Chapter_55

Wounds caused by an energy transfer from a heat source to the body, heating enough to cause damage.

• 1. Temperature of agent
• 2. Burning agent itself
• 3. Duration of contact
• 4. Conductivity of tissue
• 5. Thickness of dermal structures

• Loss of protective functions
• Inefeective Thermoregulation
• Risk of infection
• Changes in sensory function
• Loss of fluids
• Impaired skin regeneration
• Impaired secretory and excretory function

• Vascularity maintaines
• No cell death
• Red
• Blanching

• Temperature increase in tissue edema
• Vasoconstriction
• Sludging of blood cells
• Red
• No blanching

• Irreversible cell death
• White or gray
• No blanching

• (1st-2nd degree)
• Healing time: 7-10 days

• Epidermis and 1/2 to 7/8 of dermis
• Healing time: 14-21 days
• May need grafting

• 3rd-4th degree
• Needs grafting to complete healing

• Increased capillary permeability leads to leakage of plasma and proteins into tissue which leads to edema.
• Edema=loss of systemic volume.

• Initial decrease in cardiac output
• Loss of circulating plasma volume
• Hypovolemia related to fluid shift
• Can lead to hypovolemic shock
• Increases in hematocrit
• RBC's destroyed
• Decrease in platelet function
• Possibke thrombosis

• High metabolic rate
• Stress response (elevated catacholamine levels)
• severe catabolism
• Weight loss
• Decreased wound healing
• High sugar levels

• Gastric dilation
• Peptic ulcers
• Paralytic ileus
• Depressed motility

• Hypovolemia
• Decreased cardiac output
• Decreased renal blood flow
• Decreased GFR
• Myoglobin casts related to muscle destruction
• Renal tubular necrosis

• Related to smoke inhalation
• Hyperventilation
• Increased O2 consumption
• Fear
• Anxiety
• Pain

• Depresses immunoglobulins:
• IgA
• IgG
• IgM

• Head & neck: 9%
• Front: 18%
• Back: 18%
• Arm: 9% (x2)
• Leg: 18% (x2)
• Genitalia: 1%

• Head & neck: 18%
• Back: 18%
• Front: 18%
• Arm: 9% (x2)
• Leg: 13.5% (x2)
• Genitalia: 1%

• 1: emergent
• 2: acute
• 3: rehabilitation

Skin taken from another part of the body to be grafted

Topical

Topical

Topical

Topical

Topical

Topical

Topical