Types of burns
Superficial - sunburn
Partial - blistering and wet
- superficial - pink
- deep - white
Full thickness - painless, dry and brown
How to calculate body percentage?
Head - 9%
Trunk - 36%
Arm - 9%
Leg - 18%
OR palm of the hand is 1% BSA
If paediatrics - use a Lund and Browder chart
What is the Parkland formula?
4 x %BSA x weight (kg) = total fluid in 24 hours
Half of which is over 8 hours
Hartman’s
Other management of burns
IRRIGATE!
NON-ADHERENT DRESSING OR CLEAN FILM
Consideration of grafting for severe burn
Do they need to be discussed with a burns centre?
What are the signs of a smoke inhilation injury?
Cabonencuous sputum
Singed hairs
Sout around the nose and mouth
Facial burns
What is the treatment for inhalation injury?
Intubation - overkill mode activated, let’s get on with it
Describe arterial ulcers
- well defined
- punched out
- deep
- painful
- bleed less
- occur distally
Management of arterial ulcers
Treat as PAS - clopidogrel and atorvastatin
Describe venous ulcers
- less well defined
- slopping edges
- superficial
- bleed
- less painful
- gaiter area
Management of venous ulcers
Wound care and compression stockings
Types of abnormal scarring
- hypertrophic scarring
within margin of scar, occur soon after injury, get better with time, seem to respond to compression/massage - keloid scarring
grow outside of scar margin, occur up to two years after, can be symptomatic, treatments: silicone, pressure, steroid, DXT and surgery, poor response to treatment - atrophic scar
indented, treatments include chemical peeling, dermabrasion, laser etc
Management of wound dehiscence
Superficial - wound care and let it heal by secondary intention
Full - A to E, analgesia, IV antibiotics, saline-covered gauze and return to theatre
Signs of SSI
Spreading erythema
Localised pain
Discharge
Pyrexia
Management of SSI
Remove sutures or clips
Empirical abx as per local guidelines
Swab, bloods and consider need for cross sectional imaging to search for deep-seated collections
