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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