BURN CASE BASED

DISCUSSION
Plastic Surgery
#1
 Male, 25 Year old have a traffic accident. He was felt
from motorcycle and got some wound on several region
of his extremity. The largest wound is on anterolateral
side of his right knee. The wound is about 20 times 10
cm² in size, and some part of the skin was detached from
fascia. “Pedicle was on the distal part of the wound. The
next wound is on lateral side of the right lower leg, size is
about 15 time 10 cm², and the wound bed looks pink and
wet. The last wound wound is on the dorsum of the right
pedis, size is about 15 time 10 cm² and the wound bed is
subcutaneous tissue and there are tendons exposed. 
Questions (?)
 How you will treat the wound on lateral right thigh?
 Why do you treat the wound like that?
 For the wound on right lower leg, what is modality
that you will propose to treat the wound?
 Why do you treat the wound like that?
 For the last wound, what is modality that you will
propose to treat the wound
 Why do you treat the wound like that?
#2
 A 20 years-old man is brought to emergency department
after sustaining burns during fire in his fuel-stand at the
front-yard of his home 2,5 hours before admitted. He has
blisters and blanching-erythema on his face, anterior side
of his neck, anterior truncal, and both of his upper arms.
The other lesion was pale and dry on his whole of right
lower arm, and both of his thighs. He is agitated. His
pulse rate is 110x/minute, blood pressure 90/40 mmHg,
and all of his acral are cold, while he feels paresthesia on
his right hand. His body weight is 50 Kg.
Questions (?)
 What is the first treatment which is needed by that
patient (life saving)?
 Why do treat like that (clinical reason)?
 What should be performed to save his limb?
 Why do treat like that (clinical reason)?
Questions (?)
 How many percent of body surface area which
were included in burn wound?
 What is the diagnosis?
 What agent, how much and how will you give the
intravenous fluid therapy in the 24 hour after
accident based on Parkland/Baxter formula after
your performed several steps above?
 When the patient is stable, what did you to manage
the burn wound?