Management

1
Superficial PTB 2nd Degree

• Pain, blisters, moist, capillary refill
• Entire epidermis and portion of dermis
• Analgesia and early elevation AROM exercises

2
Superficial PTB 2nd Degree

• Uninjured dermis epidermal appendages at risk
• Avoid trauma, edema, and infection Follow-up
  immediately if cellulitis occurs

3
Superficial PTB Post Burn Day (PBD) 28
4
Full Thickness 3rd Degree

• Entire thickness of epidermis dermis

• Decreased pain blisters
• Dry
• Absent capillary refill

5
Full Thickness 3rd Degree

• Heals by contracture epithelial ingrowth from
  edges, or
• Excision Skin grafting

6
Sub dermal burns 4th Degree
7
Sub dermal 4th Degree
8
4th degree Digit Amputations
9
Pathology Chronic Edema
10

• Position of comfort will become the
• Position of contractures

11
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12
Minimal Hypertrophic Scarring
13
Severe Hypertrophic Scarring
14
Post Operative Hand Splinting
15
Splinting with Kirschner-wire
16
Post-op Wound vac for hands
17
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18
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19
Digit Serial Casting
20
Deep Palmer Burn
21
Volar Thumb Palm Burns

• Thumb adduction contracture
• Cupping of the palm

22
PBD 2 months
23
PBD 4 months
24
PBD 6 months Release FTSG
FTSG
25
PBD 8.5 months
26
PBD 2 months
27
SF Ray
PBD 6 months
28
PBD 8.5 months
29
POD 4 integra
POD 7 AROM
30
STSG over Integra
31
PBD 1 year
PBD 4 months