Download MBBS Burns and Plastic Surgery PPT 7 Special Burns Lecture Notes

Download MBBS (Bachelor of Medicine, Bachelor of Surgery) Burns and Plastic Surgery PPT 7 Special Burns Lecture Notes


Non Thermal injuries, Burn

Reconstruction Principles

Types of non Thermal Injuries

? 1. Electrical injuries
? 2. Chemical injuries
? 3. Cold Injuries
? 4. Ionizing radiation injuries


Electrical injuries

Contact Burns

PATHOPHYSIOLOGY

? Joule Effect:
? Passage of current through a solid conductor results in conversion of electrical

energy to heat

? Ohm's Law:
? I = V / R
? Intensity of the current (amperage) is directly proportional to the potential flow

(voltage) and inversely proportional to the resistance
? Joule's Law:

? J = 0.24 x I sq x R x T

? J = Heat Production I = Current R = Resistance T = Time

? Resistance of body tissues

? Nerves and Blood Vessels - Good to excellent conduction

? Muscle Bone and Skin - Resistant to passage of electricity Electrical

Burns

? Extent of injury depends on

? Type of current (alternating vs direct)

? Pathway of flow

? Local tissue resistance

? Duration of contact Electrical Burns

Mortality of electrical burns

?
? Low-voltage injuries:
? Alter the cardiac cycle

? High-voltage injuries
? Cause concomitant tissue damage
? Survival of contact with voltage greater than 70,000 volts uncommon



CLASSIFICATION

? I Physical

1.Heat

2.Electrical Burn injuries

3.Lightening injuries

4.Radiation burns

5.Friction burns

? I Chemical

Acids --1.Sulphuric acid

2. Hydrochloric acid

3. Nitric acid

4.hydrofluoric acid

5.Chromic acid

Classification--contd.

Alkalies ? 1.Caustic soda

2.Caustic potash

3.Lime

4. ammonia

Organics ? 1. Phenol

2. Lysol

3.Cresol

Inorganic -- 1. Phosphorus

2. Sodium

3. Magnesium

I I Other special burns

1.Hot coal tar burns

2.Jaggery burns

3.Molten metal burns

4.Hot oil burns


CHEMICAL BURNS

?Apart from damaging skin chemical toxins may get

absorbed through skin and go into circulation in

chemical burns.Toxic effects on patients are in

1. liver--acute liver atrophy
2. renal--renal failure
3. nervous ?delerium and convulsions
Carbolic acid (Phenol) , Creselic acid (cresol),
Chromic acid and Hydrofluoric acid are known to

cause systemic toxicity













Management of chemical burns

1.Wounds to be washed with running water minimum for 15 min or till

litmus test becomes negative.

2.Proper care of eyes in facial burns with ophthalmic reference
3. Early excision and skin grafting.







Surgical

Surgical Management




Special Chemical Burns

?Hydrofluoric acid burns--HF acid is used in glass

industry . Patient presents with severe intense pain

at the site of burn. Treatment in these burns is Ca

Gluconate irrigation or local injection.


?Phenol burns--- are known for its systemic

manifestations. Treatment is irrigation with copious

water and removal of phenol.


Hydrofluoric acid burns



Tar burns

Car battery acid burns


Burns of special sites


1.Burns of face ?eye, ear
2.Burns of hand



FACIAL BURNS

? Eye burns ?
? inability to close the lids
? exposure keratitis with damage to cornea.
? managed either with tarsorraphy or early excision and skin grafting


Ear burns ?
? Ear cartilage is peculiar in nature ?

1. is a single cartilage

2. perichondrium is tightly adherent with skin on both

the sides

? Burns of ear if not properly treated may lead to

chondritis and crumpled ear deformity.

? Treatment includes ?

1. closed dressing with antibacterial cream

2. pil ows to be avoided to prevent frequent rub and

subsequent infection

3.excision and temporoparietal fascial cover in full

thickness burns of ear.





Summary of tt. For specific chemical burns

? Irrigation with water-all except sodium , lithium, potassium metals

and mustard gas

? Calcium salt inj. Or irrigation ?hydrofluoric acid
? cover with oil ? Na, K ,LITH. Etc.
? cover with water ?phosphorous metal

Radiation burns
Management

? Aloe vera cream
? Corticosteroid creams
? Systemic Amifostine

Cold injuries


Frost bite

? Rewarming of the skin
? Debridement and pain medication
? Whirl pool therapy
? Anticoagulants and antibiotics
? Surgery
? Hyperbaric oxygen


Trench foot

Below freezing

Temperature

+ moisture

Management

? Rest, warming
? Picric acid, Boric acid
? Alcohol

This post was last modified on 07 April 2022