Chapter 33 - Burns and Frostbite Flashcards
First degree burns
involve epidermis only
no blistering
no \tissue death
second degree burns
penetrate dermal layer
most painful
regenerative dermal compnents are in the hair follicles and sweat glands - no skin grafting required
third degree burns
leave no tissue capable of spontaneous regeneration
all dermal layers involved
nerve endings gone - not painful
fourth degree burns
require flaps
bone and tendon involvement
Protein rich edema fluid after burns promotes what?
scarring, contracture, stiffness
HO in burns
most commonly about the elbow between the medial epicondyle and the olecranon
1-3% of burn patients
escharotomy incisions should be placed where?
midaxial along the elbow and digits
fasciotomy is more commonly required in what type of burns?
electrical
burned hands tend to fall quickly into what posture?
intrinsic minus - extended MCP, Flexed PIP, DIP
how to prevent intrinsuc minus contracture?
splint in intrinsic plus - mcp flexion pip, dip extension
Web space contractures - cause and how to treat
fibrosis of the CMC capsule, adductor pollicis, first dorsal interosseus musculature
z plasty, skin grafting, intermetacarpal pinning
how to treat intrinsic minus clawing deformity
release of the contracted MCP capsule, palmar IP capsule, subcu tissue and skin
if extensor mechanism unable to be mobilized, PIP arthrodesis
how to treat elbow contractures
simple contractures - z-plasty, more complex - scar excision plus skin grafting or flap coverage
electrical burns cause what mechanism of damage?
electrical energy yis converted to heat in deeper tissues - results in vessel thrombosis and coagulation necrosis
cardiac complications in electrical burns
with AC currents (most common) - ventricular arrhythmias
