Burns

Question 1

superficial partial thickness burn

Answer 1

• first and second degree burns
• involves the epidermis and possible portions of the upper dermis
• red or bright pink, blistered, soft, and wet
• sensation intact
• re-epithelialization in 2 weeks (no graft needed)

Question 2

deep partial thickness burn

Answer 2

• deep second degree burn
• involves epidermis and a deeper portion of the dermis
• mottled red or waxy white, soft, wet, and elastic
• sensation may or may not be present
• re-epithelialization in 3-6 weeks (graft may expedite)

Question 3

full thickness burn

Answer 3

• third degree burn
• involves the epidermis and entire dermis including hair follicles, nerve endings, and epithelial bed
• sensation absent (nerve endings destroyed)
• white or tan, waxy, dry or leathery, and rigid
• re-epithelialization impossible; skin graft required

Question 4

full thickness burn with subdermal injury

Answer 4

• fourth degree burn (electrical injury)
• involves deep tissue damage to fat, muscle, or possible bone
• require extensive debridement of necrotic tissue followed by skin grafting
• amputation may be necessary

Question 5

classic burn deformity resulting from edema and poor positioning

Answer 5

wrist flexion, MP hyperextension, IP flexion, thumb adduction, and a flattened palmar arch

Question 6

burn scar management

Answer 6

• goal is to modulate scars as much as possible to achieve a flat, smooth, supple, and cosmetically acceptable scar
• can be achieved through use of compression, silicone products, massage, and physical agent modalities

Question 7

burn scar management precautions

Answer 7

• do not apply silicone over open wounds or fragile skin
• care must be taken with heat modalities because scars may have diminished sensation and heat intolerance. Never use on open wounds or broken skin.

Question 8

burn dressings

Answer 8

• used to protect the wound and provide and optimum environment for healing
• selection of dressings depends on type and status of wound and physician’s preference
• infection control, comfort, wound immobilization, fluid absorption, debridement, and early pressure