Acute Burns

• The skin
• 15% body weight // Largest organ // Protection, sensation, warming
• Pathology of wound
• Zones of injury —> Necrosis —> Stasis (injury) —> Hyperaemia
• Waxy look
• Full thickness burn -
• No viable remaining dermis
• Effect of inflammatory mediators
• Increased cap permeability
• Increase vasodilators
• Increase vasoconstrictors
• Chemotaxis
Monitoring burn injury
• Lund and browder Burn chart

• Burn depth assessment

• Clinical examination —> COlor (Red/ PAle) // Sensation // Bleeding —> capillary bed intact
• Vasodilatation in intact ca

Wound management

BURN MANAGEMENT
• Stop burn
• Cool the wound —> Tap water (15 deg) for 15 minutes
• Primary survey —> ABCDE
• CABCDE —> Massive haemorrhage will kill first
• Imaging
• Lateral cervical spine
• Chest
• 2ndary assessment
• History
• SAMPLE
• S+S // Allergies // Medication // Precipitating hx //
• Adult resuscitation - Parkland formula
• Inhalation injury
• Carboxyhaemoglobin (normally 2-3 // >15%) —> 30-50% nearing fatal
• Perioral burn
• Carbonaceous sputum
Metabolic effects

• Skin graft —> Excision of skin

• Flap —> With blood supply // Arteries and vein // Joined up at graft site
• Where = Local —> Distal

Microstomia —> Tightening of mouth

Foliculitis burble