The document discusses burn injuries and their management. It begins by defining burns as wounds caused by exposure to heat, chemicals, fire, radiation, or electricity. Burns can result in 10-20 thousand deaths annually. Survival is best for burns covering less than 20% of the total body surface area and for patients aged 15-45 years old. The document then covers types of burns including thermal, chemical, electrical, and radiation burns. It discusses burn wound assessment and classification according to depth and extent of body surface area involved. The phases of burn care and plastic surgery for burn management are also summarized.

1. BURN INJURIES
& ITS
MANAGEMENT
BY
MR. AHMED SODHA
M.Sc.(N) – M.S.N.
4/1/2011
1

2. BURNS
4/1/2011
WOUNDS CAUSED BY EXPOSURE
TO:
1. EXCESSIVE HEAT
2. CHEMICALS
3. FIRE/STEAM
4. RADIATION
5. ELECTRICITY

3. BURNS
4/1/2011
RESULTS IN 10-20 THOUSAND
DEATHS ANNUALLY
SURVIVAL BEST AT AGES 15-45
SURVIVAL BEST BURNS COVER
LESS THAN 20% OF TBA

4. TYPES OF BURNS
4/1/2011
THERMAL
EXPOSURE TO FLAME OR A HOT OBJECT
CHEMICAL
EXPOSURE TO ACID, ALKALI OR ORGANIC
SUBSTANCES
ELECTRICAL
RESULT FROM THE CONVERSION OF
ELECTRICAL ENERGY INTO HEAT.
(EXTENT OF INJURY DEPENDS ON THE
TYPE OF CURRENT, THE PATHWAY OF
FLOW, LOCAL TISSUE RESISTANCE, AND
DURATION OF CONTACT)
RADIATION
RESULT FROM RADIANT ENERGY BEING
TRANSFERRED TO THE BODY.

5. CHEMICAL BURN
4/1/2011

6. ELECTRICAL BURN
4/1/2011

7. BURN WOUND ASSESSMENT
4/1/2011
CLASSIFIED ACCORDING TO DEPTH OF
INJURYAND EXTENT OF BODY SURFACE
AREA INVOLVED
BURN WOUNDS DIFFERENTIATED
DEPENDING ON THE LEVEL OF DERMIS
AND SUBCUTANEOUS TISSUE
INVOLVED
1.SUPERFICIAL (FIRST-DEGREE)
2.DEEP (SECOND-DEGREE)
3.FULL THICKNESS (THIRD AND
FOURTH DEGREE)

8. 4
/1
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1
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/1
/20
1
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10. SUPERFICIAL BURNS
(FIRST DEGREE)
EPIDERMAL TISSUE ONLYAFFECTED
ERYTHEMA, BLANCHING ON PRESSURE,
MILD SWELLING NO VESICLES OR
BLISTER INITIALLY
NOT SERIOUS UNLESS LARGE AREAS
INVOLVED
I.E. SUNBURN
4/1/2011

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15. DEEP (SECOND DEGREE)
*INVOLVES THE EPIDERMIS AND
DEEP LAYER OF THE DERMIS
FLUID-FILLED VESICLES –RED, SHINY,
WET, SEVERE PAIN HOSPITALIZATION
REQUIRED IF OVER 25% OFBODY
SURFACE INVOLVED
I.E. TAR BURN, FLAME
4/1/2011

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19. FULL THICKNESS
(THIRD/FOURTH DEGREE)
DESTRUCTION OF ALL SKIN LAYERS
REQUIRES IMMEDIATE
HOSPITALIZATION
DRY, WAXY WHITE, LEATHERY, OR HARD
SKIN, NO PAIN
EXPOSURE TO FLAMES, ELECTRICITY
OR CHEMICALS CAN CAUSE 3RD
DEGREE BURNS
4/1/2011

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21

22. Calculation of Burned
Body Surface Area
4/1/2011

23. TOTAL BODY SURFACE AREA
(TBSA)
4/1/2011
SUPERFICIAL BURNS ARE NOT
INVOLVED IN THE CALCULATION
LUND AND BROWDER CHART IS THE
MOST ACCURATE BECAUSE IT
ADJUSTS FOR AGE
RULE OF NINES DIVIDES THE BODY –
ADEQUATE FOR INITIAL
ASSESSMENT FOR ADULT BURNS

24. 4/1/2011

26. LUND BROWDER CHART USED FOR
DETERMINING BSA
4/1/2011

27. RULES OF NINES
4/1/2011
HEAD & NECK = 9%
 EACH UPPER EXTREMITY (ARMS) = 9%
 EACH LOWER EXTREMITY (LEGS) =18%
ANTERIOR TRUNK= 18%
POSTERIOR TRUNK =18%
GENITALIA (PERINEUM) = 1%

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31. 4/1/2011
IN PATIENTS WITH SCATTERED BURNS, A METHOD
TO ESTIMATE THE PERCENTAGE OF BURN IS THE
PALM METHOD.
THE SIZE OF THE PATIENT’S PALM
IS APPROXIMATELY 1% OF TBSA.

PALM METHOD

32. 4/1/2011


33. VASCULAR CHANGES
RESULTING FROM BURN
INJURIES
4/1/2011
CIRCULATORY DISRUPTION OCCURS AT THE BURN
SITE IMMEDIATELY AFTER A BURN INJURY
BLOOD FLOW DECREASES OR CEASE DUETO
OCCLUDED BLOOD VESSELS
DAMAGED MACROPHAGES WITHIN THE TISSUES
RELEASE CHEMICALS THAT CAUSE CONSTRICTION
OF VESSEL
BLOOD VESSEL THROMBOSIS MAY OCCUR
CAUSING NECROSIS

MACROPHAGE: A TYPE OF WHITE BLOOD THAT INGESTS (TAKES IN)
FOREIGN MATERIAL. MACROPHAGES ARE KEY PLAYERS IN
THE IMMUNE RESPONSE TO FOREIGN INVADERS SUCH AS INFECTIOUS
MICROORGANISMS.

34. FLUID SHIFT
4/1/2011
FLUID SHIFT OCCURS AFTER INITIAL
VASOCONSTRICTION,THEN DILATION
BLOOD VESSELS DILATE AND LEAK FLUID
INTO THE INTERSTITIAL SPACE
KNOWN AS THIRD SPACING OR CAPILLARY
LEAK SYNDROME
CAUSES DECREASED BLOOD VOLUME AND BLOOD
PRESSURE
 OCCURS WITHIN THE FIRST 12 HOURS AFTER
THE BURN AND CAN CONTINUE TO UP TO 36
HOURS
 [MAJOR BURNS >30%TBSA]

35. FLUID IMBALANCES
4/1/2011
FLUID IMBALANCES OCCUR AS A RESULT
OF FLUID SHIFT AND CELL DAMAGE
HYPOVOLEMIA
METABOLIC ACIDOSIS
HYPERKALEMIA
HYPONATREMIA
HEMOCONCENTRATION (ELEVATED BLOOD
OSMOLARITY, HEMATOCRIT/HEMOGLOBIN)
DUE TO DEHYDRATION

36. FLUID REMOBILIZATION
4/1/2011
OCCURS AFTER 24 HOURS
CAPILLARY LEAK STOPS
SEE DIURETIC STAGE WHERE EDEMA FLUID
SHIFTS FROM THE INTERSTITIAL SPACES INTO
THE VASCULAR SPACE
BLOOD VOLUME INCREASES LEADING TO
INCREASED RENAL BLOOD FLOW AND
DIURESIS
 HYPOKALEMIA OCCUR

37. CURLING’S ULCER
4/1/2011
ACUTE ULCERATIVE GASTRO DUODENAL
DISEASE
OCCUR WITHIN 24 HOURS AFTER BURN
DUE TO REDUCED GI BLOOD FLOW
AND MUCOSAL DAMAGE
TREAT CLIENTS WITH H2 BLOCKERS,
MUCOPROTECTANTS, AND EARLY
ENTERAL NUTRITION
WATCH FOR SUDDEN DROP IN
HEMOGLOBIN

38. 4/1/2011
MUCOPROTECTANTS - SALIVATION INDUCING AGENT

39. PHASES OF BURN CARE
4/1/2011
EMERGENT (24-48 HRS)
ACUTE
REHABILITATIVE
MANAGEMENT:-

40. 4/1/2011

EMERGENT OR IMMEDIATE
RESUSCITATIVE
FROM ONSET OF INJURY TO
COMPLETION
OF FLUID RESUSCITATION
• FIRST AID
• PREVENTION OF SHOCK
• PREVENTION OF RESPIRATORY
DISTRESS
• DETECTION AND TREATMENT
OF CONCOMITANT INJURIES
• WOUND ASSESSMENT AND
INITIAL CARE
ACUTE FROM BEGINNING OF DIURESIS
TO NEAR
COMPLETION OF WOUND
CLOSURE
• WOUND CARE AND CLOSURE
• PREVENTION OR TREATMENT
OF COMPLICATIONS, INCLUDING
INFECTION
• NUTRITIONAL SUPPORT
REHABILITATION FROM MAJOR WOUND CLOSURE
TO RETURN
TO INDIVIDUAL’S OPTIMAL
LEVEL OF PHYSICAL
AND PSYCHOSOCIAL
ADJUSTMENT
• PREVENTION OF SCARS AND
CONTRACTURES
• PHYSICAL, OCCUPATIONAL,
AND VOCATIONAL
REHABILITATION
• FUNCTIONAL AND COSMETIC
RECONSTRUCTION
• PSYCHOSOCIAL COUNSELING

41. 4/1/2011


42. PLASTIC SURGERY

43. WHAT IS PLASTIC SURGERY?
 THE NAME IS TAKEN FROM THE GREEK WORD
“PLASTIKOS”, WHICH MEANS TO FORM OR
MOLD!
 PLASTIC SURGERY IS A SPECIAL TYPE OF
SURGERY THAT INVOLVES BOTH A PERSON'S
APPEARANCE AND HIS OR HER ABILITY TO
FUNCTION.
 IT INTENDS TO IMPROVE PATIENTS'
APPEARANCE, SELF-IMAGE, AND CONFIDENCE
THROUGH BOTH RECONSTRUCTIVE AND
COSMETIC PROCEDURES.

44. WHY DO PEOPLE GET PLASTIC SURGERY?
1. TOIMPROVE THE APPEARANCE.
2. SOME PEOPLE ARE ADDICTED
TO COSMETIC SURGERY
3. TOCORRECT A PHYSICAL DEFECT OR TO
ALTER A PART OF THE BODY THAT
MAKES THEM FEEL UNCOMFORTABLE
4. TOFEEL BETTER ABOUT THE WAY THEY
LOOK

45. THERE ARE TWO MAIN KINDS OF PLASTIC
SURGERY:
1. RECONSTRUCTIVE SURGERY - IS USUALLY EMPLOYED
FOR MEDICAL PURPOSES, AND SOME COMMON
EXAMPLES INCLUDE:
*CLEFT LIP SURGERY
*BREAST RECONSTRUCTION SURGERY FOR THOSE
WHO HAD MASTECTOMY
* CONTRACTURE SURGERY FOR BURN SURVIVORS
2. COSMETIC SURGERY - IS DONE MOSTLY FOR AESTHETIC
3. ENHANCEMENT AND INCLUDES:
- DIFFERENT TYPES OF COSMETIC SURGERY INCLUDE:
TUMMY TUCK (ABDOMINOPLASTY)
* LIPOSUCTION
* BREAST LIFT
* CHEEK AUGMENTATION
* BREAST REDUCTION/ENLARGEMENT (AUGMENTATION
MAMMAPLASTY)
*

46. WHICH ARE THE MOST COMMON PLASTIC
SURGERIES ?
1. TUMMY TUCK
2. EYELID SURGERY
3. LIPOSUCTION
4. BREAST AUGMENTATION
 BREAST RECONSTRUCTION
 BREAST IMPLANT
 BREAST LIFT
 BOTOX

47. GETTING A TUMMY TUCK
 TUMMY TUCK (ABDOMINOPLASTY) HELPS TO
REDUCE THE APPEARANCE OF A PROTRUDING
ABDOMEN, LOOSE SKIN.
 STRETCH MARKS IN THE ABDOMINALAREA.
 MANY PEOPLE TURN TO A TUMMY TUCK AS A
RESULT OF PREGNANCY.
 THE ALSO TURN AS E RESULT OF AGE OR
OBESITY.

49. EYELID SURGERY
 IS PERFORMED ON ADULTS OF ANY AGE TO CORRECT
PROBLEMS ASSOCIATED TO AGING OR TO RECEIVE
TREATMENT FOR INHERITED TRAITS.
 THEY MAY HAVE LOOSE SKIN HANGING DOWN FROM THE
UPPER EYELIDS AND POSSIBLY IMPAIRING VISION
 A PUFFY APPEARANCE TO THE UPPER EYELIDS THAT MAKE
THE EYES LOOK TIRED
 EXCESS SKIN AND FINE WRINKLES OF THE LOWER EYELIDS,
 DARK CIRCLES UNDER THE EYES
 EYELID SURGERY CAN NORMALLY FIX THESE TYPES OF
PROBLEMS, BUT SOMETIMES AN EYELID SURGERY MAY BE
NEEDED IN COMBINATION WITH ANOTHER TREATMENT.

50. GUIDE TO GETTING LIPOSUCTION
 LIPOSUCTION (LIPOPLASTY) IS THE ELIMINATION
OF UNWANTED FAT.
 EVERY YEAR, HUNDREDS OF THOUSANDS OF
AMERICAN MEN AND WOMEN UNDERGO
LIPOSUCTION PROCEDURES TO ELIMINATE
UNWANTED AND PERSISTENT POCKETS OF FAT IN
THE:
 ABDOMEN
 HIPS
 THIGHS
 BUTTOCKS
 ARMS

51. BREAST AUGMENTATION
 BREAST IMPLANTS ARE USED DURING
AUGMENTATION TO INCREASE THE SIZE
OF THE BREAST.
 TO INCREASE SHAPE OF THE BREAST.
 TORESTORE BREAST VOLUME LOST
AFTER WEIGHT REDUCTION OR
PREGNANCY.

55. PROS AND CONS OF PLASTIC
SURGERY
 COSMETIC SURGERY IS
PURSUED TO ENHANCE
THE MAGNIFICENCE OF
THE PERSON.
 PLASTIC SURGERY IS TO
LOOK ENERGETIC AND
TO PLEASE HIMSELF.
 THERE IS A
DEVELOPMENT OF
SELF-ESTEEM IN THE
PERSON IF THE PLASTIC
SURGERY IS
SUCCESSFUL
 LEAVES SOME MARKS OR SPOTS ON THE
BODY WHICH CAN BE RECTIFIED BY
PERFORMING ANOTHER PLASTIC
SURGERY
 RISKS DEPEND ON THE TYPE OF PLASTIC
SURGERY. (BREAST AUGMENTATION,
BLEEDING OF GEL)
 THE RISKS OF LIPOSUCTION INCLUDE
DISCOLORATION, DEPIGMENTATION,
NUMBNES S, BRUISING AND PAIN.
 FACELIFT PLASTIC SURGERY INVOLVES
VARIOUS SIDE EFFECTS: NERVE DAMAGE
WHICH MAKES THE PERSON’S FACE
INSENSIBLE.
 THE PATIENT ALSO SUFFERS FROM MILD
SIDE EFFECTS: FEELING PAIN IN THE
AFFECTEDPART AND INFLAMMATION.
BENEFITS DRAWBACK

56. THEREFORE, PLASTIC SURGERY HAS TWO
SIDES – ONE IS BENEFIT SIDE AND THE
OTHER ONE IS THE DRAWBACK SIDE AND
THE PATIENT HAS TO EXPERIENCE
BOTH THE SIDES.

57. THANK YOU!