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Definition:: Is Defined As A Wound Caused by Exogenous Agent Leading To Coagulative Necrosis of The Tissue

This document defines burns and classifies them according to type, degree of skin layer involvement, thickness, and percentage of total body surface area affected. It discusses the pathophysiology and potential complications of burns, including changes to cardiovascular, renal, pulmonary, gastrointestinal, immune, and metabolic systems as well as sepsis. Management of burns is explained for pre-hospital care, hospital admission, wound assessment, fluid resuscitation according to different formulas, local wound management using open or closed methods and tangential excision. Wound coverage options include skin grafts, and complications like eschar, contractures, and their treatments are outlined. Non-thermal burns from electricity, chemicals, cold, and radiation are also mentioned.

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Moad Al-Talouli
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151 views

Definition:: Is Defined As A Wound Caused by Exogenous Agent Leading To Coagulative Necrosis of The Tissue

This document defines burns and classifies them according to type, degree of skin layer involvement, thickness, and percentage of total body surface area affected. It discusses the pathophysiology and potential complications of burns, including changes to cardiovascular, renal, pulmonary, gastrointestinal, immune, and metabolic systems as well as sepsis. Management of burns is explained for pre-hospital care, hospital admission, wound assessment, fluid resuscitation according to different formulas, local wound management using open or closed methods and tangential excision. Wound coverage options include skin grafts, and complications like eschar, contractures, and their treatments are outlined. Non-thermal burns from electricity, chemicals, cold, and radiation are also mentioned.

Uploaded by

Moad Al-Talouli
Copyright
© © All Rights Reserved
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
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Burn

Definition:

Is defined as a wound caused by exogenous agent


leading to coagulative necrosis of the tissue.
I. Types:
1. Thermal injury.
2. Non-Thermal injury.

II. Classification:

The burn classified according to:


1. Percentage of burn:
- Mild (minor).
- Moderate.
- Severe (major).
2. Involvement of skin layer:
 First degree.
 Second degree.
 Third degree.
 Fourth degree.

3. Skin thickness involvement:


 Partial.
 Full-thickness.
III. Assessment:

A. Assessing depth.
B. Assessing size:
1. Palmer method.
2. Wallace’s rule of nine.
3. Lund and Browder chart.
IV. Pathophysiology:
A. Local changes.
B. Systemic:
1. Cardiovascular alterations.
2. Renal changes.
3. Pulmonary changes.
4. GIT abnormalities.
5. Metabloic changes.
6. Sepsis and immunity.
V. Management:
A. Pre-hospital care:
 Stop the burning process.
 Check for other injuries.
 Cool the burn wound.
 Give oxygen.
 Elevate.
 If there is any indication for admission?
B. Hospital care:
 Admit the patient, should be in burns unit.
- Maintain airway, breathing, circulation (ABC).
- Assess the percentage, degree, and type of burn.
- Sedation and proper analgesia.
 Chemoprophylaxis: tetanus toxoid, antibiotics and local
antiseptics.
- Ryle’s tube insertion: initially for aspiration purpose, later for
feeding.
VI. Fluid resuscitation:
Formulas to calculate the fluid replacement:
1. Parkland regime.
2. Muir and Burclay regime.
3. Galveston regime.
4. Modified brooke formula.
5. Evan’s formula.
VII. Local management:
1. Open method:
Silver sulphadiazine application without dressings commonly used in burns of
face, head and neck.
2. Closed method:
Dressing done to soothen and to protect the wound, to reduce the pain, as an
absorbent.
3. Tangential excision:
Can be done within 48 hours with skin grafting in patients with less than 25%
burn. Usually done in deep dermal burns wherein dead dermis is removed layer by
layer until fresh bleeding occurs. Later skin grafting done.
VIII. Wound coverage:
- In 3 weeks the area granulate well, split skin grafting is done
(SSG, Thiersch graft).
- MESH split skin graft is used for wider area.
- If there is eschar, escharotomy is required to prevent
compression of vessels.
IX. Complications of burn:

1. Eschar:
It is a charred, denatured, full thickness, deep burns with
contracted dermis.
Escharotomy:
• Incise along medial and/or lateral surfaces.
• Avoid bony prominences.
• Avoid tendons, nerves, major vessels.
2. Contracture:
Disorganized over formation of compact collagen (three times than
normal) causes hypertrophic scar finally leading to contracture.

 Classification of Contracture in Neck (BM Achauer):


A. Mild : Inability to see ceiling.
B. Moderate: Flexion is possible but not extension.
C. Severe: Fully contracted in flexed position with pull on lower lip.
D. Extensive: Mento-sternal adhesions
 Complications of contracture:
 Ectropion.
 Disfigurement of face and microstomia.
 Hypertrophic scar and keloid formation.
 Marjolin’s ulcer.

 Treatment:
 Release of contracture surgically and use of skin graft or “Z” plasty.
 Proper physiotherapy and rehabilitation is essential.
 Pressure garments to prevent hypertrophic scars.
 Management of itching in the scar using aloe vera, antihistamines and
moisturizing creams.
X. Non-thermal burn:
 Electrical burns.
 Chemical burn.
 Cold injuries.
 Ionizing radiation.
N.B:

No time for questions 😅 😅

Thank you

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