burn which occurs when certain chemical compounds come into contact with the skin and the skin will continue to burn until the compound is diluted or removed
compounds which can cause burns include sulfuric acid, lye, hydrochloric acid and gasoline
What is a radiation burn?
A burn which occurs most commonly with exposure to external beam radiation therapy which can alter the DNA at the site of the burn and the ischemic injury may be irreversible and non-healable
What are the 3 zones of injury for burns?
Zone of coagulation
Zone of stasis
Zone of hyperemia
What is the Zone of coagulation?
area of a burn that is the most severe and has irreversible cell damage
What is the Zone of stasis?
area of less severe damage from a burn that possesses reversible damage and surrounds the zone of coagulation
What is the Zone of hyperemia?
area surrounding the zone of stasis that presents with inflammation but will fully recover without any intervention or permanent damage
What is a superficial burn?
How do these burns typically present?
How long do they take to heal?
a burn that only involves the outer epidermis
usually presents with redness and slight edema
healing usually takes place without peeling or scarring in 2-5 days
What is a superficial partial thickness burn?
How do these burns typically present?
How long do they take to heal?
involves the epidermis and papillary dermis layer (superficial dermis)
Wound is usually extremely painful and exhibits blisters
healing with minimal to no scarring usually takes 5-21 days
What is a deep partial thickness burn?
How do these burns typically present?
How long do they take to heal?
burn that involves the complete destruction of the epidermis and the majority of the dermis
Area may appear to be discolored with broken blisters and edema but only presents with mild to moderate pain due to damage of nerve endings
Hypertrophic or keloid scarring may occur in the absence of infection and will heal in 21-35 days
What is a full thickness burn?
How do these burns typically present?
How long do they take to heal?
complete destruction of the epidermis and the dermis with partial damage to the subcutaneous layer
Area typically presents with heavy eschar formation and minimal pain
Healing time varies as this burn requires a graft and is susceptible to infection, the smaller the area of damage the faster it heals, some small wounds may not even need a graft, large areas may take months to heal even with grafts
What is a subdermal burn?
How long do they take to heal?
complete destruction of epidermis, dermis, and subcutaneous layer and may involve muscles and bones
This burn often requires surgery and calls for an extensive healing timeframe
What is the most painful type of burn?
Superficial partial-thickness burns
According to the rule of nines, name the approximate percentage of skin area of each of the following:
Head and neck Anterior Trunk Posterior Trunk Upper Extremity (each) Genital Region Lower Extremity (each)
Head and neck-9%
Anterior Trunk-18%
Posterior Trunk-18%
Upper Extremity (each)-9% (4.5% anterior 4.5% posterior)
Genital Region-1%
Lower Extremity (each)-18% (9% anterior 9% posterior)
How does the rule of nines apply for children under 1 year old?
9% is taken from the lower extremities and added to the head and neck, for every year of life 1% is distributed back to the lower extremities until the age of 9
What is the anticipated deformity for burns to the anterior neck?
What are the splinting types to help address this deformity?
Deformity: flexion with possible lateral flexion
Splint: soft collar, molded collar, or Philadelphia Collar
What is the anticipated deformity for burns to the anterior chest and axilla?
What are the splinting types to help address this deformity?
deformity: shoulder adduction, extension, and medial rotation
Splint: axillary or airplane splint and shoulder abduction brace
What is the anticipated deformity for burns to the elbow?
What are the splinting types to help address this deformity?
Deformity: Flexion and Pronation
Splint: gutter splint, conforming splint, three-point splint, or an air splint
What is the anticipated deformity for burns to the hand and wrist?
What are the splinting types to help address this deformity?
Extension or hyperextension of the MCP joints, flexion of the IP joints, adduction and flexion of the thumb, and flexion of the wrist
Splints: wrist splint, thumb spica splint, palmar or dorsal extension splint
What is the anticipated deformity for burns to the hip?
What are the splinting types to help address this deformity?
flexion and adduction
Splints: anterior hip spica or abduction splint
What is the anticipated deformity for burns to the knee?
What are the splinting types to help address this deformity?
flexion
Splints: conforming splint, three point splint, or an air splint
What is the anticipated deformity for burns to the ankle?
What are the splinting types to help address this deformity?
plantar flexion
Splints: posterior foot drop splints, posterior ankle conforming splint, anterior ankle conforming splint
What are the advantages and disadvantages of applying Silver Sulfadiazine to a burn wound?
Advantages: can be used with or without dressings, painless, can be applied directly, and is effective against yeast
Disadvantages: does not penetrate into eschar
What are the advantages and disadvantages of applying Silver Nitrate to a burn wound?
Advantages: non-allergenic and application is painless
Disadvantages: poor penetration, makes assessment difficult due to discoloring, can cause severe electrolyte imbalance, and removal of dressings is painful
What are the advantages and disadvantages of applying Providone-Iodine to a burn wound?
Advantages: antifungal and easily removed with water
Disadvantages: not effective against pseudomonas, may impair thyroid function, and has a painful application
What are the advantages and disadvantages of applying Mafenide Acetate to a burn wound?
Advantages: penetrates burn eschar and may be used with or without occlusive dressings
Disadvantages: may cause metabolic acidosis, can compromise respiratory function, can inhibit epithelialization, and has a painful application
What are the advantages and disadvantages of applying Gentamicin to a burn wound?
Advantages: may be covered or left open to air
Disadvantages: has caused resistant strains, ototoxic, and nephrotoxic
What are the advantages and disadvantages of applying Nitrofurazone to a burn wound?
Advantages: bacteriocidal
Disadvantages: painful application and may lead to overgrowth of fungus and pseudomonas
