Seedlings school of nursing

Presentation on - BURN

PRESENT BY-
NAME- RAJENDRA MAHER
Bsc.nursing 3rd year
Burn
 ANATOMY OF SKIN -
 The skin is the largest organ of the body, with a
total area of about 20 square feet.the skin protect
us from microb and the elements, help regulate
body temperature,and permits the sensation of
touch,heat and cold.
 Skin has three layer-
1. The epidermis,the outermost layer of skin, provide
a waterproof barrier and creates our skin tone.
2. The demis, beneath the the epidermis, contain
tough connective tissue,hair,sweat gland
3. The deeper subcutaneous tissue (hypodermis)is
made of fat and connective
DIAGRAM of skin with burn degree -
Introduction –
A burn occurs when some
or all of the different layers of cells in the
skin are destroyed by a hot liquid (scald), a
hot solid (contact burns) or a flame (flame
burns).
Definition –
Burns are tissue damage that
results from heat, overexposure to the sun or
other radiation, or chemical or electrical
contact.
OR
Damage to the skin or other body parts caused
by extreme heat, flame, contact with heated
objects, or chemicals.
Incidence of burn-
In India, over 1 000 000 people are moderately or severely burnt every
year.
Nearly 173 000 Bangladeshi children are moderately or severely burnt
every year.
In Bangladesh, Colombia, Egypt and Pakistan, 17% of children with burns
have a temporary disability and 18% have a permanent disability.
Burns are the second most common injury in rural Nepal, accounting for
5% of disabilities.
In 2008, over 410 000 burn injuries occurred in the United States of
America, with approximately 40 000 requiring hospitalization.
 Cause of burn –
 Fire
 Hot liquid or steam
 Hot metal, glass or other objects
 Electrical currents
 Radiation, such as that from X-rays
 Sunlight or other sources of ultraviolet radiation, such as a
tanning bed
 Chemicals such as strong acids, lye, paint thinner or gasoline
 Abuse
Classification of burn –
 First degree burn.
 Superficial second degree burn.
 Deep second degree burn.
 Third degree burn.
 Fourth degree burn.
FIRST DEGREE BURN -
SUPERFICIAL SECOND DEGREE BURN -
DEEP SECOND DEGREE BURN -
THIRD DEGREE BURN -
FOURTH DEGREE BURN -
Pathology of burn-
Clinical manifestations of burn –
 Blisters.
 Pain.
 Swelling.
 White or charred (black) skin.
 Peeling skin.
Diagnostic evaluation –
 Urea & Electrolytes.
 Full Blood Examination.
 Blood group.
 Cardiac enzymes.
 Arterial Blood group.
 X – ray.
 Complications –
 Bone and joint problems, such as when scar tissue causes the
shortening and tightening of skin, muscles or tendons
(contractures)Bacterial infection, which may lead to a
bloodstream infection (sepsis)
 Fluid loss, including low blood volume (hypovolemia)
 Dangerously low body temperature (hypothermia)
 Breathing problems from the intake of hot air or smoke.
 Scars or ridged areas caused by an overgrowth of scar tissue
(keloids)
ASSESSMENT OF BURN-
Treatment of burn –
 Water based treatment.
 Fluid to prevent dehydration.
 Pain and anxiety medication.
 Burn cream and ointments.
 Dressing.
 Tetnus shot.
 Drug that fight infection.
 Antiseptic.
 Antibiotic.
Fluid resuscitation of burn-
Management of burn-
Clinical course of burn client can be divided into three
phases:-
1. Emergent phase-
 Firstly remove the victim from burn source.
 Assess ABC
 T.T prophylaxis is necessary.
 Initia wound care.
2. Acute phase –
 Start fluid replacement therapy.
 Re-assess airways, breathing and circulation.
3.Rehabilitation phase-
 To provide education.
 To immunize deformites.
 To achieve maximal functional recovery.
 Alsoprovide psychological support and physical
exercise training.
 SKIN GRAFTING

Definition –
A skin graft is the removal and
transplantation of healthy skin from one area of the
body to another area.
Indications of graft-
 Split-thickness skin grafts are otherwise indicated
in acute skin loss (burn wounds, traumatic
wounds, infection), chronic skin loss (leg ulcers),
and as adjuncts to other procedures (to cover a
muscle flap).
Classification of graft-
Autologous: The donor skin is taken from a different site on
the same individual’s body (also known as an autograft).
Isogeneic: The donor and recipient individuals are genetically
identical (e.g., monozygotic twins, animals of a single inbred strain;
isograft or syngraft).
Allogeneic: The donor and recipient are of the same species
(human→human, dog→dog; allograft).
Xenogeneic: The donor and recipient are of different species
(e.g., bovine cartilage; pig skin; xenograft or heterograft).

1. Prosthetic: Lost tissue is replaced with synthetic materials such as

metal, plastic, or ceramic (prosthetic implants).[
Type of graft-
 Split-thicknessskin grafts (STSG)- are
composed of the epidermis and a superficial
part of the dermis.
 Full-thickness skin grafts (FTSG)- contain both
the full epidermis and dermis.
 Split thickness of skin grafting -

 ADVANTAGES –
 DISADVANTAGES-
 FULL THICKNESS OF SKIN GRAFTING -

 ADVANTAGES –
 DISADVANTAGES –
Donor site selection
 Instrument of uses in skin grafting -
STSG HARVESTING
STSG
FTSG
Nursing Diagnosis –
1. Pain related to burn injury.
2.Self care deficit related to functional deficit.
3.Risk for infection related to loss of skin barrier.
4.Impaired physical mobility related to edema,
dressing.
5.Impaired Nutrition,less than body requirement
related to increase metabolic needs for wound
healing.
Prevention of burn –
 Reduce water temperature. ...
 Avoid hot spills. ...
 Establish ‘no’ zones. ...
 Keep hot devices out of reach. ...
 Test food temperature before feeding young
children. ...
 Choose a cool-mist vaporizer. ...
 Address outlets and electrical cords. ...
 Choose fire-resistant fabrics.
Summary of burn -
 Burn, Damage caused to the body by contact with
flames, hot substances, some chemicals, radiation
(including sunlight), or electricity. Burns are
classified by depth of skin damage and by
percentage of skin damaged. First-degree burns
injure only the epidermis (top layer), with redness,
pain, and minimal edema. In a second-degree
burn, damage extends into the dermis (inner
layer), with redness and blisters. Third-degree
burns destroy the entire thickness of the skin.
 BIBLIOGRAPHY -
1. http:// my.clevelandclinic.
2. http:// www.slideshare.net.
3. http:// www.who.int.
4. http://www.britannica.com.
5. medical surgical nursing book writer- p.k.
Panwar (page no.356-361).