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Exam Prep > Burns and Wounds > Flashcards

Burns and Wounds Flashcards

1
Q

Depth of Burns

A

Superficial, superficial partial thickness, deep partial thickness, full thickness, subdermal

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2
Q

Superficial burn

A

1st degree, 3-7 day healing, epidermis, mild pain, no blisters

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3
Q

Superficial partial thickness burn

A

2nd degree, 1-3 week healing, epidermis + dermis, significant pain, blisters

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4
Q

Deep partial thickness burn

A

2nd degree, 3-5 week healing, epidermis + dermis + hair follicles + sweat glans, severe pain, potential for sensory loss and hypertrophic scar

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5
Q

Full thickness burn

A

3rd degree, epidermis + dermis + hair follicles + sweat gland + nerve endings, pain free/no sensation, high potentail for hypertrophic scar, REQUIRE graft

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6
Q

Subdermal burn

A

damage to underlying tissues including muscle, fat, bone, REQUIRE surgical intervention

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7
Q

Phases of Burn Therapy

A

Emergent, acute, rehabilitative

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8
Q

Emergent Phase Burns

A

0-3 days
Assess location and prior function
Splinting in anti-deformity positions

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9
Q

Acute Phase Burns

A

3 days or until wound closure
Assess ADL, ROM, MMT, cog, psychsoc
Splinting in anti-deformity positions
Edema mgmt
Early ADL with AE
ROM as tolerated
Education

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10
Q

Neck anti-deformity

A

Slight extension

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11
Q

Chest and abdomen anti-deformity

A

Trunk extension with shoulder retraction

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12
Q

Axilla anti-deformity

A

Shoulder AB 100 with ER

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13
Q

Elbow anti-deformity

A

Extension

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14
Q

Wrist anti-deformity

A

Neutral to 30 extension

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15
Q

Hand anti-deformity

A

Intrinsic plus MP 70 flexion, IP extension, thumb AB

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16
Q

Knee anti-deformity

A

Extension (slight flexion for anterior burn)

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17
Q

Ankle anti-deformity

A

Neutral to 5 dorsiflexion

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18
Q

Rehabilitation phase

A

Post wound closure
Skin conditioning, scar mgmt, edema, therapeutic activity, splinting, increased ROM/strengthening

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19
Q

Immobilization period post graft

A

3-10 days or until graft adherence confirmed

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20
Q

No walking period for LE burns post graft period

A

5-7 days post-op

21
Q

Post graft intervention

A

Anti-deformity splinting
Movement of uninvolved extremities and other joints if possible and able to prevent graft tension (after 3-10 days gentle AROM)

22
Q

Cause of contracture

A

prolonged immobilization, hypertrophic scar, tight scar band

23
Q

Best practice for hypertrophic scar

A

Early compression (gel pads with inserts)

24
Q

Heterotrophic ossification

A

Formation of bone in abnormal areas common in elbow, knee, shoulder, hip that cause rapid ROM loss, localized pain and hard end feel with PROM

Post dx NO passive stretch or dynamic splint

AROM within pain free range to preserve joint mobility

25
Q

Dorsal hand burns precautions

A

Avoid composite flexion until extensor hood integrity is confirmed - mobilize 1 joint at a time to decrease possibility of rupture

26
Q

Boutonniere deformity

A

PIP flexion
DIP hyperextension

27
Q

When is there sensory loss with burns

A

Deeper than partial thickness`

28
Q

How to provide vascular support for LE burns

A

Wrap with elastic bandage wrap to decrease blood pooling and pain

29
Q

General rule for burn ROM

A

Start gentle AROM/PROM as early as possible ( before 3 days) with exception of post graft operation requiring 3-10 days of immobilization followed by gentle AROM

30
Q

How to measure burn size

A

Rule of 9s to calculate total body surface area of burn
LLE: 18
RLE: 18
RUE: 9
LUE: 9
Torso: 36
Head: 9

31
Q

How to desensitize hypersensitive graft site or burn scar

A

Skin massage

32
Q

Best method for scar and edema management

A

Compression therapy

33
Q

Appropriate temporary pressure bandages

A
  • Elastic bandage
  • Coban
  • Elasticated tubular support bandage
  • TED stockings
  • Spandex bicycle pants
  • Isotonic gloves with impression silicone or pad inserts
34
Q

Custom made pressure garment

A
  • Used for scars that take more than 2 weeks to heal spontaneously
  • Provide gradient pressure
  • Wear 24 hours a day except during bathing or massage
  • Conform to body contours and prominences
  • Additional flexible inserts added under garment to distribute pressure more evenly
35
Q

What should patient due before exercise and activity

A

Skin lubrication and massage

36
Q

How long does it take for scar maturation

A

1-2 years

37
Q

Hypertrophic scar timeline

A

Most apparent 6-8 weeks after wound closure

Most active in initial 4-6 months

38
Q

What causes hypertrophic scarring

A

Increased vascularity causes scar to become firmer and thicker allowing it to rise above the original surface level of skin

39
Q

Pruritis

A

Persistent itching that can lead to skin maceration and reopening due to scratching

40
Q

How to relieve pruitis

A

Compression garment
Skin lubrication
Cold pack
Anti-histamine medications

41
Q

Goal of compression glove for scar mgmt.

A
  1. Decrease scar tissue
  2. Improve appearance of scar
42
Q

Hydrogel dressing

A
  • Used for dry and shallow wounds
  • Look like jelly sheet
  • Decrease pain and pressure
    -Retain fluid well
43
Q

Film dressing

A
  • Used for minimal exudate and depth
  • Transparent to visually assess wound
  • Allow air to get through but no water or bacterial
44
Q

Foam dressing

A
  • Used for moderate depth and exudate
  • Absorbs moisture well
45
Q

Hyrocolloid dressing

A
  • Used for deeper wounds with more exudate
  • Decrease risk of infection
46
Q

Alginated

A
  • Used for very deep with max exudate
  • Really good for infection
47
Q

What type of dressing should be used for infected wound

A

Gauze - use the least occlusive dressing possible

48
Q

What type of dressing should be used for wound with a lot of exudate

A

Alginate

Exam Prep (19 decks)

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