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Burns
- 1. BURNS By Nicole klassen
- 2. Introduction The skin has an important role to play in the 鍖uid and temperature regulation of the body. If enough skin area is injured, the ability to maintain that control can be lost. The skin also acts as a protective barrier against bacteria and viruses, so without it, we would be in trouble. The anatomy of the skin is complex and there are many structures within the layers of the skin including the epidermis, dermis and hypodermis or subcutaneous layer. The amount of damage that a burn can cause depends on its location, its depth, and how much body surface area it involves.
- 3. Layers of the Skin Epidermis: the outer layer of the skin. Dermis: the middle layer of the skin made up of collagen and elastic 鍖bres. This is where nerves, blood vessels, sweat glands and hair follicles reside. Hypodermis or subcutaneous layer: where larger blood vessels are located. This is the layer of tissue that is most important for temperature regulation.
- 4. Description A burn is an injury by an exogenous agent that produces a characteristic reaction to local tissues which may vary from mild erythema to full thickness destruction of the skin and deeper tissues.
- 5. Causes Electric Chemicals Radiations Light Friction Thermal - dry heat - moist heat - 鍖ash burns
- 6. Classi鍖cation First Degree Second Degree Third Degree
- 7. First Degree Burns Least serious burn Only the epidermis is affected Skin is usually red, with mild in鍖ammation and sometimes pain A mild sunburn is the most common example Skin is usually tender to touch Usually resolves with basic 鍖rst-aid measures within several days to a week Usually heals in 1 week or less
- 9. Second Degree Burns Involves all layers of the epidermis and some of the dermis Skin is red, blisters appear instantly, edema and pain Often looks wet or moist Often leaves a permanent scar
- 11. Third Degree Burns Involves all the layers of the skin Kills that area of the skin Destroys hair shafts, sebaceous glands, erector pilli muscles, sudoriferous glands, and free nerve endings Skin looks white and/or charred and there is a leathery texture of the skin in the affected area
- 14. RULE OF 9s In addition to the depth of the burn, the total area of the burn is signi鍖cant. The rule of 9s is often used to measure the percentage of total body area affected, although this is adjusted for infants and children. Only areas with second and/or third degree burns are added together If more than 15-20% of the body is involved in a burn, signi鍖cant 鍖uid may be lost and shock may occur and risk of death also increases
- 16. Treatment and Outcomes First and second degree burns are seldom treated with anything more than soothing lotion and possibly antibiotic cream if the skin has been damaged to the point of not providing protection from infectious agents. Third degree burns must be treated with more care to minimize the accumulation of binding scar tissue. This often means would cleansing and aggressive brushing of the skin to remove debris, as well as skin grafts and plastic surgery. Untreated burns tend to develop tightly restrictive tissue contractures, which can be so severe that they interfere with blood 鍖ow and may lead to the loss of healthy cells through starvation. Skin grafts reduce contractures and provide healthier covering for the injured tissue.
- 17. Massage People with burns suffer pain, itching, and anxiety both from the burn itself and during the healing of wounds. Massage may help ease these symptoms in both the emergency-care and recovery phase. People receiving massage therapy have reported that the feel less itching, pain, anxiety and depressed mood compared to those who received standard care only. The only kind of burn that is appropriate for hands-on massage in the acute stage is a very mild sunburn, and of course even then one must work within pain tolerance. Massage may speed the healing process along by helping to slough off dead cells, but this is not something to do without a clients permission. More severe burns my be approached in the subacute stage, but the are locally contraindicated. It is appropriate to work around the edges of the burn within the pain tolerance to improve elasticity and minimize scar tissue, as long as the risk of infection is minimized. If the burn is past the subacute stage, where no pain is present and only residual scar tissue is left, massage is safe as long as sensation is intact. Patients who have received massage prior to getting debridement or other wound care, have reported to having lower levels of anxiety, pain, and depression.
- 18. Massage Essential oils may also be used to heal the skin and treat the pain cause by burns. Oils are the most bene鍖cial in the 鍖rst degree stage. Lavender oil is especially recommended for the treatment of burns, as well as calendula, comfrey, chamomile, and tea tree. The simplest way to treat your burn with these oils is to add several drops of the chosen oil into a cool bath and soak the skin in the water. You may also use a cotton ball to dab some drops directly on the burnt skin, however be careful while doing this because the oil can be harmful to the skin when used in its natural concentration.
- 19. Modi鍖cations to Massage Treatment Once burn scars have mature enough in order to refrain from shearing, which is pulling away from healthy tissue, you might want to try scar massages. This can help preserve softer, more 鍖exible tissue and avoid scar contractures. Scar massage is usually performed two or more times a day and is occasionally combined with heat, caster oil, and lotion to increase tissue 鍖exibility. Just remember that when your working with heat, it can bring back negative feelings for the client, so you have to be aware of that. Exercise therapy is a vital part of burn rehab. As a burn survivors rehabilitation moves forward, advanced exercises can be introduced in order to increase strength, motion and mobility. Exercise therapy reduces swelling in the arms, hands, feet and legs, improves joint motion and muscle strength, increases 鍖exibility, decreases the chances of having blood clots, and increases bone density. The most important thing to remember when working with not only a burn patient, any patient, you have make sure you working within the clients tolerance and make sure they are comfortable with your treatment techniques.
- 20. New Studies/ information/ Burns and 鍖res are the third leading cause of accidental death in the United States. Between 1-2 million Americans seek medical attention for burns each year, most of which occur at home, work or part of an injury from a motor vehicle accident. Most burns that happen to children come from scalding liquids. 28 burn patients were randomly assigned to receive massage therapy or standard treatment while in the hospital. Patients in the massage therapy group received 20 minute general body massage prior to wound cleaning once a day for 1 week. Reported effects include decrease anxiety, decreased pulse rate, decreased levels of cortisol, decreased pain, and improved mood.
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