Post on 11-Apr-2017
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BURNS
Defination :• Burns - Wound characterized by coagulative
necrosis of skin & underlying tissues.
TYPES OF BURNSBASED ON CAUSE
ORDINARY
SCALDS
ELECTRIC BURNS
CHEMICAL BURNS
RADIATION BURNS
COLD BURNS
ORDINARY BURN
SCALDS
TYPES OF COLD BURNS
FROSTBITE
PATHOLOGY OF BURNS
LOCAL
Severity of burn
Extent Of Burn
Vascular changes
Infection
SYSTEMIC
Shock
Biochemical Changes
Changes in Blood
Systemic lesions
Pathophysiology : Burns ( coagulative necrosis) Cellular injury & inflammation Release of vasoactive substances Increased capillary permeability Edema Burns shock Blister formation Hypovolemia Blood flow diversion Ischemia Renal GI mucosal necrosis ARF Curling’s ulcers
SEVERITY OF BURNS
ESTIMATE EXTENT OF BURN
Degree of Burn
1st Degree 2nd DegreePartial Thickness
2nd Degree Deep Burns
3rd Degree 4th Degree
Involvement Epidermis Epidermis + Dermis
E+ D E+D+Subcut tissue
E+D+S+muscles, tendons & bone
Appearance
Symptoms & Signs
Pain ++ Pain ++++ Painful -less severe
Painless,insensitive, Severe Edema
No Edema
Healing 3-5 days , spontaneousNo Scarring
2 weeks, min scarring, minimal discolouration
2-6 weeksHypertrophic scarring / formation of contractures
No spontaneous healing
No spontaneous healing
Degree of Burn
1st Degree 2nd DegreePartial Thickness
2nd Degree Deep Burns
3rd Degree 4th Degree
Involvement Epidermis Epidermis + Dermis
E+ D E+D+Subcut tissue
E+D+S+muscles, tendons & bone
Appearance Red to PinkDry, No Blisters
Red to pink, Wet and weeping woundsThin-walled, fluid-filled blisters
Mottled: Red, pink, or white areaMoist
Dry, leathery & rigid, Eschar (hard and in-elastic)Red, white, yellow or black
Black (dry, dull and charred)Eschar tissue: hard, inelastic
Symptoms & Signs
Pain ++ Pain ++++ Painful -less severe
Painless & insensitive to palpation, Severe Edema
No Edema
Healing 3-5 days , spontaneousNo Scarring
2 weeks, min scarring, minimal discolouration
2-6 weeksHypertrophic scarring / formation of contractures
No spontaneous healing
No spontaneous healing
TREATMENT
Treatment of Shock
1) Sedation
2) Fluid Resuscitation
3) Maintenance of Airway
General Treatment
1) Escharotomy and Fasciotomy
2) Tetanus Prophylaxis3) Antibiotics
4) Nutritional Support5) Gastric
decompressio6) Treatment of GI
complication
Local Treatment
1) First aid measures2) Burn Wound care
3) Skin grafting4) Physical therapy and Rehabilitation
COMPLICATION OF THERMAL BURNSCurling Ulcer
Acute Pancreatitis
Acute Acalculous Cholecystitis
Superior Mesenteric Artery Syndrome
Non Occlusive Ischemic Enterocolitis
Myocardial Infarct