3. BURNS
4/1/2011
RESULTS IN 10-20 THOUSAND
DEATHS ANNUALLY
SURVIVAL BEST AT AGES 15-45
SURVIVAL BEST BURNS COVER
LESS THAN 20% OF TBA
4. TYPES OF BURNS
4/1/2011
THERMAL
EXPOSURE TO FLAME OR A HOT OBJECT
CHEMICAL
EXPOSURE TO ACID, ALKALI OR ORGANIC
SUBSTANCES
ELECTRICAL
RESULT FROM THE CONVERSION OF
ELECTRICAL ENERGY INTO HEAT.
(EXTENT OF INJURY DEPENDS ON THE
TYPE OF CURRENT, THE PATHWAY OF
FLOW, LOCAL TISSUE RESISTANCE, AND
DURATION OF CONTACT)
RADIATION
RESULT FROM RADIANT ENERGY BEING
TRANSFERRED TO THE BODY.
7. BURN WOUND ASSESSMENT
4/1/2011
CLASSIFIED ACCORDING TO DEPTH OF
INJURYAND EXTENT OF BODY SURFACE
AREA INVOLVED
BURN WOUNDS DIFFERENTIATED
DEPENDING ON THE LEVEL OF DERMIS
AND SUBCUTANEOUS TISSUE
INVOLVED
1.SUPERFICIAL (FIRST-DEGREE)
2.DEEP (SECOND-DEGREE)
3.FULL THICKNESS (THIRD AND
FOURTH DEGREE)
15. DEEP (SECOND DEGREE)
*INVOLVES THE EPIDERMIS AND
DEEP LAYER OF THE DERMIS
FLUID-FILLED VESICLES –RED, SHINY,
WET, SEVERE PAIN HOSPITALIZATION
REQUIRED IF OVER 25% OFBODY
SURFACE INVOLVED
I.E. TAR BURN, FLAME
4/1/2011
19. FULL THICKNESS
(THIRD/FOURTH DEGREE)
DESTRUCTION OF ALL SKIN LAYERS
REQUIRES IMMEDIATE
HOSPITALIZATION
DRY, WAXY WHITE, LEATHERY, OR HARD
SKIN, NO PAIN
EXPOSURE TO FLAMES, ELECTRICITY
OR CHEMICALS CAN CAUSE 3RD
DEGREE BURNS
4/1/2011
23. TOTAL BODY SURFACE AREA
(TBSA)
4/1/2011
SUPERFICIAL BURNS ARE NOT
INVOLVED IN THE CALCULATION
LUND AND BROWDER CHART IS THE
MOST ACCURATE BECAUSE IT
ADJUSTS FOR AGE
RULE OF NINES DIVIDES THE BODY –
ADEQUATE FOR INITIAL
ASSESSMENT FOR ADULT BURNS
31. 4/1/2011
IN PATIENTS WITH SCATTERED BURNS, A METHOD
TO ESTIMATE THE PERCENTAGE OF BURN IS THE
PALM METHOD.
THE SIZE OF THE PATIENT’S PALM
IS APPROXIMATELY 1% OF TBSA.
PALM METHOD
33. VASCULAR CHANGES
RESULTING FROM BURN
INJURIES
4/1/2011
CIRCULATORY DISRUPTION OCCURS AT THE BURN
SITE IMMEDIATELY AFTER A BURN INJURY
BLOOD FLOW DECREASES OR CEASE DUETO
OCCLUDED BLOOD VESSELS
DAMAGED MACROPHAGES WITHIN THE TISSUES
RELEASE CHEMICALS THAT CAUSE CONSTRICTION
OF VESSEL
BLOOD VESSEL THROMBOSIS MAY OCCUR
CAUSING NECROSIS
MACROPHAGE: A TYPE OF WHITE BLOOD THAT INGESTS (TAKES IN)
FOREIGN MATERIAL. MACROPHAGES ARE KEY PLAYERS IN
THE IMMUNE RESPONSE TO FOREIGN INVADERS SUCH AS INFECTIOUS
MICROORGANISMS.
34. FLUID SHIFT
4/1/2011
FLUID SHIFT OCCURS AFTER INITIAL
VASOCONSTRICTION,THEN DILATION
BLOOD VESSELS DILATE AND LEAK FLUID
INTO THE INTERSTITIAL SPACE
KNOWN AS THIRD SPACING OR CAPILLARY
LEAK SYNDROME
CAUSES DECREASED BLOOD VOLUME AND BLOOD
PRESSURE
OCCURS WITHIN THE FIRST 12 HOURS AFTER
THE BURN AND CAN CONTINUE TO UP TO 36
HOURS
[MAJOR BURNS >30%TBSA]
35. FLUID IMBALANCES
4/1/2011
FLUID IMBALANCES OCCUR AS A RESULT
OF FLUID SHIFT AND CELL DAMAGE
HYPOVOLEMIA
METABOLIC ACIDOSIS
HYPERKALEMIA
HYPONATREMIA
HEMOCONCENTRATION (ELEVATED BLOOD
OSMOLARITY, HEMATOCRIT/HEMOGLOBIN)
DUE TO DEHYDRATION
36. FLUID REMOBILIZATION
4/1/2011
OCCURS AFTER 24 HOURS
CAPILLARY LEAK STOPS
SEE DIURETIC STAGE WHERE EDEMA FLUID
SHIFTS FROM THE INTERSTITIAL SPACES INTO
THE VASCULAR SPACE
BLOOD VOLUME INCREASES LEADING TO
INCREASED RENAL BLOOD FLOW AND
DIURESIS
HYPOKALEMIA OCCUR
37. CURLING’S ULCER
4/1/2011
ACUTE ULCERATIVE GASTRO DUODENAL
DISEASE
OCCUR WITHIN 24 HOURS AFTER BURN
DUE TO REDUCED GI BLOOD FLOW
AND MUCOSAL DAMAGE
TREAT CLIENTS WITH H2 BLOCKERS,
MUCOPROTECTANTS, AND EARLY
ENTERAL NUTRITION
WATCH FOR SUDDEN DROP IN
HEMOGLOBIN
39. PHASES OF BURN CARE
4/1/2011
EMERGENT (24-48 HRS)
ACUTE
REHABILITATIVE
MANAGEMENT:-
40. 4/1/2011
EMERGENT OR IMMEDIATE
RESUSCITATIVE
FROM ONSET OF INJURY TO
COMPLETION
OF FLUID RESUSCITATION
• FIRST AID
• PREVENTION OF SHOCK
• PREVENTION OF RESPIRATORY
DISTRESS
• DETECTION AND TREATMENT
OF CONCOMITANT INJURIES
• WOUND ASSESSMENT AND
INITIAL CARE
ACUTE FROM BEGINNING OF DIURESIS
TO NEAR
COMPLETION OF WOUND
CLOSURE
• WOUND CARE AND CLOSURE
• PREVENTION OR TREATMENT
OF COMPLICATIONS, INCLUDING
INFECTION
• NUTRITIONAL SUPPORT
REHABILITATION FROM MAJOR WOUND CLOSURE
TO RETURN
TO INDIVIDUAL’S OPTIMAL
LEVEL OF PHYSICAL
AND PSYCHOSOCIAL
ADJUSTMENT
• PREVENTION OF SCARS AND
CONTRACTURES
• PHYSICAL, OCCUPATIONAL,
AND VOCATIONAL
REHABILITATION
• FUNCTIONAL AND COSMETIC
RECONSTRUCTION
• PSYCHOSOCIAL COUNSELING
43. WHAT IS PLASTIC SURGERY?
THE NAME IS TAKEN FROM THE GREEK WORD
“PLASTIKOS”, WHICH MEANS TO FORM OR
MOLD!
PLASTIC SURGERY IS A SPECIAL TYPE OF
SURGERY THAT INVOLVES BOTH A PERSON'S
APPEARANCE AND HIS OR HER ABILITY TO
FUNCTION.
IT INTENDS TO IMPROVE PATIENTS'
APPEARANCE, SELF-IMAGE, AND CONFIDENCE
THROUGH BOTH RECONSTRUCTIVE AND
COSMETIC PROCEDURES.
44. WHY DO PEOPLE GET PLASTIC SURGERY?
1. TOIMPROVE THE APPEARANCE.
2. SOME PEOPLE ARE ADDICTED
TO COSMETIC SURGERY
3. TOCORRECT A PHYSICAL DEFECT OR TO
ALTER A PART OF THE BODY THAT
MAKES THEM FEEL UNCOMFORTABLE
4. TOFEEL BETTER ABOUT THE WAY THEY
LOOK
45. THERE ARE TWO MAIN KINDS OF PLASTIC
SURGERY:
1. RECONSTRUCTIVE SURGERY - IS USUALLY EMPLOYED
FOR MEDICAL PURPOSES, AND SOME COMMON
EXAMPLES INCLUDE:
*CLEFT LIP SURGERY
*BREAST RECONSTRUCTION SURGERY FOR THOSE
WHO HAD MASTECTOMY
* CONTRACTURE SURGERY FOR BURN SURVIVORS
2. COSMETIC SURGERY - IS DONE MOSTLY FOR AESTHETIC
3. ENHANCEMENT AND INCLUDES:
- DIFFERENT TYPES OF COSMETIC SURGERY INCLUDE:
TUMMY TUCK (ABDOMINOPLASTY)
* LIPOSUCTION
* BREAST LIFT
* CHEEK AUGMENTATION
* BREAST REDUCTION/ENLARGEMENT (AUGMENTATION
MAMMAPLASTY)
*
46. WHICH ARE THE MOST COMMON PLASTIC
SURGERIES ?
1. TUMMY TUCK
2. EYELID SURGERY
3. LIPOSUCTION
4. BREAST AUGMENTATION
BREAST RECONSTRUCTION
BREAST IMPLANT
BREAST LIFT
BOTOX
47. GETTING A TUMMY TUCK
TUMMY TUCK (ABDOMINOPLASTY) HELPS TO
REDUCE THE APPEARANCE OF A PROTRUDING
ABDOMEN, LOOSE SKIN.
STRETCH MARKS IN THE ABDOMINALAREA.
MANY PEOPLE TURN TO A TUMMY TUCK AS A
RESULT OF PREGNANCY.
THE ALSO TURN AS E RESULT OF AGE OR
OBESITY.
48.
49. EYELID SURGERY
IS PERFORMED ON ADULTS OF ANY AGE TO CORRECT
PROBLEMS ASSOCIATED TO AGING OR TO RECEIVE
TREATMENT FOR INHERITED TRAITS.
THEY MAY HAVE LOOSE SKIN HANGING DOWN FROM THE
UPPER EYELIDS AND POSSIBLY IMPAIRING VISION
A PUFFY APPEARANCE TO THE UPPER EYELIDS THAT MAKE
THE EYES LOOK TIRED
EXCESS SKIN AND FINE WRINKLES OF THE LOWER EYELIDS,
DARK CIRCLES UNDER THE EYES
EYELID SURGERY CAN NORMALLY FIX THESE TYPES OF
PROBLEMS, BUT SOMETIMES AN EYELID SURGERY MAY BE
NEEDED IN COMBINATION WITH ANOTHER TREATMENT.
50. GUIDE TO GETTING LIPOSUCTION
LIPOSUCTION (LIPOPLASTY) IS THE ELIMINATION
OF UNWANTED FAT.
EVERY YEAR, HUNDREDS OF THOUSANDS OF
AMERICAN MEN AND WOMEN UNDERGO
LIPOSUCTION PROCEDURES TO ELIMINATE
UNWANTED AND PERSISTENT POCKETS OF FAT IN
THE:
ABDOMEN
HIPS
THIGHS
BUTTOCKS
ARMS
51. BREAST AUGMENTATION
BREAST IMPLANTS ARE USED DURING
AUGMENTATION TO INCREASE THE SIZE
OF THE BREAST.
TO INCREASE SHAPE OF THE BREAST.
TORESTORE BREAST VOLUME LOST
AFTER WEIGHT REDUCTION OR
PREGNANCY.
52.
53.
54.
55. PROS AND CONS OF PLASTIC
SURGERY
COSMETIC SURGERY IS
PURSUED TO ENHANCE
THE MAGNIFICENCE OF
THE PERSON.
PLASTIC SURGERY IS TO
LOOK ENERGETIC AND
TO PLEASE HIMSELF.
THERE IS A
DEVELOPMENT OF
SELF-ESTEEM IN THE
PERSON IF THE PLASTIC
SURGERY IS
SUCCESSFUL
LEAVES SOME MARKS OR SPOTS ON THE
BODY WHICH CAN BE RECTIFIED BY
PERFORMING ANOTHER PLASTIC
SURGERY
RISKS DEPEND ON THE TYPE OF PLASTIC
SURGERY. (BREAST AUGMENTATION,
BLEEDING OF GEL)
THE RISKS OF LIPOSUCTION INCLUDE
DISCOLORATION, DEPIGMENTATION,
NUMBNES S, BRUISING AND PAIN.
FACELIFT PLASTIC SURGERY INVOLVES
VARIOUS SIDE EFFECTS: NERVE DAMAGE
WHICH MAKES THE PERSON’S FACE
INSENSIBLE.
THE PATIENT ALSO SUFFERS FROM MILD
SIDE EFFECTS: FEELING PAIN IN THE
AFFECTEDPART AND INFLAMMATION.
BENEFITS DRAWBACK
56. THEREFORE, PLASTIC SURGERY HAS TWO
SIDES – ONE IS BENEFIT SIDE AND THE
OTHER ONE IS THE DRAWBACK SIDE AND
THE PATIENT HAS TO EXPERIENCE
BOTH THE SIDES.
