BURN PPT FOR SURGERY BY DR NAEEM SHAIKH

burn and scald for surgery

1. Burn حرق Dr Naeem Shaikh Hod /Reader Dept Of Ilmul jarahat Al Ameen Unani Medical college

2. Assessment of Depth of burn Partial thickness of burn (

3. INCIDENCE OF BURN India records 70L burn cases annually (1.4L Die, 2.4 Disability) 70% cases are 15-35y 4/5 cases are women or children 80% cases related to kitchen 250 to 300 acid attacks/ Yr

4. Skin The skin is the largest organ of the body, . skin protects from microbes Helps regulate body temperature Permits the sensation of touch, heat and cold

5. Burn A burn is a type of injury to skin, or other tissues caused by heat, cold, electricity, chemical, friction or radiation گرم یا سرد حرارت ، طبعی و کیمیائی عوامل سے ھونیوالی بافتوں کی بربادی کو حرق کہتے ہیں Burn is defined as a wounds caused by exogenous agent leading to coagulative necrosis Of the tissues.

6. Causes اسباب Physical Burn Heat, cold, electricity, radiation Chemical burn strong acid (HCL, H²SO⁴) Strong base ( NaOH ) Traumetic burn Friction

7. Classification of burn Flame burn (Commonest, Deep burn, Partial and full thickness burn, Respiratory complication) SCALD سلق (moist heat, hot liquid, vesicle, Deep burn, children old age) Fat or Oil Burn Frost Burn Electric Burn Chemical burn Traumatic Burn Rediation Burn SCALD

8. Estimation of burn area Assessment of burn area (TBSA) Assessment of Depth of burn Degree of Burn

9. Assessment of burn area Rule of nine(Wallace) Lund and Browder chart Palmer method

10. Assessment of Depth of burn Degree of burn

11. JACKSON’S THERMAL WOUND THEORY

12. Burn severity assessment

13. Effects of burn Local effect Pain Inflammation Necrosis infection Blister/Vesicle Discoloration Hepermia Disability General effect Oedema Fever Pain Shock Infection Hypothermia Anaemia

14. Systemic effect Fluid Loss Respiratory Complications Renal complication Cardiovascular complication Multiple organ failure GIT

15. Assessment of Depth of burn Superficial burn (epidermis, Red without Blister, Dry, Painful,) Superficial Partial thickness of burn (Extend into superficial dermis, redness with clear Blister,, moist, very painful) Deep Partial thickness of burn (Deep extend into deep dermis, Yellow, Muscle compartment syndrome, hair follicle) Full thickness of burn (Full thickness of dermis and hypodermis, No pain, Black, Dry)

16. Degree of burn First degree of burn (epidermis superficial layer, quick heal, hypermia,slight oedema , pain) Second degree of burn (epidermis full thickness, vesicle,) mild (hair follicle, dermal gland, pain+, Heals,) Severe (epidermis dermis, slow healing process, skin grafting,) Third degree of burn (dermis epidermis, fat, Muscle, Bone, irreversible destruction, skin tough dry thrombosed , No pain, skin grafting,)

17. CLINICAL FEATURES of burn Pain Severe anxiety(rapid puls , palpitations, increased RR, hypotension.) Local tissue damage Fluid Loss and dehydration (hypovolemic Shock, cardiogenic shock) Special site Inflammation infection Asphyxia Head injury Coma

18. Management of burn First aid Flame burn Electric burn Chemical burn Emergency treatment Clear Airway(Mouth to mouth respiration,O2, endotracheal intubation, tracheostomy tube) Regulate body temperature Maintain blood pressure Treatment of shock

19. Treatment of shock Sedative (low dosage)(barbiturates) Analgesic (tramadol) Iv fluids phenobarbitone Fluid resuscitation Parkland method of fluid resuscitation 4ml×TBSA×Wt in kg 4×20×60=4800 2400ml/8hrs 2400ml/16hrs

20. Wound care Tetanus injection Tetanus immunoglobulin (250-500 unit) Debritment of wound ASD Sufra Tulle Antiboitics ointment (neomycin, Silver sulfa, Gentamycin,

21. Antibiotics Cephalosporin Mikacin Quinolones Nutrition 40TBSA required 2000 cal / sqemeter of burn area Nasogastric tube Iv fluids Vitamins A, C, E, some B vitamins and zinc Multivitamin syp Water 60—100ml/ hrs

22. Surgical Treatment Escharotomy Skin grafting Fasciotomy Blood transfusion

23. Skin grafting

24. Thanks