Exam 1- Burns 2

Question 1

Rule of 9: what is it?

Answer 1

how we can decide how much of out body has been burnt

Question 2

Rule of 9: chest %

Answer 2

18%

Question 3

Rule of 9: back %

Answer 3

18%

Question 4

Rule of 9: one arm %

Answer 4

9%

Front is 4.5% and back is 4.5%

Question 5

Rule of 9: one leg %

Answer 5

18%

Front is 9% and back is 9%

Question 6

Rule of 9: head %

Answer 6

9%

Question 7

Rule of 9: genital %

Answer 7

1%

Question 8

3 zones of burns

Answer 8

~coagulation
~stasis
~hyperemia

Question 9

Coagulation zone of burns

Answer 9

~Necrosis
~Bad enough burned that it dead (already dead)
~Need to clean out, relieve the pressure

Question 10

Stasis zone of burns

Answer 10

~Ischemia
~If we do not intervene, it will go to the coagulation
~if we intervene correctly, can go to hyperemia; if we don’t intervene correctly, can go to coagulation

Question 11

Hyperemia zone of burns

Answer 11

~Inflammation

~Just read and inflamed; trying to heal

Question 12

Types of grafts

Answer 12

~allografts
~Xenografts
~Skin substitute
~Biosynthetic 
~Autograft

Question 13

Allograft

Answer 13

~Cadaver

~Have been able to culture human fibroblasts and grow these cells- other human tissues

Question 14

Xenografts

Answer 14

~Animals, usually pigs- will use split thickness- we need to have some of ret layer of the dermis
~Our body will reject it eventually, but it will keep the env appropriate for healing; after a while, our body will slough it off

Question 15

Skin substitute grafts

Answer 15

~Bovine collagen

~Will impregnate the gauze with something to help keep the wound from infection/ help heal

Question 16

What is a split thickness graft?

Answer 16

~Leave some so that you body will heal

~epidermis and part of dermis

Question 17

What is a full thickness graft?

Answer 17

the whole depth

~the full dermal thickness

Question 18

Mesh graft

Answer 18

~Autograft
~Can turn into mesh then will be able to stretch; turns it into a bunch of little wounds instead of one big wound (takes a lot less time!)

Question 19

Autograft

Answer 19

~It’s us; we are not going to reject it
~We can take a sample of our skin, send it to a lab, and get sheets of our skin (takes a month or more depending on the amount of the burn)
~Can make a wound to heal a wound
~Want to have less scaring on: Face, hands, genital, feet, joints
~Mess graft
~Table 24.4 is good for positioning (will not have to write this for exam)
~Will take months to heal

Question 20

How long does it usually take a scar to heal?

Answer 20

up to 2 years

Question 21

what happens when a scar heals?

Answer 21

the skin will contract
~can lose PROM
~Can lose functional mobility
*have to stretch the tissue

Question 22

what are the names of two types of bad scars?

Answer 22

Keloid and Hypertrophic

Question 23

Hypertrophic scars

Answer 23

~goes up (not out)

~stays inside the boarders of the wound

Question 24

Keloid scars

Answer 24

(worse)
~goes outside the original boundaries of the scar
~up and out
~people of color are more likely to have this

Question 25

Why is positioning important?

Answer 25

~important for good ROM

~need to work on ROM to avoid contractures from forming

Question 26

Scars and pressure

Answer 26

~~Deformed through wolfs law (PRESSURE)
~Pressure is huge for burn pts
~Pressure garments to decrease pressure; only to bath; helps to lay down collagen uniformly
~Under armor can help some (not as much) as an alternative- not as much pressure

Question 27

What can you lose during a burn?

Answer 27

~ you can have sensation issues from losing some nerves
~Sabesous gland (need to add moisture)
~could have hair in weird areas now (have to start shaving now)
~can no longer sweat- will over heat (temperature control problem)- can get a heat stroke easier
~Tensile strength- it is weaker so be careful!

Question 28

What is a Z-plasty?

Answer 28

~you do this when a scar is too tight

~will have to be careful with the two new scars

Question 29

What is a good goal for venous?

Answer 29

edema- swelling

Question 30

What are categories for short term/ long term goals?

Answer 30

~blood flow
~nutrient
~environement
~size (undermining, etc)

Question 31

Examples of goals

Answer 31

~Pts wound will have 50% decrease in eschar by 2 weeks so that that wound will be facilitated though the healing process
~Pt will have complete absence of eschar in 4 wks;
~Pt;s wound will diminish by 2 cm circum. in 4 wks;
~Pt’s undermining will be absence by 4 weeks in order to promote a health wound bed to promote healing

Question 32

Details on environment when goal writing

Answer 32

~many be full of ec, sloff, etc- removal
~by %, time (in order to facilitate a proper wound bed to facilitate healing)
~moist/ dry
~Goal for dry- want to moisten to reach proper moisture to promote healing

Question 33

Details on size when goal writing

Answer 33

~Undermining, tunneling, depth, width, etc
~Things that you measure distance
~Decrease/ reduce to promote closure of wound