Exam 1- Burns 2 Flashcards Preview

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Flashcards in Exam 1- Burns 2 Deck (33):
1

Rule of 9: what is it?

how we can decide how much of out body has been burnt

2

Rule of 9: chest %

18%

3

Rule of 9: back %

18%

4

Rule of 9: one arm %

9%
Front is 4.5% and back is 4.5%

5

Rule of 9: one leg %

18%
Front is 9% and back is 9%

6

Rule of 9: head %

9%

7

Rule of 9: genital %

1%

8

3 zones of burns

~coagulation
~stasis
~hyperemia

9

Coagulation zone of burns

~Necrosis
~Bad enough burned that it dead (already dead)
~Need to clean out, relieve the pressure

10

Stasis zone of burns

~Ischemia
~If we do not intervene, it will go to the coagulation
~if we intervene correctly, can go to hyperemia; if we don’t intervene correctly, can go to coagulation

11

Hyperemia zone of burns

~Inflammation
~Just read and inflamed; trying to heal

12

Types of grafts

~allografts
~Xenografts
~Skin substitute
~Biosynthetic
~Autograft

13

Allograft

~Cadaver
~Have been able to culture human fibroblasts and grow these cells- other human tissues

14

Xenografts

~Animals, usually pigs- will use split thickness- we need to have some of ret layer of the dermis
~Our body will reject it eventually, but it will keep the env appropriate for healing; after a while, our body will slough it off

15

Skin substitute grafts

~Bovine collagen
~Will impregnate the gauze with something to help keep the wound from infection/ help heal

16

What is a split thickness graft?

~Leave some so that you body will heal
~epidermis and part of dermis

17

What is a full thickness graft?

the whole depth
~the full dermal thickness

18

Mesh graft

~Autograft
~Can turn into mesh then will be able to stretch; turns it into a bunch of little wounds instead of one big wound (takes a lot less time!)

19

Autograft

~It’s us; we are not going to reject it
~We can take a sample of our skin, send it to a lab, and get sheets of our skin (takes a month or more depending on the amount of the burn)
~Can make a wound to heal a wound
~Want to have less scaring on: Face, hands, genital, feet, joints
~Mess graft
~Table 24.4 is good for positioning (will not have to write this for exam)
~Will take months to heal

20

How long does it usually take a scar to heal?

up to 2 years

21

what happens when a scar heals?

the skin will contract
~can lose PROM
~Can lose functional mobility
*have to stretch the tissue

22

what are the names of two types of bad scars?

Keloid and Hypertrophic

23

Hypertrophic scars

~goes up (not out)
~stays inside the boarders of the wound

24

Keloid scars

(worse)
~goes outside the original boundaries of the scar
~up and out
~people of color are more likely to have this

25

Why is positioning important?

~important for good ROM
~need to work on ROM to avoid contractures from forming

26

Scars and pressure

~~Deformed through wolfs law (PRESSURE)
~Pressure is huge for burn pts
~Pressure garments to decrease pressure; only to bath; helps to lay down collagen uniformly
~Under armor can help some (not as much) as an alternative- not as much pressure

27

What can you lose during a burn?

~ you can have sensation issues from losing some nerves
~Sabesous gland (need to add moisture)
~could have hair in weird areas now (have to start shaving now)
~can no longer sweat- will over heat (temperature control problem)- can get a heat stroke easier
~Tensile strength- it is weaker so be careful!

28

What is a Z-plasty?

~you do this when a scar is too tight
~will have to be careful with the two new scars

29

What is a good goal for venous?

edema- swelling

30

What are categories for short term/ long term goals?

~blood flow
~nutrient
~environement
~size (undermining, etc)

31

Examples of goals

~Pts wound will have 50% decrease in eschar by 2 weeks so that that wound will be facilitated though the healing process
~Pt will have complete absence of eschar in 4 wks;
~Pt;s wound will diminish by 2 cm circum. in 4 wks;
~Pt's undermining will be absence by 4 weeks in order to promote a health wound bed to promote healing

32

Details on environment when goal writing

~many be full of ec, sloff, etc- removal
~by %, time (in order to facilitate a proper wound bed to facilitate healing)
~moist/ dry
~Goal for dry- want to moisten to reach proper moisture to promote healing

33

Details on size when goal writing

~Undermining, tunneling, depth, width, etc
~Things that you measure distance
~Decrease/ reduce to promote closure of wound