BURN INJURY

Zhang wei Department of Surgery

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Burn injury is a acute damage caused by heat, electricity and chemical materials.

devastating injury very bad consequence septicemia and MSOF prevention

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heatBURN INJURY (3)

electricityChemical materialsRadioactivematerialslaserBURN INJURY (4)

lightningexplosiveBURN INJURY (5)

Daily lifeBURN INJURY (6)

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Prevention:BURN INJURY (12)

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PATHOPHYSIOLOGY OF BURN INJURY

AREA, DEPTH, AND SEVERITY OF BURN INJURY

CLINICAL MANIFESTATION AND DIAGNOSIS OF BURN INJURY

TREATMENT OF BURN INJURY

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PATHOPHYSIOLOGY OF BURN INJURY

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Pathologic stage effusion phase infective phase repair phase rehabilitative phase

2.Local lesions and general responses BURN INJURY (16)

3. Complications shock sepsis pulmonary complications and respiratory failure acute renal failure stress ulcer heart failure cerebral edema BURN INJURY (17)

AREA, DEPTH, AND SEVERITY OF BURN INJURY BURN INJURY (18)

Calculating area of burn injury Rule of nine Rule of palmBURN INJURY (19)

3 3 9X1(9%) 3 7 6 9X2(18%) 5 13 13 9X3(27%) 1 5 21 9X5+1(46%) 13 7BURN INJURY (20)

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2. Estimating depth of burn injury 0: epidermis 0: dermis superficial 0: superficial dermis deep 0: deep dermis 0: entire epidermis and dermis (full-thickness) BURN INJURY (23)

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3. Severity of burn injury mild: 0 20%; or with severe complications

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depth: superficial: 0and superficial 0 deep: deep 0 and 0 area: small area: 30%

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CLINICAL MANIFESTATION AND DIAGNOSIS OF BURN INJURY

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0BURN INJURY (33)

superficial 0 BURN INJURY (34)

superficial 0 BURN INJURY (35)

deep 0 BURN INJURY (36)

0BURN INJURY (37)

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Chemical burnsBURN INJURY (40)

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TREATMENT OF BURN INJURY

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1. emergency aids remove heat source avoid re-damage lessen contamination control pain manage combined injuryBURN INJURY (46)

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cold therapyBURN INJURY (49)

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Dont like this !BURN INJURY (52)

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2. General treatments (1) Correct burn shock (2) Prevention and treatment of systemic infection (3) Nutritional support BURN INJURY (54)

(1) Correct burn shock choice of fluid: water, crystalloid, colloid route for fluid administration: peripheral, central vein volume and rate of infusion: 24h volume = 1.5ml%burnweight (kg) 1/2 in first 8 h monitor:

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volume and rate of infusion for 0 and 0 burn

first 24h second 24h

volume of adult child baby of first 24h %burn/weight 1.5ml 1.8ml 2.0ml

colloid : moderate and severe 1:2 as left crystalloid major 1:1 basic water 2000ml 60-80ml/Kg 100ml/Kg as left

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(2) Prevention and treatment of systemic infection control of wound infection: systemic antibiotics: support therapy:

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(3) Nutritional support total energy requirement: proportions of carbohydrate, protein, and fat: replacement of vitamins and trace elements route

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3.Management of burn wound (1)debridement: (2)dressing and exposure methods:

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(3) removal of eschar: escharectomy tangential excision escharotomy eschar slough BURN INJURY (61)

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(4) skin graft:

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(5) management of burn wound infection: wet dressing local antibiotics

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Important points

evaluation of area and depth for burn injury emergency treatment principle of burn injury treatment of burn shock management of burn woundBURN INJURY (72)