this is a detailed study on burns , and all the aspects such as definition , management, types , home remedies ,clinical aspects & evaluation, surgical methods , images & newer findings etc ,I hope this will be useful among medical professionals and others, please comment thank u

1. BURNS –A DETAIL STUDY
(MANAG,TREAT,PREVN,TYPES,DISCU)
PRESENTED BY
MARTIN SHAJI
PHARM D

2. SUMMARY
DEFENITION
TYPES OF BURNS
ASSESSMENT OF BURNS
CLINICAL EVALUVATION
MANAGEMENT
FIRST AID TREATMENT
HOME REMEDIES
SURGICAL & OTHER REMEDIES
CONCLUSION

3. Definition: Burn is the loss of epithelium and a
varying degree of dermis due to exposure to physical
form of energy, certain chemicals or radiation.
Types Of Burn Injuries
Flame
Electrical
Chemical
Steam
Radiation
Scald

4. Classes of Burn Injury Categories of Burn and their
Equivalents:-
First Degree:- Partial thickness
Second Degree:- Superficial & Deep Dermal burns
Third Degree: Loss full thickness of skin.
CLASSES OF BURN INJURY

5. Definitions:
First Degree Burns
- Involves only the epidermis
- Characterized by erythema, pain and slight edema
Pain subsides in 48 hours
- Epidermis peels off in small scales in five to ten
days.

6. • Second Degree Burn
- Involves all the epidermis and much of the corium
- Characterized by blisters, subcutaneous edema,
presence of systemic symptoms
- - infection is a threat which may convert to third-
degree burn

8. . Third Degree Burn
- Involves the entire epidermis and entire dermis down
to the deeper layers which is destroyed by
coagulation necrosis
- - Physiologic derangements are definitely present

9. Depth Of Burn: This is determined by:
• The nature of the agent
Temperature
Concentration
The length of contact
The tissues resistance to injury Skin:
vascularity thickness

10. DETERMINATION OF DEPTH & EXTENT
OF BURN INJURY
Clinical evaluation
First degree burns
Erythematous flush
Dry & painful
No blistering
Skin is intact

11. Second Degree Burns
A. Superficial:
formation of blister
smottled red or pink in appearance
quite painful and sensitive to air
blanching on pressure
pinprick increased
B . Deep Dermal:
mottled appearance pain
Positive blisters
fixed discoloration

12. THIRD DEGREE BURNS
Dry, dead white or charred in appearances
Skin feels leathery
Hair pulls out easily and painfully
Oedema
No capillary refill
Broken skin with fat exposed

13. ASSESSMENT OF AREA OF BURN
This done using the “ rule of mines “
The body is divided up in to eleven areas, each
representing 9 percentage of the total body surface

14. Body area Percentage of burn
Head and neck 9%
Anterior trunk 18%
Posterior trunk 18%
Rt . Lower extremity 18%
lt . Lower extremity 18%
Rt . Upper extremity 9%
Lt . Lower extremity 9%
Ext .genitalia & perineum 1%

16. Guide To Management ,
. Minor burns (less than 10%) can be treated in the
hospital on out patient basis
• Moderate and severe burns.......hospitalized for
treatment
• Adult patients sustaining more than 20% burn require.
Intravenous therapy.

19. First Aid Treatment.
Place the burning person in a horizontal position and roll
him over in a blanket.
In case of respiratory arrest, do positive breathing, using the
mouth-to-mouth or mouth-to-mask technique.
Cover the wound to minimize contamination and inhibit
pain by preventing air to come in contact with the injured
surface.(use clean sheet or cloth) ,

20. . Apply cold bath:
- normal saline
- kept at 10 to 15C.
Medications or home remedies should not bepp1ied
Facilitate transport to a hospital of severely burned
patients.

21. Burn Therapy For Severe Burns:
Assure an adequate airway
Look for and treat immediate life-threatening conditions
perform venipuncture with large bore needle
Remove patients clothing Obtain history (Cause, time,
place of burn, allergies, tetanus, diabetes, cardiac, renal
and liver disease)

22. • Insert indwelling catheter
• Cleanse wound:
• use soap & warm water
• Remove dirt
• Irrigate chemical burns copiously with water
• After the wound is cleansed, estimate %and depth of
burns in a chart
• Provide adequate analgesic as needed
• Calculate fluids

23. Dressing:
• Open Method
• Closed Occlusive Pressure Dressings
Care Of Burn Wounds
Face and perineum: exposed
Hands : polythene bags
c. Rest of the body : closed method

24. •Electrical burns
• Surface thermal burns
• Flash arcing
• True electrical injury
• Passage of current through the body

25. Later Care Of Post Burn Patients
• Oil or Vaseline
• Pressure garments
• Splints and physiotherapy Reconstructive surgery

26. Late Complications:
. Dyspigmentation
. Hypertrophic scars
• Contractures
Margilins ulcer

27. Medical treatment
After you have received first aid for a major burn, your medical care
may include medications and products that are intended to encourage
healing.
Water-based treatments.
Your care team may use techniques such as ultrasound mist therapy to
clean and stimulate the wound tissue.
Fluids to prevent dehydration.
You may need intravenous (IV) fluids to prevent dehydration and organ
failure.

28. Pain and anxiety medications.
Healing burns can be incredibly painful. You may need morphine and
anti-anxiety medications — particularly for dressing changes.
Burn creams and ointments.
If you are not being transferred to a burn center, your care team may
select from a variety of topical products for wound healing, such as
bacitracin and silver sulfadiazine (Silvadene). These help prevent
infection and prepare the wound to close.
Drugs that fight infection.
If you develop an infection, you may need IV antibiotics.

29. Dressings.
Your care team may also use various specialty wound
dressings to prepare the wound to heal. If you are being
transferred to a burn center, your wound will likely be
covered in dry gauze only.
Tetanus shot.
Your doctor might recommend a tetanus shot after a burn
injury.

30. Lifestyle and home remedies
To treat minor burns, follow these steps:
Cool the burn.
Hold the burned area under cool (not cold) running water or apply a
cool, wet compress until the pain eases. Don't use ice. Putting ice
directly on a burn can cause further damage to the tissue.
Remove rings or other tight items. Try to do this quickly and gently,
before the burned area swells.
.

31. Bandage the burn.
Cover the burn with a sterile gauze bandage (not fluffy cotton). Wrap it loosely to
avoid putting pressure on burned skin. Bandaging keeps air off the area, reduces
pain and protects blistered skin.
Take a pain reliever.
Over-the-counter medications, such as ibuprofen (Advil, Motrin IB, others),
naproxen sodium (Aleve) or acetaminophen (Tylenol, others), can help relieve
pain.
Consider a tetanus shot.
Make sure that your tetanus booster is up to date. Doctors recommend that people
get a tetanus shot at least every 10 years

32. Don't break blisters.
Fluid-filled blisters protect against infection. If a blister breaks, clean the
area with water (mild soap is optional). Apply an antibiotic ointment. But if
a rash appears, stop using the ointment.

33. Surgical and other procedures
You may need one or more of the following procedures:
Breathing assistance. If you've been burned on the face or neck,
your throat may swell shut. If that appears likely, your doctor
may insert a tube down your windpipe (trachea) to keep oxygen
supplied to your lungs.
Feeding tube.
People with extensive burns or who are undernourished may
need nutritional support. Your doctor may thread a feeding tube
through your nose to your stomach.

34. Easing blood flow around the wound.
If a burn scab (eschar) goes completely around a limb, it can
tighten and cut off the blood circulation. An eschar that goes
completely around the chest can make it difficult to breathe.
Your doctor may cut the eschar to relieve this pressure.
Skin grafts.
A skin graft is a surgical procedure in which sections of your
own healthy skin are used to replace the scar tissue caused
by deep burns. Donor skin from deceased donors or pigs can
be used as a temporary solution.

35. Plastic surgery.
Plastic surgery (reconstruction) can improve the
appearance of burn scars and increase the flexibility of
joints affected by scarring.