Lymphedema & Burns

Question 1

What are the types of burns?

Answer 1

Thermal:
- flame, hot liquid, steam
Chemical:
- industrial accidents, assaults, acids, bases
- alkaline burns more severe than acidic burns (melts skin away)
Electrical:
- charred entrance, explosive exit
- potential for multiple system involvement

Question 2

How are burns normally described?

Answer 2

Usually by tissue involvement:
- superficial
- superficial partial-thickness
- deep partial-thickness
- full-thickness
- subdermal

Question 3

What are the different zones of a burn?

Answer 3

Zone of coagulation:
- central portion, irreparable damage
- characterized by coagulation, ischemia, necrosis
Zone of stasis: middle zone
- area of cellular injury and compromised perfusion
Zone of hyperemia: outer red zone
- outer edges, minimal cellular injury

Question 4

What is the description of a superficial 1st degree burn?

Answer 4

• bright red skin that blanches with pressure
• resolves 3-5 days w/o scar

sunburn, minor flash burn

Question 5

What is the description of a superficial partial-thickness 2nd degree burn?

Answer 5

• Painful, moist, weeping, blistered skin
• blanches w/ immediate capillary refill
• resolves 10-14 days w/ minimal to no scarring

brief contact burns, flash burns

Question 6

What is the description of a deep partial thickness 2nd degree burn?

Answer 6

• Mottled areas of red with white eschar, blistering possible, may have areas of insensitivity
• 3 or more weeks to heal

severe sunburn, scald, flash burn

Question 7

What is the description of a full-thickness 3rd degree burn?

Answer 7

• Initially red then mottled white/black, dry, leathery eschar
• very painful
• surgical debridement and grafting likely required

prolonged contact w/ flame, immersion scald injury

Question 8

What is the description of a subdermal 4th degree burn?

Answer 8

• charred, mummified appearance
• exposed deep tissues
• insensate to light touch
• may have permanent nerve damage

electrical burn, strong chemical burn

Question 9

What classification systems are used when classifying burns?

Answer 9

Rule of Nines

Lund-browder (for kids)

Question 10

What are some contamination factors to consider with burns?

Answer 10

Cardiovascular system: fluid retention
Respiratory compromise: inhaling smoke, carbon monoxide, etc.
Metabolism: 2-3x increase so need more nutrients
Immune system: infection and sepsis
Orthopedic: fractures
Psychological dysfunction
Other systems: GI & kidney, CNS

Question 11

What can PT’s help with preventing complications of burn victims?

Answer 11

• contractures
• infections
• deconditioning
• pulmonary dysfunction
• pressure ulcers