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1. O T IN ORTHOPAEDIC BURNS PRESENTATION BY GROUP 3

2. Definition Burns are injuries to the skin or underlying tissues caused by heat, radiation, electricity, chemicals, or friction. They can range in severity from mild to severe and can cause damage to the skin, blood vessels, nerves, and other tissues. BURNS

3. There are several types of burns, categorized based on the cause and severity of the injury. Here are the most common types: Thermal burns: These burns occur due to contact with flames, hot objects, steam, or hot liquids. They can range from mild to severe, depending on the duration and intensity of exposure. Chemical burns: These burns are caused by contact with strong acids, alkalis, or other corrosive substances. Chemical burns can be very damaging and may require immediate medical attention. Electrical burns: These burns result from contact with an electrical current. They can cause damage not only to the skin but also to internal tissues and organs, even if the skin appears unaffected. Radiation burns: Exposure to high levels of radiation, such as from nuclear accidents or cancer treatments, can cause radiation burns. These burns can be severe and may require specialized medical treatment . Friction burns: These burns occur when the skin rubs against a rough surface, causing heat and damage. Examples include rope burns or road rash from a motorcycle accident . Sunburns : Sunburns are a type of thermal burn caused by overexposure to ultraviolet (UV) radiation from the sun or tanning beds. They can range from mild redness and discomfort to severe blistering and peeling.

4. FIRST-DEGREE BURNS : These are the mildest type of burns and only affect the outer layer of the skin, known as the epidermis. Symptoms include redness, pain, and mild swelling . First-degree burns usually heal within a week without scarring. SECOND-DEGREE BURNS : These burns affect both the outer layer of the skin (epidermis) and the underlying layer (dermis). They can be further classified into two subcategories : Superficial Partial-thickness Burns : These burns involve the top layers of the dermis and cause symptoms like blistering, severe pain, redness, and swelling. They typically heal within two to three weeks with minimal scarring. Deep Partial-thickness Burns : These burns extend deeper into the dermis and cause symptoms like white or waxy appearance, fluid-filled blisters, intense pain, and swelling. Healing may take several weeks to months, and scarring is more likely.

5. THIRD-DEGREE BURNS : These burns are the most severe and extend through all layers of the skin, reaching the underlying tissues. They may appear white, blackened, or charred. Third-degree burns often result in numbness because nerve endings are destroyed. Immediate medical attention is necessary, and skin grafting or other surgical interventions are usually required for healing.

6. THERMAL BURNS : These burns occur due to exposure to heat sources such as flames, hot objects, steam, or hot liquids. Common causes include fires, scalding water, contact with hot surfaces or objects, and explosions . CHEMICAL BURNS : These burns result from contact with strong acids, alkalis, or other corrosive substances. They can occur due to accidental spills, exposure to industrial chemicals, or improper handling of household cleaning products . ELECTRICAL Burns : These burns are caused by contact with an electrical current. They can occur from faulty electrical equipment, exposed wiring, or lightning strikes. Electrical burns can be particularly dangerous as they can cause internal injuries and damage to organs .

7. RADIATION BURNS : Exposure to high levels of radiation, such as from nuclear accidents, X-rays, or radiation therapy for cancer treatment, can cause radiation burns. These burns can be severe and have long-lasting effects on the skin and underlying tissues . FRICTION BURNS : These burns occur when the skin rubs against a rough surface, generating heat and causing damage. Examples include rope burns, road rash from accidents, or friction burns from machinery or equipment . SUNBURNS : Sunburns are a type of burn caused by overexposure to ultraviolet (UV) radiation from the sun or tanning beds. Prolonged exposure without adequate protection can lead to skin damage and burns

8. Redness : In first-degree burns and superficial partial-thickness burns, the affected area may appear red or pink . Blistering : Superficial partial-thickness and deep partial-thickness burns often lead to the formation of fluid-filled blisters on the skin. Blisters may be clear or filled with blood or other fluids . Swelling : Burns can cause local swelling or edema in the affected area due to inflammation and fluid accumulation . Pain : Burns are typically painful, especially in the superficial and deep partial-thickness stages. Third-degree burns may initially be less painful due to nerve damage, but surrounding areas may be extremely painful . Skin Texture Changes : Depending on the severity of the burn, the affected skin may become dry, leathery, or charred. It may also feel rough or waxy.

9. Peeling or sloughing : As burns heal, the damaged skin may start to peel or slough off. This is a natural part of the healing process . Numbness or decreased sensation : In severe burns, nerve endings may be damaged, leading to numbness or decreased sensation in the affected area . Scarring : Deep burns, including third-degree burns, can result in significant scarring. The appearance of scars can vary depending on the individual and the location of the burn . Respiratory symptoms : Inhalation of hot gases or smoke during a burn incident can cause respiratory symptoms such as coughing, difficulty breathing, or hoarseness.

10. Assessment : Evaluate the burn’s depth, size, and location to determine its severity. This helps categorize burns into first, second, or third degree . Initial First Aid: Immediately cool the burn with running water for a specific duration, usually 10–20 minutes, to minimize tissue damage . Pain Management : Administer pain relief, often with analgesics, to make the patient more comfortable . Cleaning and Dressing : Clean the burn area and apply sterile dressings to prevent infection. Some burns might require specialized dressings or topical treatments . Fluid Replacement : For severe burns, intravenous fluids may be necessary to prevent dehydration and maintain blood pressure .

11. Tetanus Vaccination : Ensure the patient’s tetanus vaccination is up to date, especially for burns with potential contamination. Monitoring and Infection Prevention : Regularly assess the burn for signs of infection, and administer antibiotics if needed. Proper hygiene is crucial Pain and Itch Management : Continued pain management and addressing itching, which can be common during the healing process.

12. Excision and Debridement : Removing damaged tissue is crucial to promote healing. Surgical excision involves cutting away burned areas, and debridement removes dead or contaminated tissue . Skin Grafting : In cases where the burned area is extensive, skin grafts may be necessary. This involves taking healthy skin from one part of the body (donor site) and transplanting it to cover the burn area. Flap Surgery : For deep burns affecting underlying structures, flap surgery may be performed. This involves transferring skin, along with its blood supply, from a nearby or distant healthy area to cover the burn . Reconstructive Surgery : After the initial healing, reconstructive surgery might be considered to improve the appearance and function of the affected area .

13. Occupational therapy plays a crucial role in the rehabilitation and long-term management of burns. Key aspects include: Assessment of Functional Impairments : Occupational therapists assess the impact of burns on a person’s ability to perform daily activities and identify areas of functional impairment . Range of Motion Exercises : Designing and implementing exercises to maintain or improve joint flexibility and prevent contractures, which are common after burns . Scar Management : Providing interventions to manage and minimize scarring, including scar massage and the application of pressure garments . Custom Splinting : Designing and fitting custom splints to support proper positioning and prevent deformities during the healing process . Activities of Daily Living (ADL) Training : Assisting individuals in relearning or adapting daily activities such as dressing, grooming, and eating to promote independence.

14. Psychosocial Support : Addressing the psychological and emotional aspects of recovery, including counseling and support to cope with changes in body image and self-esteem . Assistive Devices and Adaptive Equipment : Recommending and training individuals on the use of assistive devices and adaptive equipment to enhance independence . Work and Vocational Rehabilitation: Collaborating with individuals to assess their ability to return to work and providing vocational rehabilitation to support a successful transition . Community Reintegration : Assisting with community reintegration by addressing challenges related to social participation, transportation, and leisure activities. Occupational therapy aims to improve the overall quality of life for individuals recovering from burns by focusing on functional independence and participation in meaningful activities .

15. Seek Immediate First Aid : For minor burns, cool the affected area with running water for 10-20 minutes. Avoid using ice. For severe burns, seek emergency medical attention. Professional Medical Assessment : Consult with healthcare professionals for a thorough evaluation of the burn’s severity and appropriate treatment. Do Not Pop Blisters : If blisters form, do not pop them, as they serve as a protective layer. Keep the area clean and covered. Pain Management : Use over-the-counter pain relievers, as recommended by healthcare professionals, to manage pain. Avoid Home Remedies : Avoid using home remedies like butter, toothpaste, or oils on burns, as they can worsen the injury and increase the risk of infection. Keep the Area Clean : Practice good wound care by keeping the burn clean and covered with a sterile dressing to prevent infection. Stay Hydrated : Adequate hydration is essential for the healing process. Drink plenty of fluids unless otherwise directed by medical professionals. Follow Medical Instructions : Adhere to any prescribed medications, ointments, or dressings as instructed by healthcare providers. Watch for Signs of Infection : Monitor the burn for signs of infection, such as increased redness, swelling, or discharge. Seek medical attention if these occur.

16. Burn injury is an important public health concern and it is associated with high morbidity and mortality. Burns are one of the most common household injuries, especially among children Burns are characterized by severe skin damage that causes the affected skin cells to die. Some burns may be treated with first aid, most burns are severe injuries that requires immediate medical attention.

17. Johnson, R.M. and R. Richard, Partial-thickness burns: identification and management. Adv Skin Wound Care, 2003. 16(4):178-87. Herndon DN (Ed): Total Burn Care. Philadelphia, Elsevier Saunders, 2007 Jaskille , A.D., et al., Critical review of burn depth assessment techniques: Part I. Historical review. J Burn Care Res, 2009. 30(6):937-47. Jaskille , A.D., et al., Critical review of burn depth assessment techniques: part II. Review of laser doppler technology. J Burn Care Res, 2010. 31(1):151-7. Reed, J.L. and W.J. Pomerantz , Emergency management of pediatric burns. Pediatric Emerg Care, 2005. 21(2):118-29.