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
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