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1. {
Soft-Tissue Trauma
and Burns
Chapters 31 & 32

2. • The Simpsons
• Fight Club
• Caddyshack
• The Day After
Disclaimer:
these movies/TV shows will be referenced (poorly)

3. Lots of Terms in this Chapter
chemotactic factors
collagen
desquamation
epithelialization
granulocytes
high pressure injection injuries
hypertrophic scar
keloid scar
myositis
necrotizing fasciitis
neovascularization
paronychia
pedicle
phagocytosis

4. Lots of Terms in this Chapter
• chemotactic factors- cause
cells to migrate to a location
• collagen- protein gives tensile
strength
• desquamation-shedding of
dead cells on surface of skin
• epithelialization- formation of
fresh tissue
• granulocytes- cells that
contain granules
• high pressure injection
injuries
• lymphangitis- red streaks
• hypertrophic scar- has excess
collagen
• keloid scar- people with dark
skin
• myositis- inflammation of
muscle
• necrotizing fasciitis
• neovascularization
• paronychia- infection of the
nail bed
• pedicle- part of the avulsion
that’s still attached
• phagocytosis

5. Tension Lines

7. • Compromise of
• vessels
• nerves
• muscles
• tendons or ligaments
• Foreign body or cosmetic complications
• Heavy contamination
Soft Tissue Injury Conditions
that Require Transport

8. • Hemostasis
• Inflammation
• Epithelialization
• Neovascularization
• Collagen Synthesis
Wound Healing

9. • Vasoconstriction
• Platelet aggregation
• Clotting cascade
Hemostasis

12. Inflammation

13. Epithelialization
‘baby skin’

14. Neovascularization

15. Collagen Formation

16. High Risk Wounds

18. Abnormal Scars
Hypertrophic
Scar
Keloid Scar

21. Lymphangitis

22. Paronychia

23. Necritizing Faciitis

24. Dressing Types
• Sterile
• Nonsterile
• Hemostatic
• Occlusive
• Adherent
• Nonadherent
• Thousand Island
• Dry
• Wet
• Roller bandage
• Gauze bandage
• Elastic bandage
• Triangular
bandage
• Medical tape

28. Flexor tenosynovitis

29. Burns

30. • Thermal burns
• Inhalation burns
• Chemical burns
• Electrical burns
Types of Burns

31. Thermal Burns
Flame Burn
Scald Burn
Steam Burn
Contact Burn
Flash Burn

34. Airway Burns

35. Bronchoscopy

36. Normal vs.
Swollen Vocal Cords

39. • Partial thickness > 10 %
• Face, hands, feet, genitalia
• Full thickness burns
• Electrical burns
• Chemical burns
• Inhalation burns
• Preexisting medical conditions
• Burns with other trauma
• Circumferential burns
Burn Center Criteria

40. Consensus Formula
2 – 4 mL X BSA (%) X weight (kg)

42. Avoid ‘Fluid Creep’
too much fluid

43. Chemical Burns

44. Chemical Burns
try to identify what it is…

45. Chemical Burns
if unknown wet chemical…
flush, flush, flush, flush, flush…

47. Acid Burns
cause coagulation necrosis

48. Alkali Burns
cause liquifaction necrosis

49. Dry Chemicals
brush, brush, brush, brush, brush… then….
flush, flush, flush, flush, flush

50. Hot Tar
cool with water so it hardens…

51. Hydrofluoric
Acid

53. Inhaled Chlorine
nebulize bicarb

54. Chemical Burns to Eye
flush, flush, flush, flush, flush

55. Electrical Burn

56. If electricity were water pipes…

57. … or these guys.

58. Ohm’s Law

59. o True electrical injury (contact)
o TASER effects
o Arc-type or flash burn
o Flame burn (clothes on fire)
Electrical Burn

60. True Electrical Contact

61. True vs. Flash

62. Tissue Damage + Acidosis

63. Rhabdomyolysis
follow your protocols
2 mEq/kg
1 gram/kg

64. -Don’t be the tallest person outside.
-Don’t stand under the tallest tree.
-Take shelter or take a squat.
-Avoid touching good conductors.

65. Radiation