Burns

Burns: Or something else? Differential Diagnosis

Skin and subcutaneous (L00-L99). Lyell syndrome (synonyms: epidermolysis acuta toxica; epidermolysis bullosa; scalded skin syndrome) – rare skin condition characterized by vesicular detachments of the epidermis (cuticle). Mortality (death rate) is higher than that in burn victims with the same extent of skin damage.Two forms of Lyell’s syndrome are distinguished based on etiology (cause): drug-induced … Burns: Or something else? Differential Diagnosis

Burns: Consequential Diseases

The following are the most important diseases or complications that may be contributed to by burns: Skin and subcutaneous (L00-L99). Hyper-/hypopigmentation Keloid (bulging scar) Infectious and parasitic diseases (A00-B99). Sepsis (blood poisoning; most common cause of death in burn victims). Wound infection, unspecified Environmental pollution – intoxications (poisoning). Inhalation trauma – lung damage caused by … Burns: Consequential Diseases

Burns: Classification

Staging according to the depth of a burn Grade Symptom Burn depth 1 Redness, edema (combustio erythematosa). Superficial epithelial damage 2a Blistering on reddened skin (combustio bullosa); very painful Epidermis (cuticle) and superficial portions of dermis (dermis) with sequestration 2b Blistering on light background; painful Dermis; hair follicles and glandular appendages preserved 3 Epidermal shreds, … Burns: Classification

Burns: Examination

A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; furthermore: Inspection (viewing). Burned area and determination of the burned body surface area (KOF) as a percentage of the KOF and its degree of burn Needle prick test (checking pain sensitivity) – … Burns: Examination

Burns: Lab Test

1st order laboratory parameters – obligatory laboratory tests. Small blood count Inflammatory parameters – CRP (C-reactive protein). Electrolytes – calcium, chloride, potassium, magnesium, sodium, phosphate ↓ Fasting glucose (fasting blood glucose). Blood gas analysis (ABG); including carboxyhemoglobin (COHb) in arterial ABG for detection of carbon monoxide intoxication Total protein, albumin Urea i. Serum [> 35: … Burns: Lab Test

Burns: Drug Therapy

Therapeutic target Best possible care and improvement of prognosis Therapy recommendations Wound care (dressing changes always under adequate analgesia/anesthesia): Expose wound and cool (do not use ice water because of the risk of cooling; see “Further therapy”) From grade 2b burns (see below burns/classification): remove necrotic tissue (debridement; surgical, hydrosurgical, enzymatic). Wound covering with non-adherent … Burns: Drug Therapy

Burns: Medical History

The medical history (history of the patient) represents an important component in the diagnosis of burns. Family history Social history What is your occupation? Are you exposed to harmful working substances in your profession? Current medical history/systemic medical history (somatic and psychological complaints). Where are the skin lesions localized? How did the burns occur? Vegetative … Burns: Medical History

Burns: Diagnostic Tests

Optional medical device diagnostics – depending on the results of the history, physical examination, laboratory diagnostics, and obligatory medical device diagnostics – for differential diagnostic clarification. Arterial pulse contour analysis – method for monitoring hemodynamics in patients requiring intensive care. Electrocardiogram (ECG; recording of the electrical activities of the myocardium)Note: If there is a history … Burns: Diagnostic Tests

Burns: Surgical Therapy

Recommended course of action for the treatment of thermal injuries: Burns 2a: Conservative occlusive dressings (dressing in which the wound surface to be treated is covered with an impermeable or semipermeable plastic film). Temporary synthetic/biological skin substitute. Usually heals well. Grade 2b burns: Surgical debridement (surgically performed cleansing of a wound to remove dead tissue … Burns: Surgical Therapy

Burns: Prevention

To prevent burns, attention must be paid to reducing individual risk factors. Behavioral/disease-related risk factors. Fire Hot liquids / gases Hot bodies / objects Friction Radiation

Burns: Symptoms, Complaints, Signs

The following symptoms and complaints may indicate burns: The depth of a burn is described as follows: Grade Clinical picture Burn depth 1 Redness, edema (combustio erythematosa). Superficial epithelial damage 2a Blistering on reddened skin (combustio bullosa); very painful Epidermis (cuticle) and superficial portions of dermis (dermis) with sequestration 2b Blistering on light background; painful … Burns: Symptoms, Complaints, Signs

Burns: Causes

Pathogenesis (development of disease) Burns refer to tissue damage caused by exposure to heat. The heat may be caused by hot bodies, friction, heated gases or liquids, or radiation. Capillary damage occurs, resulting in edema (water accumulation) and consequent large volume loss. In addition to the primary burn, attention must also be paid to the … Burns: Causes