Term
| Criteria for burn admission |
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Definition
-partial thickness (2nd deg) burns >10% total body surface area
-burns involving face, hands, feet, genitalia, perineum, major joints
-full thickness (3rd deg) burns in any age group
-electrical burns (inclu. lightening)
-chemical burns
-inhalation injury
-burn injury in pts w/ preexisting medical disorders that could complicate management, prolong recovery, or affect mortality
-children in hospitals w/o resources to care for them
-burn pts who require special social, emotional, or long-term rehab intervention |
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Term
| Integumentary system characteristics |
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Definition
-controls thermoregulation
-sensory input
-protect from infection
-conserve body fluids
-physical and personal identity |
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Term
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Definition
-very thin layer
-avascular
-purpose: protection, water proof, regeneration |
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Term
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Definition
-20-30x thicker than epidermis
-vascular
-contains collagen and elastic fibrils, blood vessels, lymphatics, nerves
-gives tensile strength and provides nutrition to epidermis
-bilayered
-rete peg region (epidermal-dermal jnc) |
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Term
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Definition
| no damage unless prolonged exposure |
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Term
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Definition
| rate of cellular death doubles with each degree rise in temp. |
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Term
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Definition
| only brief exposure will cause cellular and skin breakdown |
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Term
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Definition
| aka superficial burn, i.e. sunburn, only epidermis burned w/ no risk for hypertrophic scarring or contracture, seldom clinically significant, pain and redness (analgesia, early elevation, AROM exs), heals <3-7 days, peeling |
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Term
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Definition
| aka partial thickness burns (either superificial-SPT, or deep-DPT); dermis damage |
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Term
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Definition
| burn through all layers, aka full thickness-FT burn, dry and leathery skin |
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Term
| superficial partial thickness burn |
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Definition
| uninjured dermis and epidermal appendages at risk, skin graft may improve cosmetic outcome, heals spontaneously in 2-3 wks |
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Term
| Deep partial thickness burn |
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Definition
| swelling, pain, blisters, moist, capillary refill, entire epidermis and portion of dermis burned, provide analgesia, early elevation, and AROM exs |
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Term
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Definition
| deep into dermis (deep PTB) or entire thickness of epidermis and dermis (subdermal/full thickness) burn, dec. pain and blisters, dry, absent capillary refill, risk for vascular compromise, tight, white, dry looking skin, leathery skin may bind body parts if pressure rises and req. escarotomy/fasciotomy to relieve pressure |
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Term
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Definition
| involve deep structures, similar to deep FT but involves damage to muscle, tendon, and/or bone |
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Term
| Integumentary complications of burns |
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Definition
| hypertrophic scars, contractures, pruritis (itching), dryness, sensory changes, dec. sweating, dec. thermoregulation |
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Term
| GI complications of burns |
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Definition
| dec. peristalsis, high risk for gastric ulcers, ileus commonly affected |
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Term
| GI complications of burns |
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Definition
| dec. peristalsis, high risk for gastric ulcers, ileus commonly affected |
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Term
| Pulmonary complications of burns |
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Definition
| inhalation injury, signs (facial burns, singed nasal hairs/eyebrows, harsh cough or hoarseness, adventitious breath sounds, respiratory distress, carbonaceous sputum (white snot), headache), carbon monoxide poisoning |
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Term
| cardiovascular complications of burns |
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Definition
| inc. CO and HR, altered platelet conc., RBC dysfxn, dec. Hgb and Hct, reduced plasma and intravascular fluid leading to edema |
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Term
| Metabolic complications of burns |
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Definition
| inc. in catabolism leading to dec. in body weight (dobb hoff tube often needed), dec. in energy stores, inc. in caloric needs, neg. nitrogen balance, muscle tissue often used as energy source, core temp is dec. so need to inc. room temp |
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Term
| Split-thickness skin graft (STSG) |
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Definition
| contains all of epidermis and only superficial layers of dermis |
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Term
| Full-thickness skin graft (FTSG) |
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Definition
| contains epidermis and most of the dermis |
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Term
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Definition
| skin graft that's applied without any alteration after it's harvested; common in face, neck, and hands |
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Term
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Definition
| skin graft that's run through a mesher permitting the graft to be expanded to allow for a larger surface area |
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Term
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Definition
| aka heterograft, skin from another species, typically a pig |
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Term
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Definition
| aka homograft, skin from an indiv. of the same species, typically a cadaver |
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Term
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Definition
| skin taken from pt's own skin |
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Term
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Definition
| site where skin for a graft is harvested from; typically the back, buttock, or thighs |
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Term
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Definition
| devitalized tissue, necrotic, dry and leathery appearance |
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Term
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Definition
| incision made to relieve the pressure in a compartment |
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Term
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Definition
| incision made through eschar to relieve compression and maintain normal circulation |
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Term
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Definition
| consists of macrophages, fibroblasts, and blood vessels; healthy and healing tissue, provides a scaffold for epidermal cell migration, appears red and beefy |
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Term
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Definition
| epidermal cell detach from the basal layer and migrate across the wound, proliferate by mitosis and differentiate into mature epidermal cells (closing of wound) |
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Term
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Definition
| ABCDE's, clear trauma to spine, fxs, or internal injuries, remove clothing and jewelry, intubate before it's too late, estimate TBSA (total body surface area), fluid resuscitation, monitor urine output for kidney fxn, EKG, bp, abdominal and extremity pressures, any circumferential burn needs to be monitored for compartment syndrome |
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Term
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Definition
| primary excision of eschar, debridement, skin grafting (thinner grafts adhere better, adherence dep. upon penetration of blood vessels into new graft site and immobilization) |
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Term
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Definition
| used to prevent or treat burn wound infection and/or sepsis |
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Term
| biomechanics of skin and scar tissue |
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Definition
1. collagen fibers-give tensile strength
2. elastic fibers-give tissue recoil
3. ground substance-lubricates tissue
4. burn scar-collagen fibers arrange in whorls or nodules, elastic fibers lost |
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Term
| PT EVALUATION of IP burn pt |
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Definition
| ROM, strength, sensation, edema, bed mobility, transfers, ambulation, burn wound (%TBSA, location, depth), prior level of fxn, work/social hx, PMH |
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Term
| PT TREATMENT of IP burn pt |
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Definition
| ROM (A to AA to P), conditioning, positioning (maintain tissue in elongated state, max. fxnal position, dec. edema and risk of neuropathy, splint as needed), ADLs, chest PT (for ventilated pts), ambulation |
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Term
| how longs does it take for scars to remodel |
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Definition
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Term
| Types of pressure providing devices for dec. hypertrophic scars |
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Definition
| compression garments, interim pressure garments (custom), ace wraps, tubigrip |
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Term
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Definition
| apply asap (wounds 80-90% healed is ready), 23 hr wear, child need freq. remeasurements, consider lifestyle and work hx |
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Term
| Pros of pressure garments |
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Definition
| flattens scar, dec. pruritis/edema, thins dermis, potential acceleration of car maturation process |
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Term
| Cons of pressure garments |
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Definition
| compliance, pressure not equally applied, cost, uncomfortable, difficult to don, hot, may cause skin breakdown |
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Term
| OP goals for scar management |
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Definition
| optimal cosmesis of burn wound, preserve ROM to wnl, min. itching, indep. HEP, return to work/school, indep. ambulation/ADLs/scar management |
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