Download MBBS Burns and Plastic Surgery PPT 5 Fluid Therapy And Wound Care In Burns Complications Burns Lecture Notes

Download MBBS (Bachelor of Medicine, Bachelor of Surgery) Burns and Plastic Surgery PPT 5 Fluid Therapy And Wound Care In Burns Complications Burns Lecture Notes

Fluid therapy and wound

care in burns,Complications

of burns

Fluid therapy in burns


Why fluid therapy?

Prompt fluid resuscitation is essential for survival in these patients.

Since the implementation of efficient, dynamic fluid replacement, fewer

patients die in the first 24?48 h

All formulas are guides: Clinical decisions


Assessment of Burn Area

The Rule of 9

Simple

Due to differences in body

proportions, the percentage for

each body area is different in

adults and children.

Lund and Browder chart


Hand

Fluid formula

Parkland

Initial 24 hours: RL 4 ml/kg/% burn (adults)
Next 24 hours: Begin col oid infusion of 5% albumin 0.3?1 ml/kg/% burn/per hour

Modified Brooke

Initial 24 hours: No col oids. RL solution 2 ml/kg/% burn in adults and 3 ml/kg/%

burn in children

Next 24 hours: Col oids at 0.3?0.5 ml/kg/% burn and no crystal oids are given.

Glucose in water is added in the amounts required to maintain good urinary

output.
Pediatric Galveston

Initial 24 hours: RL 5000 ml/m2 burn + 2000 ml/m2 total (1/2 of total volume

over 8 hours, rest of the total volume in 16 hours)

Assessment of adequacy of fluid

therapy

Urine output:

1ml/kg/hour children
0.5 ml/kg/hour adults
1.5-2 m/kg/hr electrical burn

Invasive monitoring
Fluid therapy after 24 hours

Colloids

Evaporative water loss

Oral feeding

Type of Fluid :

Isotonic

Hypertonic saline

Colloid

Dextran


Wound Care

Outpatient Burn Management

Who can be treated as outpatient

burn?

Blisters

Cleansing the wound

Topical agents

Dressings

Follow up


Acute Burn wound management

Cleansing

Pain control

Topical agents

Dressings

Dressings in Burn

Synthetic dressings

Bilogical dressings: Amniotic

membrane

Skin substitutes: Alloderm,

Biobrane


Debridement

Tangential excision:

Tangential excision removes burned skin while preserving the underlying viable

tissue

Full thickness excision

Tangential

excision


Wound coverage

Sk

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Complications of Burns


Early complications

Burn shock
Pulmonary complications
Infection and sepsis
Organ failure
Death
Limb loss
Curling's ulcer
Wound complication

Late Complications

Joint contractures

Hypertrophic scars

Keloids

Psychological stress

Marjolin's ulcer



Questions

1. What is the most common topical agent used for burn dressing?

2. What is the fluid required for resuscitation of superficial burns involving 10%

TBSA in a 50 kg man?

3. What is marjolin's ulcer?