BURN INJURY Zhang wei Department of Surgery

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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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heat
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electricity
Chemical materials
Radioactive materials
laser
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lightning
explosive
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Daily life
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Prevention
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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

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3. Complications ? shock ?
sepsis ? pulmonary complications and
respiratory failure ? acute renal
failure ? stress ulcer ? heart
failure ? cerebral edema
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AREA, DEPTH, AND SEVERITY OF BURN INJURY
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Calculating area of burn injury ? Rule of
nine Rule of palm
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????? ?? ?????
?? ?? 3 ??
3 9X1(9) ??
3 ??? ??? 7
??? 6 9X2(18) ??
5 ?? ???
13 ??? 13 9X3(27)
?? 1 ??? ??
5 ??? 21
9X51(46) ??? 13
?? 7
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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)
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3. Severity of burn injury mild ?0
lt10TBS moderate ?0 10-30 or
?0lt10TBS severe total area
30-50 or ?0 10-20 or with
shock, airway burn, combined
injury major total area gt50 ?0 gt20
or with severe complications
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depth superficial ?0and superficial ?0
deep deep ?0 and ?0 area
small area lt15 middle area 15-30
large area gt30
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CLINICAL MANIFESTATION AND DIAGNOSIS OF BURN
INJURY
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?0
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superficial ?0
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superficial ?0
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deep ?0
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? 0
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Chemical burns
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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 injury
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cold therapy
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Dont like this !
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2. General treatments (1) Correct
burn shock (2) Prevention and
treatment of systemic infection
(3) Nutritional support
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(1) Correct burn shock ? ? choice of
fluid water, crystalloid,
colloid ? route for fluid administration
peripheral, central vein ?
volume and rate of infusion 24h volume
1.5mlburnweight (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 ½ of
first 24h burn/weight 1.5ml 1.8ml
2.0ml colloid moderate and
severe 12 as left crystalloid
major 11 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
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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 wound
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