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27 Cards in this Set

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Scar
Material of Wound healing
For scar to mature- 6 months to 2 years
Collagen
Glue-like protein that is the chemical of a scar
Epithelialization
Occurs whenever a wound breaks the skin in both primary and secondary intention healing
Process by which the top layer of skin heals itself
Primary Intention
Simple laceration or cut that is sutured directly in a straight line
No intervention needed
Secondary Intention
Wound that's missing tissue so that the skin edges of the wound cannot be brought together
Continual Damage
Swelling
leads to ischemia
No circulation
damage- leading to dead tissue
Eschar
layer of dead, burned tissue
tends to shrink as forms
can lead to tourniquette effect
then to echarotomy
Surgical Care of burn involves
Reduce pain
Protect against bacteria
Close wound to prevent fluid loss
Removal of dead tissue debriedment
Contactors
Skin shrunk, muscles shrunk
Joints seize, immobile because in single position
What does skin do?
Protects
prevents loss of fluid
Regulates body temperature
Epithelium
Skin-
1.7 square meters of skin on body: Largest organ of body
Epidermis
Upon dermis
Upper outer layer
4 layers thick, 5 layers on feet and hands
holds germinal epithelial cells: production sites for new skin
Dermis
2 layers of connected tissue
thicker inner layer
House:
hair follicles
Sebatious glands (fatty oil glands)
Sweat glands
Lined with germinal epithelial cells
Rule of Nines
Body viewed as multiple of 9's
Lund and Browder Chart
Body parts change in size over years
How bad the burn is depends on:
1. Extent of Burn
2. Depth of Burn
3. Predisposing factors
Superficial
1st Degree or Partial Thickness
Burn in epidermis
Bright red, pink skin
Blisters (wet and soft)
Heal from lower level epidermis (germinal epidermal)
no scarring
Partial Thickness
2nd Degree or Deep-Partial Thickness
Epidermis is gone
All or part of dermis
Leave dermal appendages
Waxy, white, dry, elastic, sensitive to pressure
Heals 3-4 weeks and from margins
not as attractive when healed
scars occur
Full Thickness
3rd Degree
Entire depth of skin: epidermis, dermis,dermal elements, and some subcutaneous tissue
Spontaneous regeneration not possible
Dry, black, leathery, not elastic, eschar
No pain or pressure senses
4th Degree
Burn down to bone
Amputation required
Burned beyond recognition of any body part involved
Debriedment
Removal of dead tissue
Must be done before wound is closed
Remove non-viable dead tissue
Tweezers
Scrub it off
Surgical
Chemical Enzymes
Grafting
Definition & Reason
Biological Dressing

1. Maintain life
2. Preserve functioning
3. Maintain cosmetic effect
Autograft
Graft from good place on own body
Optimal and permanent
Homograft
from same species, dead or alive
Permanent to some degree
Heterograft
Xenograft
different species (pig)
temporary 4-6 weeks
Rejection
Hypertrophic Scarring
Excessive growth
Cosmetically unattractive
Not functional
Bumps and contours
Prevented by wearing pressure garment 24/7 for 2 years
Piecemeal
Take one amputation at a time
Not recommended
Example:
1. Take toes
2. Ankele
3. Etc.