2. 1/4/2023 2
DEFINITION
ļ¬Burn injury can be defined as bodily
injury resulting from exposure to heat,
cold, chemical, electricity or radiation
ļ¬Burn causes coagulation necrosis of the
skin and underlying tissues
3. 1/4/2023 3
EPIDEMIOLOGY
Incidence
ļ¬Burn injury constitutes a major health
problem allover the world affecting
approximately 1% of the world
population each year
ļ¬In the United States, approximately 2.4
million burn injuries are reported every
year
ļ¬In TZ burn injury is one of the
commonest form of trauma
4. 1/4/2023 4
Morbidity / mortality
ļ¬Burn injury contributes significantly to
high morbidity and mortality
ļ¬Patients with extensive burns frequently
die, and for those with less severe
injuries, physical recovery is slow and
painful
ļ¬In addition to physical damage caused
by burns, patients also may suffer
emotional and psychological problem
5. 1/4/2023 5
Age
ļ¬Age incidence depends on the type of
burn
ļ¬Scald is common in children < 5 year of
age while flame, electrical and chemical
burn injuries are common in adult
6. 1/4/2023 6
Sex
ļ¬Sex distribution depends on the place of
burn
ļ¬Domestic burn injury is common in
females while occupational and
recreational burns are common in males
9. 1/4/2023 9
Mechanism of injury
ļ¬Depends on the causes
ā Thermal injuries
ā¢ Scald
ā¢ Flame
ā¢ Contact
ā Chemical injuries
ā Electrical injuries
ā Radiation injuries
ā Cold injuries
10. 1/4/2023 10
Thermal injuries
ļ¬Scalds
ā About 70% of burns in children are caused
by scalds
ā They also often occur in elderly people
ā The common mechanisms are spilling hot
drinks or liquids or being exposed to hot
bathing water
ā Scalds tend to cause superficial to
superficial dermal burns
11. 1/4/2023 11
ļ¬ Flame
ā Flame burns comprise 50% of adult burns
ā They are often associated with inhalational injury
and other associated injuries
ā Flame burns tend to be deep dermal or full
thickness
ļ¬ Contact
ā In order to get a burn from direct contact, the object
touched must either have been extremely hot or the
contact was abnormally long
ā The latter is a more common reason, and these
types of burns are commonly seen in people with
epilepsy or those who misuse alcohol or drugs
ā They are also seen in elderly people after a loss of
consciousness
ā Contact burns tend to be deep dermal or full
thickness
12. 1/4/2023 12
Electrical injuries
ļ¬ Account for 3-4% of burn admissions
ļ¬ An electric current will travel through the
body from one point to another, creating
"entry" and "exit" points
ļ¬ The tissue between these two points can be
damaged by the current
ļ¬ The amount of heat generated, and hence the
level of tissue damage, is equal to
0.24x(voltage)2xresistance
ļ¬ The voltage is therefore the main determinant
of the degree of tissue damage
13. 1/4/2023 13
ļ¬ Electrocution injuries can be divided into two
categories:-
ā Low voltage injuries
ā¢ Considered to be anything <1000 volts
ā¢ This includes domestic electrical supply
ā High voltage injuries
ā¢ Can be further divided into:-
ā True high tension injuries
ā¢ Caused by high voltage current passing through the body
ā¢ > 1000V
ā¢ There is extensive tissue damage and often limb loss
ā¢ There is usually a large amount of soft and bony tissue
necrosis
ā¢ Muscle damage gives rise to rhabdomyolysis, and renal
failure may occur with these injuries
ā Lighting injuries
ā¢ Caused by exposure to an extremely high voltage
current
ā¢ Result from an ultra high tension
ļ¬ A particular concern after an electrical injury is
the need for cardiac monitoring
14. 1/4/2023 14
Chemical injuries
ļ¬Chemical injuries are usually as a result
of industrial accidents but may occur
with household chemical products
ļ¬Chemical burn may also occur as a
result of assault
ļ¬These burns tend to be deep, as the
corrosive agent continues to cause
coagulative necrosis until completely
removed
ļ¬Alkalis tend to penetrate deeper and
cause worse burns than acids
17. 1/4/2023 17
CLASSIFICATION
ļ¬According to the type [causes] of burn
ā Thermal burn
ā¢ Scald
ā¢ Flame burn
ā¢ Contact burn
ā Electrical burn
ā Chemical burn
ā Radiation burn
ā Cold burn
18. 1/4/2023 18
ļ¬According to body site burned
ā Facial burn
ā Head & neck
ā Trunk
ā Limbs
ā Perineal burn etc
ļ¬According to burn depth
ā Superficial burn
ā¢ Epidemal
ā¢ Dermal
ā Deep burn
ā¢ Dermal
ā¢ Full thickness
ā Mixed burn
19. 1/4/2023 19
ļ¬According to the degree of tissue injury
ā First degree burn
ā Second degree burn
ā Third degree burn
ā Fourth degree burn
ļ¬According to the Size/Extent of Burn
Injury
ā Total body surface area (TBSA) burned
ļ¬According to the severity of burn
ā Minor burn
ā Moderate burn
ā Major burn
21. 1/4/2023 21
A. Local responses
ļ¬Divided into three zones of a burn
which were described by Jackson in 1947
āJacksonās zones of burn wound
ļ¬These zones include:-
ā Zone of coagulation
ā Zone of stasis/ischaemia
ā Zone of hyperamia
23. 1/4/2023 23
a. Zone of coagulation
ļ¬This occurs at the point of maximum
damage
ļ¬In this zone there is irreversible tissue
loss due to coagulation of the
constituent proteins
24. 1/4/2023 24
b. Zone of stasis /ischemia
ļ¬ The zone of stasis is characterized by decreased
tissue perfusion
ļ¬ The tissue in this zone is potentially salvageable
ļ¬ The main aim of burns resuscitation is to
increase tissue perfusion here and prevent any
damage becoming irreversible
ļ¬ Additional insultsāsuch as prolonged
hypotension, infection, or edemaācan convert
this zone into an area of complete tissue loss
25. 1/4/2023 25
c. Zone of hyperaemia
ļ¬In this outermost zone tissue perfusion
is increased
ļ¬The tissue here will invariably recover
unless there is severe sepsis or
prolonged hypoperfusion
26. 1/4/2023 26
B. Systemic response
ļ¬The release of cytokines and other
inflammatory mediators at the site of
injury has a systemic effect once the
burn reaches 30% of total body surface
area
27. 1/4/2023 27
a. Cardiovascular changes
ļ¬Capillary permeability is increased,
leading to loss of intravascular proteins
and fluids into the interstitial
compartment
ļ¬Peripheral and splanchnic
vasoconstriction occurs
ļ¬Myocardial contractility is decreased,
possibly due to release of tumor necrosis
factor
28. 1/4/2023 28
ļ¬Cardiac output decreases due to loss of
intravascular volume
ļ¬These changes, coupled with fluid loss
from the burn wound, result in systemic
hypotension and end organ
hypoperfusion
29. 1/4/2023 29
b. Respiratory changes
ļ¬Inflammatory mediators cause
bronchoconstriction, and in severe
burns adult respiratory distress
syndrome can occur
ļ¬Pulmonary dysfunction may occur as
result of:-
ā Inhalation injury
ā Aspiration
ā Shock
ā Upper airway injury/edema
ā Circumferential thoracic eschar ā RLD
ļ¬Hypovolemia may cause V/Q mismatch
30. 1/4/2023 30
c. Gastrointestinal changes
ļ¬Characterized by mucosal atrophy,
changes in the digestive absorption and
ļ£ intestinal permiability
ļ¬Burn also causes reduced glucose,
amino acids and fatty acids
ļ¬Stress (curlingās) ulcer
ļ¬Acute pseudo-obstruction of the colon
ā massive colonic dilation without organic
cause
ļ¬Acalculous cholecystitis
31. 1/4/2023 31
d. Renal changes
ļ¬Uncommon, but can result from:
ā prolonged hypotension due to hypovolemia
ā myoglobin release from damaged
muscle/tissue
ā hemoglobinuria from heat-induced
ļ¬ļ¤ BV & CO ļ ļ¤RBF ļ ļ¤GFRļ :-
ā Release of Angiotensin II, aldosterone,
vasopresinļ further reduction of RBF &
GFRļ ARF
ā Oliguria ļ ATN & ARF
32. 1/4/2023 32
e. CNS Changes
ļ¬CNS dysfunction in up to 14% of burn
patients
ā most had >50% BSA involvement
ļ¬Hypoxia most common etiology
ā smoke inhalation, pulmonary edema,
pneumonia
33. 1/4/2023 33
f. Haematological changes
ļ¬Mild thrombocytopenia (sequestration)
early, followed by thrombocytosis (2-4x
normal) by end of the first week
ļ¬Persistant thrombocytopenia associated
with poor prognosis--suspect sepsis
ļ¬DIC with generalized bleeding can
occur
ā shock, sepsis, hypoxia, reperfusion
34. 1/4/2023 34
g. Immunologic Changes
ļ¬Loss of Skin as an organ of host
defenseā:-
ā Loss of keratin layers which act as physical
barrier to bacterial invasion āwound
sepsis
ā Loss of stratum corneum containing of
unsaturated free fatty acid film which is
bacteriostatic and fungistatic
ļ¬ļ¤ Cellular Immune Function
ā Several circulating mediators in burn
patient sera suppress normal lymphocyte
function
ā ļ¤CD4 count
35. 1/4/2023 35
ļ¬ļ¤Humoral Immune Function
ā immunoglobulin levels decreased
proportional to burn size
ā leakage of IgG & IgA from the circulation,
fibronectin depletion, impaired
opsonization
ļ¬ļ¤Phagocyte Function
ā early granulocytopenia common
ā diminished chemotactic responsiveness
ā¢ diffuse endothelial cell activation, and adhesion
molecule overexpression
ā decreased oxygen radical production, with
impaired bactericidal activity
ā PMN margination/aggregation
36. 1/4/2023 36
h. Metabolic changes
ļ¬Metabolic changes in burn injury occur
in 2 phases:-
ā Ebb phase
ā Flow phase
ā¢ Catabolic phase
ā¢ Anabolic [recovery phase]
37. 1/4/2023 37
Ebb phase
ļ¬Occurs during the 1st 24 hours
ļ¬Characterized by ļ¤ MR, hypothermia,
ļ¤CO & ļ¤ oxygen consumption
39. 1/4/2023 39
a. Catabolic phase
ļ¬ Occurs after 24 hours after burn injury
ļ¬ Characterized by:-
ā ā Cardiac output
ā ā Oxygen consumption
ā ā Heat production [hyperthermia]
ā ā BMR
ā Hyperglycemia
ā Proteolysis
ā Peripheral lipolysis
ļ¬ Mediated through release of catabolic
hormones [ i.e. catecholamines,
glucocorticoids, glucagon etc ] and other
chemical mediators e.g. cytokines, lipid
mediators etc
40. 1/4/2023 40
b. Anabolic phase
ļ¬Also called recovery phase
ļ¬Characterized by:-
ā Slow re-accumulation of protein and fat
ā This phase continues for weeks to months
after injury
43. 1/4/2023 43
ļ¬Type of burn
ā Thermal
ā Chemical
ā Electrical
ā Radiation
ā Cold
ļ¬Mechanism of injury
ļ¬Associated injuries
ļ¬Associated inhalation injuries
ļ¬Associated clothing iginition
ļ¬Whether first aid measures was done at
the site of accident
45. 1/4/2023 45
ļ¬Systemic examination
ā Cardiovascular system
ā Respiratory system
ā PA
ā CNS
ļ¬Local examination [assessment of burn
wound]
ā Body region burned
ā Extent of burn
ā Burn depth
ā Severity of burn
46. 1/4/2023 46
a. Body region burned
ļ¬Head / neck
ļ¬Upper limbs
ļ¬Trunk
ļ¬Lower limbs
ļ¬Genitalia / Perineal areas
47. 1/4/2023 47
b. Extent of burn [%TBSA]
ļ¬Size of a Burn Injury
ā Total Body Surface Area (TBSA) Burned
ā¢ Palmar Method
ā A quick method to evaluate scattered or localized burns
ā Clientās palm = 1 % TBSA
ā¢ Rule of Nines
ā A quick method to evaluate the extent of burns
ā Major body surface areas divided into multiples of nine
ā Modified version for children and infants (Rule of
Sevens )
ā¢ Lund-Browder Method
ā Most Accurate; based on age (growth)
ā Can be used for the adult, children & infants
50. 1/4/2023 50
c. Burn depth
ļ¬ Superficial (First Degree)
ļ¬ Partial Thickness
ā Superficial ( Second Degree)
ā Deep ( Second Degree)
ļ¬ Full Thickness ( Third Degree)
ļ¬ Deep-Full Thickness (4th degree)
51. 1/4/2023 51
i. Superficial (First Degree)
ļ¬Involves the epidermis
ā Wound Appearance:
ā¢ Red to pink (light skin)
ā¢ Mild edema
ā¢ Dry and no blistering
ā¢ Pain / hypersensitivity to touch
ā i.e. Classic sunburn
ā¢ Desquamation occurs 2-3 days
ā Wound Healing
ā¢ Wound Healing spontaneous
ā¢ Duration 3 to 5 days
ā¢ No scarring / other complications
55. 1/4/2023 55
iii. Deep 2nd Degree Burns
ļ¬Wound Appearance:
ā Mottled: Red, pink, to white surface
ā Moist
ā No blisters
ā Moderate edema
ā Painful; usually less severe than superficial 2nd
Degree
ļ¬Wound Healing:
ā May heal spontaneously 2-6 weeks
ā If so Hypertrophic scarring / formation of
contractures
ļ¬Wound Management:
ā Treatment of choice: surgical excision & skin
grafting
60. 1/4/2023 60
d. Severity of burn
ļ¬Severity is determined by:-
ā Type of burn
ā Depth of burn injury
ā Total body surface (TBSA) burned
ā Location of burn( face, hands, feet and perineum are
considered severe !! )
ā Patientās Age
ā Presences of other preexisting medical
conditions
ā Presence of associated injuries
ā Complications ( Inhalation , Hypothermia , Shock )
62. 1/4/2023 62
i. Minor burn injury
ļ¬Characterized by:-
ā <10% in adult
ā < 5% <10 yo >50 yo
ā < 2% full thickness
ā No associated injuries, no complications,
no pre-morbid illness, no circumferential
burns, not involving the hands, face,
perineum
ļ¬Minor burn needs outpatient
management
63. 1/4/2023 63
ii. Moderate burns
ļ¬Moderate ā admit
ā 10 - 20 % in adult
ā 5 - 10 % <10 yo >50 yo
ā High voltage, suspected inhalation,
circumferential or susceptibility to
infection
64. 1/4/2023 64
iii. Major burns
ļ¬ Second and third-degree burns greater than
10% body surface area (BSA) in patients
under 10 or over 50 years of age
ļ¬ Second and third-degree burns greater than
20% BSA in patients between 10 and 50 years
of age
ļ¬ Second and third-degree burns with serious
threat to functional and cosmetic impairment
that involve the face, hands, feet, genitalia,
perineum, and other major joints
ļ¬ Third-degree burns greater than 5% BSA
ļ¬ Specialized injuries such as electrical burns,
including lightning and chemical burns, with
serious threat of functional or cosmetic
impairment
65. 1/4/2023 65
ļ¬Significant inhalation injuries
ļ¬Circumferential burns of the extremities
or the chest
ļ¬Pre-existing medical disorders that
complicate management, prolong
recovery, or affect mortality
ļ¬Concomitant trauma in which the burn
injury poses the greatest risk of
mortality
68. 1/4/2023 68
Objectives of management
ļ¬To prevent fluid and electrolyte
imbalance
ļ¬Rapid and painless healing
ļ¬To prevent complications
ļ¬Rehabilitation
69. 1/4/2023 69
Burn team
ļ¬ Consists of multidisciplinary group whose
individual skills are complementary to each
other
ļ¬ Includes:-
ā Surgeons āreconstructive (plastic), General or
trauma surgeon, Paediatric surgeon
ā Nurses
ā Anesthetist
ā ICU team
ā Physiotherapist
ā Occupational therapist
ā Social workers
ā Psychologists
ā Psychiatrist
ā Dietitians
70. 1/4/2023 70
Criteria for admission
ļ¬ Type of burn
ā Electrical
ā Chemical
ā Lightening
ļ¬ %TSBA
ā >15% in adult
ā >10% in children
ļ¬ Body site affected: face, hands, perineum,
genitalia
ļ¬ Complications- inhalation burn
ļ¬ Pre-existing illness ā renal diseases, Diabetes
mellitus, respiratory diseases
ļ¬ Circumferential burns of the limbs or chest
71. 1/4/2023 71
Phases of management
ļ¬As in all trauma patients the mgt of
burn injury is divided into 5 phases
according to ATLS (Advanced Trauma
Life Support)
ļ§ Phase I: Primary survey phase
ļ§ Phase II: Resuscitation phase
ļ§ Phase III :Secondary survey phase
ļ§ Phase IV: Supportive care phase
ļ§ Phase V: Definitive treatment phase
72. 1/4/2023 72
Phase I: Primary survey phase
ļ¬Aim: to identify life threatening
conditions
ļ¬The life threatening conditions include:
ā A=Airway
ā B=Breathing
ā C=Circulation
ā D=Disability- neurological status
ā E=Exposure
ļ¬This should go hand in hand with the
phase II
73. 1/4/2023 73
Phase II: Resuscitation phase
ļ¬Aim: to treat the immediately life
threatening condition
ļ§ Airway āsecure airway & Immobilize the
cervical spine
ļ§ Breathing ā optimize ventilation
ļ§ Circulation- establish i.v. access
ļ§ Disability- assess neurological deficit
ļ§ Expose the patient to avoid missed injury
ļ§ Fluid therapy
74. 1/4/2023 74
Airway
ļ¬A clear patent and functional airway
should be established
ļ¬This can be achieved by:-
ā Use of airways
ā Proper position of the patient
ā Endotracheal intubation
ā Ambubags
ā Tracheostomy
75. 1/4/2023 75
Breathing / Ventilation
Make sure the patient is breathing
properly
Achieved by:-
ā Use of oxygen masks
ā Mechanical ventilators
76. 1/4/2023 76
Disability: Neurological Status
ļ¬Establish level of consciousness
ā A= Alert
ā V= Response to Vocal stimuli
ā P= Response to Painful stimuli
ā U= Unresponsive
ļ¬Examine the pupillary response to light
ļ¬Be aware of hypoxemia and shock can
cause ļ¤ level of consciousness
77. 1/4/2023 77
Exposure with Environment control
ļ¬Remove all clothing and jewellery
ļ¬Keep the patient warm
79. 1/4/2023 79
Fluid replacement
ļ¬ Fluid replacement is important to replace fluid loss
ad treat shock
ļ¬ i.v. should be administered through a wide bore
canula
ļ¬ The volume of fluid to be given is calculated as
follows:-
= 2-4ml x %TBSA x kg of body weight
ļ¬ The type of fluid to be given in the 1st 24 hrs is
Crystalloid
ļ¬ Ā½ of the calculated fluid is given in the 1st 8 hrs, and
the remaining half is distributed over remaining
sixteenth hrs
ļ¬ Calculation fluid commences at time of injury not at
admission
80. 1/4/2023 80
Fluid maintenance
ļ¬At the end of 24 hours, colloid infusion
is begun at a rate of 0.5 mlx(total burn
surface area (%))x(body weight (kg)),
and maintenance crystalloid (usually
dextrose-saline) is continued at a rate of
1.5 mlx(burn area)x(body weight)
ļ¬The end point to aim for is a urine
output of 0.5-1.0 ml/kg/hour in adults
and 1.0-1.5 ml/kg/hour in children.
81. 1/4/2023 81
Phase III :Secondary survey
phase
Not started until phase I &II are
complete
This include:-
ļ§ History
ļ§ Physical examination
ļ§ Investigations as above
82. 1/4/2023 82
Phase IV: Supportive care phase
ļ¬Analgesics-iv narcotics
ļ¬Systemic antibiotics against Ć-
hemolytic streptococcus
ļ¬Tetanus toxoid
ļ¬Nasogastric tube for patients with >
25%TBSA
ļ¬Monitor
ā vital signs
ā Input /output
ļ¬Urethral catheterization
ļ¬Nutrition support
83. 1/4/2023 83
Phase V: Definitive treatment
phase (Wound care)
ļ¬Depends on the characteristics and size
of the wound
ā Conservative treatment
ā Surgical treatment
85. 1/4/2023 85
a. Wound dressing
ļ¬The dressing should serve the following
fx:-
ā Protect the damaged epithelium,
minimizing bacterial ad fungal
colonization (protective fx)
ā Provide splinting action to maintain the
desired position of function (splinting fx)
ā Occlusive to reduce evaporative heat loss
and minimize cold tress
ā Provide comfort over the painful wound
ļ¬The choice of dressing is based on the
characteristics of the wound
86. 1/4/2023 86
ļ¬Sterile Dressing
ļ¬Several layers dressings
ļ¬Special Considerations:
ā Joint area lightly wrapped to allow mobility
ā Facial wounds maybe left open to air, kept
moist
ā Circumferential burns: wrap distal to
proximal
ā All fingers and toes should be wrapped
separately
ā Splints applied over dressings
ā Functional positions maintained; not always
comfortable
87. 1/4/2023 87
b. Antimicrobial Agent
ļ¬Apply an Antimicrobial Agent
ā Silverex
ā¢ Broad spectrum , Ideal choice.
ā Silvadene
ā¢ Broad spectrum; the most common agent used
ā Sulfamylon
ā¢ Penetrates eschar for invasive wound infections
ā¢ Painful burns for approximately 20 minutes after applied
ā Acticoat (antimicrobal occlusive dressing)
ā¢ A silver impregnated gauze that can be left in place for 5
days
ā¢ Moist with sterile water only; remoisten every 3-4 hours
89. 1/4/2023 89
a. Escharotomy
ļ¬Indicated for patients with
circumferential burns of the limbs, neck
or chest causing distal circulatory and
respiratory impairment respectively
ļ¬Only the burnt tissue is divided, not any
underlying fascia, differentiating this
procedure from a fasciotomy
ļ¬Incisions are made along the midlateral
or medial aspects of the limbs, avoiding
any underlying structures
91. 1/4/2023 91
ļ¬For the chest, longitudinal incisions are
made down each mid-axillary line to the
subcostal region
ļ¬The lines are joined up by a chevron
incision running parallel to the
subcostal margin
ļ¬This creates a mobile breastplate that
moves with ventilation
ļ¬Escharotomies are best done with
electrocautery, as they tend to bleed
96. 1/4/2023 96
ii. Temporary Skin Grafts
ļ¬ Why temporary ??
ā Clients with large amounts of TBSA burned do
not have enough donor sites.
ā Available donor sites are used first, but in large
burns not enough to cover all burn wounds.
ā While waiting for donor site to heal so it can be
reused a temporary covering is needed.
ļ¬ Types of temporary Skin Grafts
ā Biosynthetic
ā Artificial Skins
ā Synthetic
97. 1/4/2023 97
a. Autograft
ļ¬Harvested from client
ļ¬Non-antigenic
ļ¬Less expensive
ļ¬Decreased risk of infection
ļ¬Can utilize meshing to cover large area
ļ¬Negatives: lack of sites and painful
98. 1/4/2023 98
b. Cultured Epithelial Autografts
(CEA)
ļ¬ A small piece of clientās skin is harvested and
grown in a culture medium
ļ¬Takes 3 weeks to grow enough for the
first graft
ļ¬ Very fragile; immobile for 10 days post
grafting
ļ¬ Great for limited donor sites
ļ¬ Negatives: very expensive; poor long term
cosmetic results and skin remains fragile for
years
100. 1/4/2023 100
a. Homograft
ļ¬AKA Allograft
ļ¬Live or cadaver human donors
ļ¬Fairly expensive
ļ¬Best infection control of all biologic
coverings
ļ¬Negatives:
ā Risk of disease transmission (i.e. HBV &
HIV)
ā Antigenic: body rejects in 2 weeks
ā Not always available
ā Storage problems
101. 1/4/2023 101
b. Heterograft
ļ¬AKA Xenograft
ļ¬Graft between 2 different species
ā i.e. Porcine (pig) most common
ļ¬Fresh, frozen or freeze-dried (longer
shelf life)
ļ¬Amendable to meshing & antimicrobial
impregnation
ļ¬Antigenic: body rejects 3-4 days
ļ¬Fairly inexpensive
ļ¬Negatives: Higher risk of infection
102. 1/4/2023 102
2. Artificial Skins
ļ¬Transcyte
ā A collagen based dressing impregnated
with newborn fibroblasts
ļ¬Integra
ā A collagen based product that helps form a
āneodermisā on which to skin graft
103. 1/4/2023 103
3. Synthetic
ļ¬Any non-biologic dressing that will help
prevent fluid & heat loss
ā Biobrane, Xeroform or Beta Glucan
collagen matrix
104. 1/4/2023 104
Donor Site: Wound Considerations
ļ¬The donor site is often the most painful
aspect for the post-operative client
ā We have created a brand new wound !!
ā Variety of products are used for donor
sites.
ā¢ Most are left place for 24 hours and then left
open to air
ā Donor sites usually heal in 7-10 days
107. 1/4/2023 107
b. Late Complications
ļ¬Contractures
ļ¬Keloids
ļ¬Hypertrophic scars
ļ¬Marjolinās ulcer
ļ¬Acalculous Cholecystitis
108. 1/4/2023 108
Prognosis
ļ¬The prognostic factors for burns are
classified as follows:-
ā Patient characteristics
ā Circumstances of the injury
ā Characteristics of burn wound
ā Treatment parameters
110. 1/4/2023 110
Circumstances of the injury
ļ¬Nature of the injury
ļ¬Type of burn
ļ¬Timing in seeking medical care
ļ¬Associated injuries
ļ¬Associated burning of clothes
ļ¬Inhalation injury
ļ¬First-aid measures taken at the site of
accident
111. 1/4/2023 111
Clinical characteristics of burn
wound
ļ¬Body regions burned
ļ¬% total surface area burnt (%TSAB)
ļ¬Burn depth
ļ¬Severity of burn
ļ¬Burn wound sepsis