Local Management :

• Dressing at regular intervals under general

anaesthesia using paraffin gauze ,
hydrocolloids , plastic films , fenestrated
silicon sheets or biological dressings like
amniotic membrane

•OPEN METHOD
With application of silver sulfadiazine without
any dressings , used commonly in burns of face ,
head and neck

•CLOSED METHOD
In this dressings are done to soothen and to
protect the wound, to reduce the pain.
After cleaning with POVIDINE IODINE SOLUTION silver
sulfadiazine ointment is used. It is an antiseptic and soothing agent.
It causes neutropenia.
 WOUND COVERAGE:
•Once the area granulates well in 3 weeks usually , split skin grafting is done.(SSG)
•For wider are MESH is used.
•If there is eschar, escharotomy is used to prevent compression of vessels.
•In certain areas like face and ear, full thickness graft ( WOLFE GRAFT) or flap is required.
•Cultured skin is used.
•SYNTHETIC DRESSINGS:
•Hydrocolloid dressing – it helps in proper epithelization. Used in mixed deep burns.
•Opsite
•Transcyte
•Integra
•BIOLOGIC DRESSINGS:
•It is used to cover the wound temporarily as the barrier and also have some immunologic
functions.
•Possible problem is transmission of viral diseases.
•Commonly used are: XENOGRAFT is of PIG SKIN, ALLOGRAFT is of CADAVER SKIN.
ESCHAR:
• It is the charred, denatured , full
thickness deep burns with
contracted dermis.
• CIRCUMFERENTIAL ESCHAR:
seen in the upper limb, lower
limb , neck and thorax can cause
more oedema with initially venous
compression and later arterial
compression causing ischemia,
gangrene of the distal part.
ESCHAROTOMY:
• Deep longitudinal full thickness
are made in different areas so as
to prevent collection of oedema
fluid and also to prevent
compression over the vessels.
This is called as ESCHAROTOMY.
• It causes large quantity of blood
loss so blood transfusion is
required . It should be placed in
such a way to prevent injury to
major neurovascular system.
BURNS AND NUTRITION:
• One of the most important
aspects in treating burns
patients is nutrition. Any
adult greater than 15% of
total body surface area has
an increases nutritional
requirement.
• If 20% of TBSA or greater
should receive a nasogastric
tube.
• Various formulas are
available to calculate the
energy requirements of
burns patients.
CONCLUSION: