IV - B.S.

Occupational Therapy

OT 5 STR: BURNS

March 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 SKIN

1. 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 & itch
b. Merkels: touch
c. Meissners: touch
d. Ruffinis: warm
e. Krause: cold
Karen Abinsay

IV - B.S. Occupational Therapy

OT 5 STR: BURNS

March 09, 2015

f. Pacinian: pressure & vibration

3. 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 wall
2. Infection
CLASSIFICATION
1. Superficial (1): epidermis only
-sunburn; dry and red; (-) blisters; slight edema
-2-3 days to desquamate
2. 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 discoloration
3. 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 musclesskintendoncartilagebone
ZONE OF TISSUE DAMAGE
1. Zone of coagulation: irreversible damage
Karen Abinsay

IV - B.S. Occupational Therapy

OT 5 STR: BURNS

March 09, 2015

2. 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