Burns

Question 1

Allograft

Answer 1

Skin substitute, donor skin taken from another human

Body usually rejects in 10-14 days

Question 2

Autograft

Answer 2

Split-thickness skin grafts from an uninjured donor site of the patient, provides quick and permanent closure of the wound

Question 3

Two primary factors that influence the amount of tissue destruction that occurs following a burn injury are

Answer 3

1. Temperature

2. Duration of exposure

Question 4

Zone of coagulation

Answer 4

Area of maximum damage (exposed to the most amount of heat and ensures the most damage),
Area of irreversible tissue destruction

Question 5

Zone of stasis

Answer 5

Surrounds zone of coagulation,
where damage results in decreased tissue perfusion, tissue may be salvageable, the main goal of burn resuscitation is to increase tissue perfusion here and prevent any irreversible damage

Perfusion- process of a body delivering blood to a capillary bed in its biological tissue

Question 6

Zone of hyperemia

Answer 6

Tissues in the outer zones surrounding coagulation and stasis zones,
are damaged but with proper care should recover and heal,

w/o proper care further damage may result and increased tissue loss can occur

Question 7

Aim of care after burn injury

Answer 7

Reduce or prevent dermal ischemia, avoiding further tissue death

Question 8

Eschar

Answer 8

Residual narcotic layers of skin destroyed by direct heat damage or injury occurring secondary to heat damage

Question 9

Most common cause of burns

Answer 9

Fire/flame 42%

Question 10

Superficial burn injury

Answer 10

First degree, burn involves only the epidermal laters of the skin
Redness and pain
Dry, does not form blisters
Sensitive to air/ light touch
Heals within 3-6 days w/o residual scarring

Question 11

Partial-Thickness burn

Answer 11

Second degree, epidermal and extends down into the dermal layer
Large, thick blisters
Deep red- waxy white 
Leaks body fluid
Sensitive to pressure 
7-20days with residual scarring

Question 12

Superficial partial thickness

Answer 12

Upper layers of the papillary dermis
Clear blisters, weeping, wet skin
Will blanch when touched

Question 13

Deep partial-thickness burn

Answer 13

Entire epidermis, and entire dermis (spares base of hair follicle)
Appear white, and will not blanch when touched

Question 14

Full-thickness

Answer 14

Third degree, destroys entire epidermal, dermal layers of skin and extends down into the subcutaneous fat
Dry, leathery in texture, small fragile thin walled blisters
*nerve ends destroyed
At risk for contracture formation

Question 15

Deep full-thickness burn

Answer 15

Fourth-degree, all layers of skin and extends down into muscle, tendons or bone
Challenging to close, can result in partial or total loss of function
(Amputations may be warranted)

Question 16

Complications of inhalation injuries (pulmonary)

Answer 16

Carbon monoxide poisoning
Upper-airway obstruction
Restrictive defects

Question 17

Carbon monoxide toxicity and cyanide

Answer 17

Displacing oxygen and leading to asphyxia

Question 18

Complication of cardiac system- Burn shock

Answer 18

Fluid or plasma portion of the circulating blood levels (volume shifts),
Capillary permeability is increased immediately following a burn,
Greatest in first 8 hours, continues through 24 hours
Burn wound edema
Organ failure and tissue hypoxia can occur

Question 19

Hypermetabolism

Answer 19

Results in increased energy catabolism, skeletal muscle catabolism, immune deficiencies, peripheral lipolysis, and reduced bone mineralization and growth

Question 20

Leading cause of death following a burn injury

Answer 20

Infection

Question 21

Burn scar contracture

Answer 21

Shortening and tightening of the burn scar, are more problematic over large joints, limit ROM

Question 22

TBSA

Answer 22

Total burn surface area, use Lund-Browder, rule of nines, and rule of palms

Question 23

Debridement

Answer 23

Cleansing and removal of non adherent and non viable tissue (painful procedure)

Question 24

Impact on OT

Answer 24

Perform ADL’s, IADL’s,
Deep-partial thickness and full thickness that result in more sever scar formation, contractures, joint restrictions, major joints, high TBSA

Question 25

Client factors

Answer 25

Decreased joint mobility, and joint function, both passive and active ROM (from edema in initial stages, and scars and contractures later on

Muscle power and muscle endurance
PTSD

Question 26

Rule of nine

Answer 26

Convenient and rapid method,
May be used @ scene of accident
Body surface into areas of 9%
Limited accuracy for children

Question 27

Other causes

1. Scalding
2. Contact burns
3. Electrical
4. Chemical
5. Other

Answer 27

1. 31%
2. 9%
3. 4%
4. 3%
5. 11%

Question 27

Risk of morbidity/ mortality

Answer 27

Increasing burn size,
Age of patient,
Presence of pulmonary injury

Question 27

Criteria for burn injuries to be transferred to burn center

Answer 27

1. TBSA greater than 10% partial-thickness
2. Burns involving face, hands, feet, genitalia, and major joints
3. Full-thickness
4. Electrical burns
5. Chemical burns
6. Pulmonary injury
   7.

Question 27

Acute phase of burn wound management

Answer 27

Sepsis - most common cause of death to occur during this stage
Debridement

Question 28

Grafting priority

Answer 28

Hands given priority

Question 29

Cultured epithelium

Answer 29

Biopsy of unburned skin that is sent to a lab to grow skin for grafting,
3-4 weeks
Fragile
Sensitive to infection

Question 30

Emergency phase

Answer 30

ROM (preservation of joint function)
Appropriate positioning
Splinting

Question 31

Acute phase

Answer 31

Reconditioning
ROM
Splinting
Ambulatory and ADL

Question 32

Rehabilitation (after wounds and grafts have healed)

Answer 32

Reconditioning
ROM
Scar revision
Contraction release
Reconstruction 
Proper education