burns Flashcards

1
Q

transparent film dressing

A
  • semi-occlusive
  • primary or secondary dressing
  • reduces infection risk
  • creates moist healing environment
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2
Q

hydrogel sheet dressing

A
  • hydrates wound
  • keeps bacteria out
  • promotes autolytic debridement
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3
Q

alginate dressing

A
  • primary wound care dressing
  • can absorb large quantities of exudate
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4
Q

autolytic debridement

A
  • body’s own enzymes break down nonviable tissue
  • hydrogel sheet dressing to promote
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5
Q

mechanical debridement

A
  • hydrotherapy
  • wet-to-dry dressings
  • wound irrigation followed by suction
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6
Q

autograft

A

transplanting someone’s own skin from unburned area to burned area

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7
Q

split-thickness graft

A

full epidermal & partial dermal layers & a % of fat layers from donor site
- graft survival is high

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8
Q

full thickness graft

A
  • full thickness of epidermal & dermal layers & % of fat layers from donor site
  • graft survival is less
  • outcome better if graft adherence occurs
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9
Q

meshed graft

A

stretched to cover greater surface area

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10
Q

sheet graft

A

donor graft laid down as is

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11
Q

how is edema measured with a burn?

A

circumferential measurements (no volumeter)

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12
Q

when is scar management completed after a burn?

A

6-12 weeks after wound closure

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13
Q

when is the emergent phase of a burn?

A

0-72 hours after

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14
Q

xenografts

A

biologic dressing
- bovine skin, processed pig skin to protect skin from infection, debride, comfort during emergent phase

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15
Q

allograft

A

human cadaver skin
-protect skin from infection, debride, comfort during emergent phase

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16
Q

superficial/epidermal burn

A

1st degree
- superficial epidermis
- PAIN: min to mod
- BLISTERING: none
- min erytheme (redness)
- HEALING TIME: 3-7 days

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17
Q

superficial partial thickness burn

A

superficial 2nd degree
- epidermis & dermis
- PAIN: significant
- BLISTERING: wet
- erytheme
- HEALING TIME: 1-3 weeks

18
Q

deep partial thickness burn

A

deep 2nd degree
- epidermis, deep dermis, hair follicles, sweat glands
- PAIN: severe, even to light touch
- erythema, with or without blisters
- high risk of turning into full thickness burn due to infection
- consider grafting to prevent infection
- SENSATION: highly impaired
- high potential for hypertropic scar
- HEALING TIME: 3-5 weeks (varies)

19
Q

full thickness burn

A

3rd degree
- epidermis, dermis, hair follicles, sweat glands, nerve endings
- PAIN: none
- SENSATION: none, even to light touch
- burn is pale, non blanching
- requires skin graft
- very high potential for hypertrophic scar

20
Q

subdermal burn

A
  • full thickness burn with damage to underlying tissue (fat, muscle, bone)
  • charring, exposed fat, tendons, muscles
  • electrical burn = nerve pathway destruction
  • significant peripheral nerve damage
  • surgical intervention for wound closure or amputation
  • extremely high potential for hypertrophic scar
21
Q

which burn phase includes charring?

A

subdermal burn

22
Q

what burn phase has no pain?

A

full thickness/3rd degree

23
Q

during what burn phase are skin grafts required?

A

full thickness/3rd degree

24
Q

what types of precautions are necessary during the emergent phase of burn?

A

0-72 hrs after burn
- universal precautions for staff/family

25
Q

what pharmacological treatment is used during the emergent phase to manage pain?

A

narcotic analgesics

26
Q

escharotomy & debridement

A

removing burnt/dead skin, allowing new vascularized skin to close up wound

27
Q

how long does the acute phase of burn last?

A

72 hrs after injury to wound closure (days or months later)

28
Q

basic first aid for a 1st degree burn

A
  1. immediately immerse in cool water/cool compress
  2. apply sterile dressing to cover area
29
Q

protocol for dorsal hand burns

A
  • Boutonniere precaution
  • avoid active or passive composite flexion (ROM to MP with IP straight, ROM to IP with MP & DIP straight, confirm extensor hood integrity before composite flexion allowed)
30
Q

ROM protocol for burn areas

A

gentle AROM/PROM early as possible except for post graft (wait until graft has adhered before AROM initated)

31
Q

what should be done for LEs before standing, walking, prolonged sitting are attempted after a burn?

A

compression wrapping for vascular support beforehand to avoid pooling of fluid/blood in LEs

32
Q

protocol following skin graft

A
  1. splint hand in safe position for 5-7 days to allow graft to take & wounds to heal (prevent deformity)
  2. AROM/PROM when graft has fully adhered
33
Q

how long is hand in safe position after skin graft?

A

5-7 days

34
Q

during which type of burn protocol is gross sensory screening completed?

A

electrical burns due to peripheral nerve involvement

35
Q

scar management protocol after a burn

A
  • mobilization orthosis (sub max stretch)
  • massage (manual, graded vibration)
  • compression (gloves, tubular gloves)
  • desensitization (graded touching, textures)
  • ROM (active, passive)
  • thermal modalities (ultrasound, moist heat)
36
Q

which modalities should be applied in scar management protocol after a burn?

A

ultrasound, moist heat

37
Q

pruritus

A

persistent itching, can lead to reopening of wound & skin maceration
- tx: compression garments, skin lubrication, cold packs, antihistamines

38
Q

edema management during acute phase of burn

A

elevate, AROM (if movement allowed), wrap with elastic bandage unless bulky wound dressing is used

39
Q

Splinting with hand burns

A
  • Splint opposite if burn is on volar side of hand (will develop contracture if not)
  • if burn is on dorsal side of hand, put it into extension as well (splint on same side)- makes client more functional
  • want position of discomfort
40
Q

Intrinsic plus

A

Safe position/antideformity/clam digger position
- MCPs in 70-90 degrees flexion
- IPs in 0 degrees extension