Hydrotherapy & Burn Wound Care

Bailey Burge RN, BSNBurn Intensive Care Unit

April 28, 2011

ObjectiveIdentify important aspects of hydrotherapy

and wound care.

Hydrotherapy RoomProcedure Room

Environmental comfort Patient’s room remains “safe-haven”

Water pressureAvailability of specialized equipment and

productsAids in maintenance of ROM

Hydrotherapy Room

Burn Wound CareGreatest threat to survival after resuscitationGoal:

Early wound closureMaintain functionPrevent infection

Introduction of topical antibiotics has significantly reduced mortality

ProcessCultures

On admission and every Monday & Thursday Assists in treatment modality & reduces cost

Debridement On admission Get between dead and viable tissue

Pictures On admission, every Wednesday and graft T/D day

Clean PI sponges & sterile gloves per body part

Dressings Determined by cultures, degree of burn, staff experience, physician

Wrap Kerlex, surginet, ace, burn vests

Supplies

Specific AgentsSilver Dressings: Topicals:Aquacel AgSilver NitrateSilver Matrix

NeosporinMafenide acetate

(Sulfamylon)SantylBactrobanNystatinPovidone Iodine

Temporary wound coverings:Porcine xenograftHuman cadaver allograftsBiobrane

Graft & Donor SitesGraft: Graft care:Split thickness skin graft

Meshed (1:1.5, 1:2, 1:3, 1:4)

Unmeshed (sheet graft)Full thickness skin graftPermanent wound

coverageInitial dressings provide

security and compression

Splint applied if crosses joint

Protect from pressure, shear and movement

Keep initial dressing on until 3 days post-op

Take down day:% adheredRemove every other

staplePictureCultures

Graft Site

Retrieved from: http://apps.tpta.org/courses/Burn06/Graft.htm

Graft & Donor SitesDonor:

Donor Care with Glucan:

Harvested tissue sitePainfulMonitor bleedingHeals by

reepithelialization

Initial dressing remains intact for 48 hrs post-op

Take down day:Remove outer dressingObserve site

May appear yellowish and “soupy”

Remove staplesMay leave open to airTreat like a scab

Donor Site

Retrieved from: http://www.woundsinternational.com/pdf/content_196.pdf

SummaryHydrotherapy treatment continually washes

away dead skin and bacteria and decreases the risk of infection

Patient’s room can remain a safe placeBurn wound care is performed to promote

healing, maintain function and prevent infection and burn wound sepsis.

ReferencesAmerican Burn Association. 2007. Advanced Burn Life

Support Course: Provider Manual. Chicago, IL.: American Burn Association.

Beldon, P. (2007). What You Need to Know about Skin Grafts and Donor Site Wounds. Retrieved from http://www.woundsinternational.com/pdf/content_196.pdf

Herndon, D. N. (2007). Total Burn Care. Galveston, TX: Elsevier Health Sciences.

Weber, J., & McManus, A. (n.d.). Infection Control in Burn Patients. Retrieved from http://www.worldburn.org/documents/infectioncontrol.pdf

Wiegand, D. & Carlson, K. (2005). AACN Procedure Manual for Critical Care. St. Louis, MO: Elsevier Saunders