IT IS USEFUL FOR 3 YEAR BASIC B.Sc.(N) & 2 YEAR GNM STUDENTS.

1. BURN INJURIES
& ITS
MANAGEMENT
BY
MR. AHMED SODHA
M.Sc.(N) – M.S.N.
4/1/2011
1

2. BURNS
4/1/2011
WOUNDS CAUSED BY EXPOSURE
TO:
1. EXCESSIVE HEAT
2. CHEMICALS
3. FIRE/STEAM
4. RADIATION
5. ELECTRICITY

3. BURNS
4/1/2011
RESULTS IN 10-20 THOUSAND
DEATHS ANNUALLY
SURVIVAL BEST AT AGES 15-45
SURVIVAL BEST BURNS COVER
LESS THAN 20% OF TBA

4. TYPES OF BURNS
4/1/2011
THERMAL
EXPOSURE TO FLAME OR A HOT OBJECT
CHEMICAL
EXPOSURE TO ACID, ALKALI OR ORGANIC
SUBSTANCES
ELECTRICAL
RESULT FROM THE CONVERSION OF
ELECTRICAL ENERGY INTO HEAT.
(EXTENT OF INJURY DEPENDS ON THE
TYPE OF CURRENT, THE PATHWAY OF
FLOW, LOCAL TISSUE RESISTANCE, AND
DURATION OF CONTACT)
RADIATION
RESULT FROM RADIANT ENERGY BEING
TRANSFERRED TO THE BODY.

5. CHEMICAL BURN
4/1/2011

6. ELECTRICAL BURN
4/1/2011

7. BURN WOUND ASSESSMENT
4/1/2011
CLASSIFIED ACCORDING TO DEPTH OF
INJURYAND EXTENT OF BODY SURFACE
AREA INVOLVED
BURN WOUNDS DIFFERENTIATED
DEPENDING ON THE LEVEL OF DERMIS
AND SUBCUTANEOUS TISSUE
INVOLVED
1.SUPERFICIAL (FIRST-DEGREE)
2.DEEP (SECOND-DEGREE)
3.FULL THICKNESS (THIRD AND
FOURTH DEGREE)

8. 4
/1
/20
1
1
8

9. 4
/1
/20
1
1
8

10. SUPERFICIAL BURNS
(FIRST DEGREE)
EPIDERMAL TISSUE ONLYAFFECTED
ERYTHEMA, BLANCHING ON PRESSURE,
MILD SWELLING NO VESICLES OR
BLISTER INITIALLY
NOT SERIOUS UNLESS LARGE AREAS
INVOLVED
I.E. SUNBURN
4/1/2011

12. 4/1/2011
12

13. 4/1/2011
13

14. 4/1/2011
14

15. DEEP (SECOND DEGREE)
*INVOLVES THE EPIDERMIS AND
DEEP LAYER OF THE DERMIS
FLUID-FILLED VESICLES –RED, SHINY,
WET, SEVERE PAIN HOSPITALIZATION
REQUIRED IF OVER 25% OFBODY
SURFACE INVOLVED
I.E. TAR BURN, FLAME
4/1/2011

16. 4/1/2011
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17. 4/1/2011
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18. 4/1/2011
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19. FULL THICKNESS
(THIRD/FOURTH DEGREE)
DESTRUCTION OF ALL SKIN LAYERS
REQUIRES IMMEDIATE
HOSPITALIZATION
DRY, WAXY WHITE, LEATHERY, OR HARD
SKIN, NO PAIN
EXPOSURE TO FLAMES, ELECTRICITY
OR CHEMICALS CAN CAUSE 3RD
DEGREE BURNS
4/1/2011

20. 4/1/2011
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21. 4/1/2011
21

22. Calculation of Burned
Body Surface Area
4/1/2011

23. TOTAL BODY SURFACE AREA
(TBSA)
4/1/2011
SUPERFICIAL BURNS ARE NOT
INVOLVED IN THE CALCULATION
LUND AND BROWDER CHART IS THE
MOST ACCURATE BECAUSE IT
ADJUSTS FOR AGE
RULE OF NINES DIVIDES THE BODY –
ADEQUATE FOR INITIAL
ASSESSMENT FOR ADULT BURNS

24. 4/1/2011

26. LUND BROWDER CHART USED FOR
DETERMINING BSA
4/1/2011

27. RULES OF NINES
4/1/2011
HEAD & NECK = 9%
 EACH UPPER EXTREMITY (ARMS) = 9%
 EACH LOWER EXTREMITY (LEGS) =18%
ANTERIOR TRUNK= 18%
POSTERIOR TRUNK =18%
GENITALIA (PERINEUM) = 1%

28. 4/1/2011

29. 4/1/2011

30. 4/1/2011 24

31. 4/1/2011
IN PATIENTS WITH SCATTERED BURNS, A METHOD
TO ESTIMATE THE PERCENTAGE OF BURN IS THE
PALM METHOD.
THE SIZE OF THE PATIENT’S PALM
IS APPROXIMATELY 1% OF TBSA.

PALM METHOD

32. 4/1/2011


33. VASCULAR CHANGES
RESULTING FROM BURN
INJURIES
4/1/2011
CIRCULATORY DISRUPTION OCCURS AT THE BURN
SITE IMMEDIATELY AFTER A BURN INJURY
BLOOD FLOW DECREASES OR CEASE DUETO
OCCLUDED BLOOD VESSELS
DAMAGED MACROPHAGES WITHIN THE TISSUES
RELEASE CHEMICALS THAT CAUSE CONSTRICTION
OF VESSEL
BLOOD VESSEL THROMBOSIS MAY OCCUR
CAUSING NECROSIS

MACROPHAGE: A TYPE OF WHITE BLOOD THAT INGESTS (TAKES IN)
FOREIGN MATERIAL. MACROPHAGES ARE KEY PLAYERS IN
THE IMMUNE RESPONSE TO FOREIGN INVADERS SUCH AS INFECTIOUS
MICROORGANISMS.

34. FLUID SHIFT
4/1/2011
FLUID SHIFT OCCURS AFTER INITIAL
VASOCONSTRICTION,THEN DILATION
BLOOD VESSELS DILATE AND LEAK FLUID
INTO THE INTERSTITIAL SPACE
KNOWN AS THIRD SPACING OR CAPILLARY
LEAK SYNDROME
CAUSES DECREASED BLOOD VOLUME AND BLOOD
PRESSURE
 OCCURS WITHIN THE FIRST 12 HOURS AFTER
THE BURN AND CAN CONTINUE TO UP TO 36
HOURS
 [MAJOR BURNS >30%TBSA]

35. FLUID IMBALANCES
4/1/2011
FLUID IMBALANCES OCCUR AS A RESULT
OF FLUID SHIFT AND CELL DAMAGE
HYPOVOLEMIA
METABOLIC ACIDOSIS
HYPERKALEMIA
HYPONATREMIA
HEMOCONCENTRATION (ELEVATED BLOOD
OSMOLARITY, HEMATOCRIT/HEMOGLOBIN)
DUE TO DEHYDRATION

36. FLUID REMOBILIZATION
4/1/2011
OCCURS AFTER 24 HOURS
CAPILLARY LEAK STOPS
SEE DIURETIC STAGE WHERE EDEMA FLUID
SHIFTS FROM THE INTERSTITIAL SPACES INTO
THE VASCULAR SPACE
BLOOD VOLUME INCREASES LEADING TO
INCREASED RENAL BLOOD FLOW AND
DIURESIS
 HYPOKALEMIA OCCUR

37. CURLING’S ULCER
4/1/2011
ACUTE ULCERATIVE GASTRO DUODENAL
DISEASE
OCCUR WITHIN 24 HOURS AFTER BURN
DUE TO REDUCED GI BLOOD FLOW
AND MUCOSAL DAMAGE
TREAT CLIENTS WITH H2 BLOCKERS,
MUCOPROTECTANTS, AND EARLY
ENTERAL NUTRITION
WATCH FOR SUDDEN DROP IN
HEMOGLOBIN

38. 4/1/2011
MUCOPROTECTANTS - SALIVATION INDUCING AGENT

39. PHASES OF BURN CARE
4/1/2011
EMERGENT (24-48 HRS)
ACUTE
REHABILITATIVE
MANAGEMENT:-

40. 4/1/2011

EMERGENT OR IMMEDIATE
RESUSCITATIVE
FROM ONSET OF INJURY TO
COMPLETION
OF FLUID RESUSCITATION
• FIRST AID
• PREVENTION OF SHOCK
• PREVENTION OF RESPIRATORY
DISTRESS
• DETECTION AND TREATMENT
OF CONCOMITANT INJURIES
• WOUND ASSESSMENT AND
INITIAL CARE
ACUTE FROM BEGINNING OF DIURESIS
TO NEAR
COMPLETION OF WOUND
CLOSURE
• WOUND CARE AND CLOSURE
• PREVENTION OR TREATMENT
OF COMPLICATIONS, INCLUDING
INFECTION
• NUTRITIONAL SUPPORT
REHABILITATION FROM MAJOR WOUND CLOSURE
TO RETURN
TO INDIVIDUAL’S OPTIMAL
LEVEL OF PHYSICAL
AND PSYCHOSOCIAL
ADJUSTMENT
• PREVENTION OF SCARS AND
CONTRACTURES
• PHYSICAL, OCCUPATIONAL,
AND VOCATIONAL
REHABILITATION
• FUNCTIONAL AND COSMETIC
RECONSTRUCTION
• PSYCHOSOCIAL COUNSELING

41. 4/1/2011


42. PLASTIC SURGERY

43. WHAT IS PLASTIC SURGERY?
 THE NAME IS TAKEN FROM THE GREEK WORD
“PLASTIKOS”, WHICH MEANS TO FORM OR
MOLD!
 PLASTIC SURGERY IS A SPECIAL TYPE OF
SURGERY THAT INVOLVES BOTH A PERSON'S
APPEARANCE AND HIS OR HER ABILITY TO
FUNCTION.
 IT INTENDS TO IMPROVE PATIENTS'
APPEARANCE, SELF-IMAGE, AND CONFIDENCE
THROUGH BOTH RECONSTRUCTIVE AND
COSMETIC PROCEDURES.

44. WHY DO PEOPLE GET PLASTIC SURGERY?
1. TOIMPROVE THE APPEARANCE.
2. SOME PEOPLE ARE ADDICTED
TO COSMETIC SURGERY
3. TOCORRECT A PHYSICAL DEFECT OR TO
ALTER A PART OF THE BODY THAT
MAKES THEM FEEL UNCOMFORTABLE
4. TOFEEL BETTER ABOUT THE WAY THEY
LOOK

45. THERE ARE TWO MAIN KINDS OF PLASTIC
SURGERY:
1. RECONSTRUCTIVE SURGERY - IS USUALLY EMPLOYED
FOR MEDICAL PURPOSES, AND SOME COMMON
EXAMPLES INCLUDE:
*CLEFT LIP SURGERY
*BREAST RECONSTRUCTION SURGERY FOR THOSE
WHO HAD MASTECTOMY
* CONTRACTURE SURGERY FOR BURN SURVIVORS
2. COSMETIC SURGERY - IS DONE MOSTLY FOR AESTHETIC
3. ENHANCEMENT AND INCLUDES:
- DIFFERENT TYPES OF COSMETIC SURGERY INCLUDE:
TUMMY TUCK (ABDOMINOPLASTY)
* LIPOSUCTION
* BREAST LIFT
* CHEEK AUGMENTATION
* BREAST REDUCTION/ENLARGEMENT (AUGMENTATION
MAMMAPLASTY)
*

46. WHICH ARE THE MOST COMMON PLASTIC
SURGERIES ?
1. TUMMY TUCK
2. EYELID SURGERY
3. LIPOSUCTION
4. BREAST AUGMENTATION
 BREAST RECONSTRUCTION
 BREAST IMPLANT
 BREAST LIFT
 BOTOX

47. GETTING A TUMMY TUCK
 TUMMY TUCK (ABDOMINOPLASTY) HELPS TO
REDUCE THE APPEARANCE OF A PROTRUDING
ABDOMEN, LOOSE SKIN.
 STRETCH MARKS IN THE ABDOMINALAREA.
 MANY PEOPLE TURN TO A TUMMY TUCK AS A
RESULT OF PREGNANCY.
 THE ALSO TURN AS E RESULT OF AGE OR
OBESITY.

49. EYELID SURGERY
 IS PERFORMED ON ADULTS OF ANY AGE TO CORRECT
PROBLEMS ASSOCIATED TO AGING OR TO RECEIVE
TREATMENT FOR INHERITED TRAITS.
 THEY MAY HAVE LOOSE SKIN HANGING DOWN FROM THE
UPPER EYELIDS AND POSSIBLY IMPAIRING VISION
 A PUFFY APPEARANCE TO THE UPPER EYELIDS THAT MAKE
THE EYES LOOK TIRED
 EXCESS SKIN AND FINE WRINKLES OF THE LOWER EYELIDS,
 DARK CIRCLES UNDER THE EYES
 EYELID SURGERY CAN NORMALLY FIX THESE TYPES OF
PROBLEMS, BUT SOMETIMES AN EYELID SURGERY MAY BE
NEEDED IN COMBINATION WITH ANOTHER TREATMENT.

50. GUIDE TO GETTING LIPOSUCTION
 LIPOSUCTION (LIPOPLASTY) IS THE ELIMINATION
OF UNWANTED FAT.
 EVERY YEAR, HUNDREDS OF THOUSANDS OF
AMERICAN MEN AND WOMEN UNDERGO
LIPOSUCTION PROCEDURES TO ELIMINATE
UNWANTED AND PERSISTENT POCKETS OF FAT IN
THE:
 ABDOMEN
 HIPS
 THIGHS
 BUTTOCKS
 ARMS

51. BREAST AUGMENTATION
 BREAST IMPLANTS ARE USED DURING
AUGMENTATION TO INCREASE THE SIZE
OF THE BREAST.
 TO INCREASE SHAPE OF THE BREAST.
 TORESTORE BREAST VOLUME LOST
AFTER WEIGHT REDUCTION OR
PREGNANCY.

55. PROS AND CONS OF PLASTIC
SURGERY
 COSMETIC SURGERY IS
PURSUED TO ENHANCE
THE MAGNIFICENCE OF
THE PERSON.
 PLASTIC SURGERY IS TO
LOOK ENERGETIC AND
TO PLEASE HIMSELF.
 THERE IS A
DEVELOPMENT OF
SELF-ESTEEM IN THE
PERSON IF THE PLASTIC
SURGERY IS
SUCCESSFUL
 LEAVES SOME MARKS OR SPOTS ON THE
BODY WHICH CAN BE RECTIFIED BY
PERFORMING ANOTHER PLASTIC
SURGERY
 RISKS DEPEND ON THE TYPE OF PLASTIC
SURGERY. (BREAST AUGMENTATION,
BLEEDING OF GEL)
 THE RISKS OF LIPOSUCTION INCLUDE
DISCOLORATION, DEPIGMENTATION,
NUMBNES S, BRUISING AND PAIN.
 FACELIFT PLASTIC SURGERY INVOLVES
VARIOUS SIDE EFFECTS: NERVE DAMAGE
WHICH MAKES THE PERSON’S FACE
INSENSIBLE.
 THE PATIENT ALSO SUFFERS FROM MILD
SIDE EFFECTS: FEELING PAIN IN THE
AFFECTEDPART AND INFLAMMATION.
BENEFITS DRAWBACK

56. THEREFORE, PLASTIC SURGERY HAS TWO
SIDES – ONE IS BENEFIT SIDE AND THE
OTHER ONE IS THE DRAWBACK SIDE AND
THE PATIENT HAS TO EXPERIENCE
BOTH THE SIDES.

57. THANK YOU!