23 terms

Burns treatment

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