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US for burns

stimulate fibroblast and microphages - decrease inflammation

Hydrotherapy for burns

cleans and debrides - ex easier, 20 min. 98 - 102, not with new graft

Estim for burns

increase circulation and decrease pain

Hyberbaric Oxygen for burns

increase oxygen, used in combo with debridement..all nonviable tissue must be removed - not used when pseudomonas present

Pulsed lavage for burns

debrides - shearing and suction at same time

Mechanical debridement for burns

clean wound by force

Wet - to - dry gauze dressing

Indications: moist necrotic wounds (not with eschar) Contraindications: clean wound Procedure: damp sterile 4x4 to wound, remove when dry Disadvantage: painful, not specfic, costly

Wound irrigation

Indications: lean ound gentle, necrotic wound, vigorous Contraindications: allergic to certain irrigant Procedure: flush wound to debride loose necrotic tissue Disadvantage: Messy, chance of maceration

Enzymatic / Chemical

Indications: All necrotic wounds Contraindications: Infection, gangrene, dry eschar Procedure: topical agent Disadvantages: slow 3 - 30 days, clean wound bed

Surgical Sharps to remove nonviable tissue

Indications: Necrotic wounds (best if moist) Contraindications: untrained, dry gangrene, ischemic or clean/healing wounds


Indications: all necrotic wounds (best if dry) Contraindications: Dry gangrene or ischemic wounds Procedure: Apply dressing to retain moisture and let RBC liquefy and help remove eschar and slough Disadvantages: takes time

High Exudate dressing

Gauze (wet - to - dry), hydrocolloids, adhesive foam, calcium alginate

Min. Exudate dressing

Hydrocolloids, Aldinate and transparent film, thin foam dressing

Dry wound dressing

Gels / hydrogels, moistened alginate with transparent film, hydrogel with hydrocolloid

Occlusive dressing

cover wound to prevent contamination, healing wounds with granulation

Topical medications

Silver sufadiazine, Mafenide acetate, silver nitrate, Bacitracin / polsporis, Nitrofurazone, Gentamucin, Collagenase

Hypertrophic scars

thick raised inelastic scar within the original boundries of wound

Keloid scars

extends outside the borders of original wound

Wound management

Compression garmet - 23 hr/day, 30mmHg, on wounds quarter size or less

Wound heals 1 - 7 days

no compression garmet needed

Wound heals 7 - 14 days

consider compression garmet

Wound heals 14 - 21 days

Requires compression garmet

Wound heals 21 + days

hypertrophic scar will result - compression garmet required

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