27 - Burns

Question 1

calculating TBSA for children

Answer 1

rule of 9s except take 9 from the legs and put it in the head so head is total 18

Question 2

superficial or first degree burn

Answer 2

only the epithelium
no dermal loss and no long term scarring

Question 3

superficial partial thickness burns, what is it and treatment

Answer 3

superficial partial thickness is upper half of the dermis (blister)
Tx - cleaning regularly, cover with dressing, silver sulfadiazine

Question 4

deep partial thickness burns

Answer 4

extend more than half way through the dermis, most painful
deep scarring

Question 5

full thickness burns, what is it

Answer 5

entire dermal layer extending into subQ tissue

Question 6

Parkland formula

Answer 6

3 to 4ml/kg/%TBSA (usually 3 in children) = total amount in first 24 hours

Question 7

Galveston formula

Answer 7

nutrition supplementation for child with burns, table shows caloric requirements by age

Question 8

integra

Answer 8

bovine collagen matrix to cover tendons or bones, requires an operation for placing it and then a second operation for covering it with a skin graft (grafts can be thinner than typical)

Question 9

culture epithelial autograft

Answer 9

covers very large burns. Biopsy is used to grow epithelial cells over 6 weeks. Expensive.

Question 10

ReCell

Answer 10

skin cells are emulsified and then sprayed on skin

Question 11

oxandrolone use with burns

Answer 11

anabolic steroid administered for burns greater than 20%, now standard of care

Question 12

bone density and burns

Answer 12

hypermetabolic response results in bone demineralization, effects persist as long as 5 years post injury
IV pamidronate can modulate these changes

Question 13

treating itch a/w burns

Answer 13

gabapentin most effective. antihistamines haven’t been shown to do anything.
compression garments helpful

Question 14

heat tolerance and burns

Answer 14

usually only impacts TBSA 40%+
they are at high risk of heat exhaustion or heat stroke, can use cooling vests

Question 15

how do prevent hypertrophic scarring

Answer 15

hydration, creams, massage, pressure therapy

Question 16

how much pressure should pressure garments apply

Answer 16

15 to 25mmHg

Question 17

most commonly affected joints for contractures due to burns

Answer 17

in order:
shoulder
elbow
wrist
knee
ankle

Question 18

most common location of HO with burns

Answer 18

elbow