Burns Flashcards
(52 cards)
Burn injury results from
thermal, chemical, electrical, or radioactive agents
Burn wound - zones
Zone of coagulation
Zone of stasis
Zone of hyperemia
Burn wound - zone of coagulation
cells are irreversibly injured, cell death occurs
Burn wound - zone of stasis
cells are injured, may die without specialized tx, usually within 24-48 hours
Burn wounds - zone of hyperemia
minimal cell injury, cells should recover
Degree of burn - first degree
epidermal burn
damage is to epidermis only
no blistering, minimal edema
Degree of burn - second degree - superficial partial thickness burn
Epidermis and upper layer of dermis are damaged
Blanching with brisk capillary refill
Blisters, moist surface, weeping
Moderate edema, painful, sensitive to touch and temp changes
Degree of burn - second degree - deep partial thickness burn
Severe damage to epidermis and dermis with injury to nerve endings, hair follicles and sweat glands
mixed red or waxy white appearance
Blanching with slow capillary refill
Broken blisters, wet surface
Marked edema
Sensitive to pressure but insensitive to light touch or soft pin prick
Degree of burn - third degree
Full thickness burn
Complete destruction of epidermis, dermis, and subcutenous tissues - might extend into muscle
White, charred, tan, or black appearance
No blanching - poor circulation
Dry leathery surface, depressed area
Little pain - nerve endings destroyed
Degree of burn - fourth degree
Subdermal burn
Complete destruction of epidermis, dermis, with involvement of subcutaneous tissues and mm
Charred appearance
Destruction of vascular system
Additional complications if electrical burn
Extent of burned area - rule of
Nines for estimating burn area Head and neck 9% Anterior trunk 18% Posterior trunk 18% Arms 9% each Legs 18% each Perineum 1%
Classification by % of body area burned - Critical
10% of body with 3rd degree burns and 30% or more with 2nd degree
Complications are common
Classification by % of body area burned - moderate
less than 10% with 3rd degree and 15-30% with 2nd degree
Classification by % of body area burned - minor
less than 2% with 3rd degree and 15% with 2nd degree
Complications of burn injury
Infection Shock Pulmonary complications Metabolic complications Cardiac and circulatory complications Integumentary scars
Complications of burn injury - Pulmonary complications
Smoke inhalation - pulmonary edema, airway obstruction
Restrictive lung disease if burns to trunk
Pneumonia
Complications of burn injury - Metabolic
Inc metabolic and catabolic activity results in weight loss, negative nitrogen balance and dec energy
Complications of burn injury - Cardiac and circulatory
fluid and plasma loss results in dec CO
Burn healing - Epidermal healing
Retention of viable cells allows for epithelialization to occur
Protection of epithelial cells is critical
Loss of sebaceous glands can result in drying and cracking of wound
Burn healing - dermal healing
results in scar formation
scars are initially red or purple, later become white
Burn healing - phases
Inflammatory phase
Proliferative phase
Maturation phase
Burn healing - Inflammatory phase
characterized by redness, edema, warmth, pain, decreased ROM, lasts 3 to 5 days
Burn healing - Proliferative phase
Granulation or fibroblastic phase
Four primary events - Angiogenesis, granulation formation, wound contraction, epithelialization
Burn healing - proliferative phase - fibroblasts…
synthesize collagen, glycoaminoglycans, and elastin
Type III collagen is initially deposited and replaced later with Type I collagen
Myofibroblasts are responsible for wound contraction in dermal wounds
