Thermal Burn Flashcards
increased risk of fire-related injuries and death
children ≤4 years of age, adults ≥65 years of age, African Americans and Native Americans, persons living in rural areas, persons living in manufactured homes or substandard housing, and persons living in poverty
Local effects of thermal injury
liberation of vasoactive substances,
disruption of cellular function,
and formation of edema
systemic response alters the neurohormonal axis
histamine, kinin, serotonin, arachidonic acid metabolites, and free oxygen radicals
systemic response alters the neurohormonal axis
histamine, kinin, serotonin, arachidonic acid metabolites, and free oxygen radicals
factors may influence prognosis,
the severity of the burn, the presence of inhalation injury, associated injuries, the patient’s age, comorbid conditions, and acute organ system failure are most important.
Cell damage occurs at temperatures of
> 45°C
tissue is irreversibly destroyed with thrombosis of blood vessels;
zone of coagulation
stagnation of the microcirculation
become progressively more hypoxemic and ischemic if r tion is not adequate
zone of stasis
there is increased blood flow
minimal damage to the cells and spontaneous recovery is likely
zone of hyperemia
Epidermis
No blisters, painful
7d healing
Superficial (first degree)
Epidermis and superficial dermis
Blisters, very painful
14–21 d, no scar healing
Superficial partial-thickness (superficial second degree)
Epidermis and deep dermis, sweat glands, and hair follicles
Blisters, very painful
3–8 wk, permanent scar healing
Deep partial-thickness (deep second degree)
Entire epidermis and dermis charred, pale, leathery; no pain
Months, severe scarring, skin grafts necessary healing
Full-thickness (third degree)
Entire epidermis and dermis, as well as bone, fat, and/or muscle
Months, multiple surgeries usually required healing
Fourth degree
Major burn = Burn Center Treatment
Partial-thickness >25% BSA, age 10–50 y
Partial-thickness >20% BSA, age <10 y or >50 y
Full-thickness >10% BSA in anyone
Burns involving hands, face, feet, or perineum
Burns crossing major joints
Circumferential burns of an extremity
Burns complicated by inhalation injury
Electrical burns
Burns complicated by fracture or other trauma
Burns in high-risk patients