Burns in surgury from lawrens & scharts .pptx

Its about burning in surgury by dr narges dehghan. She is fellowship of plastic surgury

1. Burns Dr N.Dehghani

2. PATHOPHYSIOLOGY OF BURN INJURY Epidermal burns (first-degree burns) Partial-thickness burns (second-degree burns) Full-thickness burns (third-degree burns) fourth-degree

3. Lund and Browder chart

4. CLASSIFICATION OF BURNS Burns are commonly classified as thermal, electrical, or chemical burns Inhalation Injury : less apparent , severe morbidity and mortality,, occur during a fire in an enclosed space,, The treatment of inhalation injury is largely Supportive ,, The patient will initially experience headache, progressing to dizziness, weakness, and syncope CO poisoning should be strongly suspected in any patient who presents with altered mental status following exposure to smoke pulse oximetry is not accurate in detecting CO poisoning;

5. CLASSIFICATION OF BURNS Electrical Burns low-voltage (<1,000 V ) household(120 V):only small cutaneous burns high-voltage (>1,000 V) injuries industrial current contact: underlying soft tissue damage produce blunt trauma cataracts and peripheral neuropathy

6. CLASSIFICATION OF BURNS Chemical Burns Alkalis,, Acid,, Organic compounds

7. INITIAL CARE OF THE BURN PATIENT Burn patients should be considered victims of multiple trauma Stop the Burning Process Primary Survey Resuscitation Secondary Survey Burn Center Referral

8. INITIAL CARE OF THE BURN PATIENT Burn Center Referral

9. DEFINITIVE CARE OF BURN INJURIES Resuscitation Wound Coverage Period Rehabilitation

10. DEFINITIVE CARE OF BURN INJURIES Resuscitation Consensus formula the Parkland or Baxter formula 2–4 mL lactated Ringer’s × body weight (Kg) × %TBSA burns = total fluid for the first 24 hr . For the first 8 hours after injury, give half the total calculation. Second and third 8 hr after injury, give one-fourth the total calculation . guided by patient response: urine output, vital signs, and mental status compartment syndrome: escharotomy ,, fasciotomies

11. DEFINITIVE CARE OF BURN INJURIES Resuscitation compartment syndrome escharotomy

12. DEFINITIVE CARE OF BURN INJURIES Wound Coverage Period Excision and Skin Grafting early excision: fascial and tangential excision Autograft:full-thickness or split-thickness Allograft

13. DEFINITIVE CARE OF BURN INJURIES Wound Coverage Period

14. DEFINITIVE CARE OF BURN INJURIES Rehabilitation begins at the time of injury aimed at preventing and correcting contractures stretching exercises, tightfitting garments

15. DEFINITIVE CARE OF BURN INJURIES Infection Control Burn wound sepsis silver nitrate ,, silver sulfadiazine,, mafenide acetate The most effective technique in the battle against burn wound infection is early burn excision and skin grafting Pneumonia thrombophlebitis Localized infections in exposed bone or cartilage, the urinary

16. Care of Outpatient and Minor Burns less than 10% TBSA in children or in the elderly are less than 5% TBSA begins with removal of the offending agent and cooling the injury water at 12 to 25°C Epidermal burns without blistering do not require topical care

17. Treatment of Itching and Pain

18. Thanks for your attention