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COMBUSTIO
Dr.Dian Syahputra
1. Ethiology Grade
{ D : e-burn gr@sulo }
ETHIOLOGY
Anamnesis : Grade/Severity
SCALD I & II
FLAME II & III
ELECTRICAL III
CHEMICAL III
INHALATION respiratory
Time of injury fluid resusitation first 8 hours
GRADE
Erythema
Blister
Pinprick ( - )
ESTIMATION OF
BODY SURFACE AREA
% BSA
9
9 9
9 9
9 9
9 9 9 9
1%
Increase
permeability
Interstitial tissue
Interstitial tissue
1. General/Medical Treatment :
Fluid Resusitation
Prevention infection
2. Local : Topical Antibiotic
3. Surgery :
a. Debridement
b. Excharatomy
c. Excicion + Grafting
d. Granulating Tissue + Grafting
ESTIMATION OF
FLUID RESUSCITATION
Parkland Hospital Formula :
24 hours
4 ml Lact. Ringers x % BSA x Kg BW = X ml
X ml in first 24 hours
x ml in first 8 hours
24 48 Koloid
Inhalation burn
face neck
Respiratory distress
first 24 hours & 1-5 days
Sistemic Antibiotic
Tetanus Prophylactic
Analgesic & Sedatives
Nutritional support :
Formula Curreri (24 hours caloric requirment)
Adult : 25 kilocal/kg BW + 40 kilocal % BSA
Child : 60-90 kilocal/kg BW + 35 kilocal % BSA
TOPICAL ANTIBIOTIC
Silver Sulfadiazine
Cream in consentration of 1 %
Applied twice daily : open or
close
Effective Gram + & Gram
Prevention :
Position arm & leg
Thin
Grafting : STSG
Moderate
Prompt
Large : Electro Dermatome
1 2 weeks Granulating
MESH Graft
Scald Burn
Scald Burn with Pregnancy
Scald Burn in specific area
Flame Burn Suicide 40%
Flame Burn 30%
Cemical Burn
Electrical Burn
Flame Burn Escharatomy
Upper Arm
Granulating Tissue Grafting
1-2 weeks
COMPLICATION
Pulmonary Oedema
Gastrointestinal
33% Curling Ulcer
Infection : - Septichemi
- UTI
- Auricular chondritis
Late Complication
6 months 2 years
1. Contracture
2. Keloid
Late complication Keloid
Finger contracture
Diagnose e-burn gr@sulo
Emergency
life saving Mortality
Ed Sept 2003