JACKSONS ZONES OF TISSUE INJURY
Jackson’s Burn Wound Model provides a model for understanding the pathophysiology of a burn wound. Primary injury is the zone of coagulation nearest to the heat source . This zone has irreversible tissue necrosis at the centre of the burn due to exposure to heat, chemicals or electricity. The extent of the injury is dependent on the duration and the temperature of exposure .
Zone of Ischaemia is the zone surrounding the central zone of necrosis in which there is a reduction in the dermal circulation. This is a damaged but potientially viable tissue. This ischemic zone may progress to full necrosis unless the ischemia is reversed. If the ischemia is not relieved, for example when resuscitation and wound care are suboptimal, then persisting ischaemia will worsen, and the burn depth will increase.
The third zone of hyperaemia is at the periphery of the burn characterised by a reversible increase in blood flow and inflammation. Fig.5. JACKSONS ZONESOF TISSUE INJURY.
BURN CENTER REFERRAL CRITERIA [7]
A burn center may treat adults, children, or both.
Burn injuries that should be referred to a burn center include:
1. Partial thickness burns greater than 10% total body surface area (TBSA). 2. Burns that involve the face, hands, feet, genitalia, perineum, or major joints.
3. Third degree burns in any age group. 4. Electrical burns, including lightning injury.
5. Chemical burns.
6. Inhalation injury.
7. …show more content…
Consequently, the volume predicted by a resuscitation formula must be altered according to the individuals response to therapy. In optimizing fluid resuscitation in severely burned patients, the amount of fluid should be just enough to maintain vital organ function without causing iatrogenic pathological
Jackson’s Burn Wound Model provides a model for understanding the pathophysiology of a burn wound. Primary injury is the zone of coagulation nearest to the heat source . This zone has irreversible tissue necrosis at the centre of the burn due to exposure to heat, chemicals or electricity. The extent of the injury is dependent on the duration and the temperature of exposure .
Zone of Ischaemia is the zone surrounding the central zone of necrosis in which there is a reduction in the dermal circulation. This is a damaged but potientially viable tissue. This ischemic zone may progress to full necrosis unless the ischemia is reversed. If the ischemia is not relieved, for example when resuscitation and wound care are suboptimal, then persisting ischaemia will worsen, and the burn depth will increase.
The third zone of hyperaemia is at the periphery of the burn characterised by a reversible increase in blood flow and inflammation. Fig.5. JACKSONS ZONESOF TISSUE INJURY.
BURN CENTER REFERRAL CRITERIA [7]
A burn center may treat adults, children, or both.
Burn injuries that should be referred to a burn center include:
1. Partial thickness burns greater than 10% total body surface area (TBSA). 2. Burns that involve the face, hands, feet, genitalia, perineum, or major joints.
3. Third degree burns in any age group. 4. Electrical burns, including lightning injury.
5. Chemical burns.
6. Inhalation injury.
7. …show more content…
Consequently, the volume predicted by a resuscitation formula must be altered according to the individuals response to therapy. In optimizing fluid resuscitation in severely burned patients, the amount of fluid should be just enough to maintain vital organ function without causing iatrogenic pathological