IV - B.S. Occupational TherapyOT 5 STR: BURNSMarch 09, 2015

ANATOMY/PATHOPHYSIOLOGY

Skin (15-20% of body weight)

Functions:

P - Protection

I - Insulation

R- Reception (receptors in dermis)

A- Aids in homeostasis

T- Temperature regulation

E- Elimination

S- Synthesis Vit. D

3 LAYERS OF THE SKIN1. Epidermis: consists of 5 layers

a. Stratum corneum

b. Stratum lucidum

c. Stratum granulosum

d. Stratum spinosum

e. Stratum basale

2. Dermis: also called true skin and is 20-30x more thicker than the epidermis. It contains blood vessels, nerve endings, lymphatics, sweat & sebaceous glands, collagen and elastic fibers.

Receptor Types:

a. Free nerve endings: pain & itchb. Merkels: touchc. Meissners: touchd. Ruffinis: warme. Krause: coldf. Pacinian: pressure & vibration3. Subcutaneous Tissue: also called hypodermis.

TYPES OF BURNS (ETIOLOGY)

1. Thermal burn: from actual contact with flames/explosions

2. Scalds: from steam, hot water, etc.

3. Electrical burn: AC/DC passes through body

4. Chemical burn: from acid/alkali

EFFECTS

1. Shock- #1 to combat; results from fluid & protein loss d/t increase permeability of vessel wall2. Infection

CLASSIFICATION

1. Superficial (1): epidermis only-sunburn; dry and red; (-) blisters; slight edema

-2-3 days to desquamate2. Superficial Partial Thickness: epidermis + upper third of dermis (1/3)-epidermis completely destroyed; (+) blisters; inflammation; bright red; extremely painful

-7-21 day healing time; may have discoloration3. Deep Partial Thickness(2): epidermis + 2/3 of dermis-nerve endings; hair follicles and glands injured

-mixed red & white; wet surface

-3-5 weeks healing time; keloids/hypertrophic consequences

4. Full Thickness (3): epidermis + dermis TOTAL-black/white due to necrosis; rigid; dry & leather like

-anesthetic wound; marked edema

5. Subdermal: epidermis +dermis+subcutaneous-mms and bones may be damaged

*Flows from the least resistant to greatest: nerves blood vessels musclesskintendoncartilageboneZONE OF TISSUE DAMAGE

1. Zone of coagulation: irreversible damage2. Zone of stasis: may become nerotic and die within 24-48 hours.3. Zone of hyperemia: minimum cell involvement and spontaneous recovery within 7 days.RULE OF NINE

It determines the burn size by percentage of total body surface area (TBSA).

Trunk-36%

Lower Ex- 18% each

Upper Ex- 9% each

Head & Neck- 9%

Genital-1%

Karen Abinsay