Burns

Question 1

3 risk factors for developing hypertrophic scars (HTS).

Answer 1

1) young age
2) dark skin
3) meshed skin grafts

Question 2

What causes HTS?

Answer 2

Overproduction of collagen fibers

Question 3

The Vancouver Scar Scale (VSS)17 is a 0- to 15-point
scale to assess scar characteristics of pliability, height, pigmentation, and vascularity and was chosen to numerically
assess the left foot HTS. A higher number on the VSS indicates a less OR more aggressive scar.

Answer 3

MORE aggressive

Question 4

Burn injury results in increased/decreased resting energy expenditure.

Answer 4

Increased

***Hypermetabolism (11), muscle wasting (15), and insulin resistance (20, 21)
are all hallmarks of the stress response to major burns.
**this could last years

Question 5

In a study looking at the effects of exercise on muscle peak torque, burned patients were
subsequently randomized to one of two treatments: home-based exercise program focusing
on range of motion exercises or supervised isokinetic leg exercise. Did the HEP or supervised group display greater gains in muscle peak torque?

Answer 5

Supervised

Question 6

If there is a serious burn resulting in muscle wasting of one muscle in an antagonist pair, what could be the resulting deficit?

Answer 6

chronically flexed joints

Question 7

What intervention can help reduce number of overall corrective surgeries and contracture releases needed?

Answer 7

RET (exercise therapy)

Question 8

Which drugs have positive effects on lessening tachycardia, hypermetabolism, and muscle catabolism?

Answer 8

Propanolo and B Blockade (propanolol used long term and may also improve VO2 peak and muscle mass)

Question 9

Which drug can increase skeletal muscle protein which can lead to improved muscle mass.

Answer 9

Oxandrolone

Question 10

What is most common type of burn in children under 5yoa?
A) scald
B) contact
C) flame

Answer 10

SCALD

Question 11

A majority of scald burns occur in 1) kitchen/bathroom and ones that occur in kitchen/bathroom are more severe.

Answer 11

1) Kitchen

2) Bathroom

Question 12

Which formula to determine TBSA in burn patients under age 15?

Answer 12

Berkow formula

Question 13

Head of infant is what percent of body surface?

Answer 13

20% (adult is 9%)

Question 14

What type of burn is indicative of abuse

Answer 14

Circumferential with clear line of demarcation (indicate limb dipped in hot water)

Question 15

When a child is dipped into hot tub of water where would burns be found and why?

Answer 15

Buttocks, deer, perineum due to child reflexively moving into flexed position

Question 16

What layers of skin are affected in superficial burn

Answer 16

Epidermal later

Question 17

Does fluid loss occur in superficial burns?

Answer 17

No (therefore not included in TBSA calculations)

Question 18

What skin layers are affected in partial thickness burns

Also note difference between superficial partial and deep partial

Answer 18

Epidermis and dermis

Superficial: primarily the papillary dermis

Deep: reticular dermis

Question 19

Are superficial partial thickness burns likely to form scar tissue?

Answer 19

No

Question 20

If a deep partial thickness burn does not heal in ___ days then it should be considered for skin grafting.

Answer 20

21

Question 21

Full thickness burns extend through what layers of skin.

Answer 21

Epidermis, dermis, and subcutaneous adipose tissue

Question 22

When patients limit movement in a swollen limb, edema persists I’m in tissue spaces around tendons, joints, and ligaments. If motion is not restored what can happen to this fluid

Answer 22

Fluid will organize into adhesions

Question 23

3 immediate ricks/concerns following burn incident

Answer 23

1) Hypovolemia
2) Poor temperature regulation
3) Infection

Question 24

5 Signs of ill fitting or improperly applied splint

Answer 24

1) Maseration – white moist skin
2) Inflammation
3) Numbness
4) Tingling
5) Pain (EXCEPT low throbbing pain = normal background pain)

Question 25

2 reasons to increase splint wear time

Answer 25

1) Decrease in ROM

2) compensatory movements

Question 26

Exercise to joints proximal and distal to skin graft are or are not recommended in acute phase after graft?

Answer 26

NOT recommended as it can decrease graft stability

Question 27

What burn uses arm trough splint?

Answer 27

Axilla

Question 28

When what joint is burned you don’t want to be in frog leg position?

Answer 28

Knee