Burns

50 terms by mcatherinebroussard 

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Thermal Burn

caused by conduction or convection (e.g., hot liquid, fire, steam)

Electrical Burn

caused by the passage of electrical current through the body; typically there is an entrance & an exit wound; complications can include cardiac arrhythmias, respiratory arrest, renal failure, neurological damage, & fractures (ex: lightning)

Chemical Burn

occurs when certain chemical compounds come in contact w/the body; the reaction will continue until the chemical compound is diluted from the site; compounds include sulfuric acid, lye, hydrochloric acid, & gasoline

Burn Classification

the extent & severity of a burn is dependent on gender, age, duration of burn, type of burn, & affected area; burns are most appropriately classified according to the depth of tissue destruction

Superficial Burn

involves only the outer epidermis; the involved area may be red w/slight edema; healing occurs w/o evidence of scarring

Superfical Partial-Thickness Burn

involves the epidermis & the upper portion of the dermis; the involved area may be extremely painful & exhibit blisters; healing occurs w/minimal to no scarring

Deep Partial-Thickness Burn

involves complete destruction of the epidermis & the majority of the dermis; the involved area may appear to be discolored w/broken blisters & edema; damage to nerve endings may result in only moderate levels of pain; healing occurs w/hypertrophic scars & keloids

Full-Thickness Burn

involves complete destruction of the epidermis & dermis along w/partial damge of the subcutaneous fat layer; the involved area often presents w/eschar formation & minimal pain; pts. require grafts & may be susceptible to infection

Subdermal Burn

involves the complete destruction of the epidermis, dermis & subcutaneous tissue; may involve muscle & bone & as a result often require surgical intervention

Zone of Coagulation

the are of the burn that received the most severe injury along w/irreversible cell damage

Zone of Stasis

the area of less severe injury that possesses reversible damage & surrounds the zone of coagulation

Zone of Hyperemia

the area surrounding the zone of stasis that presents w/inflammation, but will fully recover w/o any intervention or permanent damage

Rule of Nines (Adult)

allows for a gross approximation of the % of the body affected by a burn

Head and Neck

9%

Anterior Trunk

18%

Posterior Trunk

18%

(B) Anterior Arm, Forearm, & Hand

9%

(B) Posterior Arm, Forearm, & Hand

9%

Genital Region

1%

(B) Anterior Leg & Foot

18%

(B) Posterior Leg & Foot

18%

Silver Sulfadiazine Advantages

can be used w/or w/o dressings; painless; can be applied to wound directly; broad-spectrum; effective against yeast

Silver Sulfadiazine Disadvantages

does not penetrate into eschar

Silver Nitrate Advantages

broad-spectrum; non-allergenic; dressing application is painless

Silver Nitrate Disadvantages

poor penetration; discolors, making assessment difficult; can cause severe electrolyte imbalances; removal of dressings is painful

Povidone-iodine Advantages

broad-spectrum; antifungal; easily removed w/water

Povidone-iodine Disadvantages

not effective against Pseudomonas; may impair thyroid function; painful application

Mafenide Acetate Advantages

broad-spectrum; penetrates burn eschar; may be used w/or w/o occlusive dressings

Mafenide Acetate Disadvantages

may cuase metabolic acidosis; may compromise respiratory function; may inhibit epithelialization; painful application

Gentamicin Advantages

broad-spectrum; may be covered or left open to air

Gentamicin Disadvantages

has caused resistant strains; ototoxic; nephrotoxic

Nitrofurazone Advantages

bacteriocidal; broad-spectrum

Nitrofurazone Disadvantages

may lead to overgrowth of fungus & Pseudomonas; painful application

Allograft (homograft)

a temporary skin graft taken from another human, usually a cadaver, in order to cover a large burned area

Autograft

a permanent skin graft taken from a donor site on the patient's own body

Heterograft (xenograft)

a termporary skin graft taken from another species

Mesh graft

a skin graft that is altered to create a mesh-like pattern in order to cover a larger surface area

Sheet graft

a skin graft that is transferred directly from the donor site to the recipient site

Split-thickness skin graft

a skin graft that contains only a superficial layer of the dermis in addition to the epidermis

Full-thickness skin graft

a skin graft that contains the dermis & the epidermis

Dermis

the vascular layer of skin below the epidermis that contains hair follicles, sebaceous glands, & sweat glands

Donor site

a site where healthy skin is taken & used as a graft

Epidermis

the superficial avascular layer of skin that contains the hair follicles, sebaceous glands, & sweat glands

Eschar

the necrotic & nonviable tissue resulting from a deep burn; this skin is hard, dry, & doesn't possess qualities of normal skin

Escharotomy

a surgical procedure that removes eschar from a burn site & subsequently enhances circulation

Hypertrophic scarring

an abnormal & disorganized scar formation characterized by a raised, firm scar w/collagen fibers that don't follow any pattern

Normotrophic scarring

a scar w/organized formation of collagen fibers that align in a parallel fashion

Pressure garments

a custom-made garment that applies sustained pressure in order to improve the structure of a scar; they are worn 22-23 hrs/day & may be required for up to 2 yrs.

Recipient site

a site that has been burned & requires a graft

Z-plasty

a surgical procedure to eliminate a scar contracture; an incision in the shape of a "z" allows the contracture to change configuration & lengthen the scar

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