Welcome To Zhengzhou University

Welcome to Zhengzhou University

BURN INJURY Department of Plastic Surgery The First Teaching Hospital Zhengzhou University shiyan

PLASTIC

SURGERY

Mission: repair deficiency, restore function, improve appearance

Cure:

congenital malformation, acquired defect , aesthetic surgery

le:4 courses

n, diagnose( extent,depth) 　　　　　　　　　　　

degree; course of disease; field first aid 　　　　　　

al care: prevention and cure of shock 　　　　　

al care: treatment of the raw surface 　 　

luoyang

hengyang beijing

jiaozuo zhengzhou

1. Definition Thermal Injury Hurt caused by heat power. Heat power—— *flame,steam-thermal burn,scald burn *electric current-electric burn * strong acid, strong base-chemical burn * radioactive ray-radiographic inspection

2. Diagnosis • Determinations of body surface area (BSA)extent 1. New rule of Nines used in large area

• Determinations of the depth of burn *Three degrees for four classifications

2. Rule of patient’s hand used in small area Using combined both of them

*Skin structure

Total Body Surface Area (TBSA)

Diagnosis :TBSA

New rule of Nines

Location Hair Head Face Neck

Hands

Adu 3% 3% 3%

5%

Diagnosis: BSA (The Rule of patient’s hand

The area of patient’s hand covered approximately 1%.

Using of “New Rule of Nines”and “The Rule of Patient’s Hand”

New rule of Nines: in large area of burn The Rule of patient’s hand: in small area of burn

In clinic :Using both of them.

the Depth of burn: Superficial degree burns First degree: Erythematous burns Superficial second-degree: Blisters burns

Deep degree burns Deep second-degree: Blisters burns Third-degree: Eschar burns They are mixed and changeable in patients

First Degree: Epidermis Red Dry or small to moderate sized blisters Painful Erythematous burn No blisters 3~5 days healing No scars

Superficial second-degree Superficial of dermis Pink or mottled red Blister (large) ,moist weeping surface Painful 2 weeks healing No scars Pigmentation

Deep second Degree: Deep layer of dermis anesthetic to pinprick, hypalgesia Blisters (small) painful 3~4 weeks healing, Dense scars

Third Degree: -prolonged exposure to flame,hot object,contact with hige-voltage electricity -Full thickness -No pain , No blisters , Eschars,Insensate surface -3~4 weeks eschars issolve , -Skin grafting

degree depth manifestation First Epidermis No blister

agglutination

3~5 days Erythematous burn healing No scars

Superfi Superfici Blisters (large) 2 weeks healing,No cial II al layer of dermis

scars ,pigmentation

Deep II

Deep layer of dermis

Blisters (small) painful hypalgesia

3-4 weeks healing dense scars

III

hypalgesi No pain . No 3-4 weeks a blisters. eschars eschars dissolve Skin grafting

Categorization of Severity of Burns 1.In clinic : Small area burns ： Adult , II , <15%; Children , II , <10%; or III <5%. Large area burns ： Adult , II ,>15%; Children , II , >10%; or III >5%; or major area burn in head , face , neck or hands.

Severity of Burns 2.divided as the severity of burns

Mild Burns －－ Small area Moderate Burns 　 Severe Burns 　　 Large area Special Severe Burns

Severity of Burns

Severity II Degree III Degre 　

Mild

Moderate

< 10%

10%-29%

<5%

5%-9%

Severe 　 Special Severe 30%-50% 10%-19%

>50% >20%

ＮＯＴＥＳ : the patient is complicated with ① shock; ② respiratory tube burns; ③ compound injury; * Even total area of burns < 30% , whose severity of burns is severe degree. * Even total area of burns < 50% , whose severity of burns is special severe degree .

Inhalation Injury (respiratory tube burns) Caused by: Inhalation of smoke,gas and other irritative or poisoning products. Effects:heating power,chemical erosion, poisoning all over the body （ CO ） .

Diagnose 　　　　　　　　　

1. The spot is always relatively closed tightly; explosion; 　　　　　　 2. Degree: above the throat------mild; big bronchus------moderate; deep to small bronchus------severe;

Diagnose 3. Symptom: Stimulus in airway charred hairs of nose hoarse voice expectorate Carbo Medicinalis lose one's breath wheezing rale in lung deep burn in face,neck,mouth and nose

Inhalation Injury (respiratory tube burns)

Class is over

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