surgical procedures and management

Apr 15th, 2015
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Burn managementIntroduction-1 One of the most devastating injuries Affects the largest organIntroduction-2 Commonly affects individuals withunderdeveloped or impaired ability to avoidinjury Effects are: Physical PsychologicalEpidemiology Local study:About 170 children admitted annually to PGH, Nakurumean age 2.6 yearsM:F ratio 1.4:190.2% of the burns due to scaldsThe mortality was 11.9% American Burn Association 2.2 million people are burned in the US every year 5500 deaths result from burn injury 60,000 admitted for hospital careCausesScaldsFlameContactElectricalChemicalCold burnsFlashFrictionRadiationPathogenesis Injured cells release inflammatory mediators Mediators cause an inflammatory response with increased capillarypermeability Occurs in the first 3 days Peak at 4-8hours Loss of fluid containing electrolytes and proteins SIRS or clinical capillary leak syndromeSystemic effects of burn injuryDepend on Extent of burn Age Depth Delay in resuscitation3 zones of injuryDescribed by Jackson in 1947 Central necrosis Zone of stasis (at risk of necrosis) Zone of hyperemiaZones of injuryRenal effects Kidneys In extensive burns- microalbuminuria Albumin rich fluid results in kidney edema Increased pressure in the glomeruli Reduced filtration ADH release

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