and other thermal injuries 烧伤课件

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1、BurnsandotherthermalInjuriesDr.YonglinLi(李永林),MDDirector,associateprofessorDepartmentofPlasticSurgeryandBurnsFirstAffiliatedHospitalSoochowUniversityFourClasses&160minutesIntroductionofBurnInjuryBurns:thermalinjury/chemicalinjury/electricalinjury/laserorradiationburns,etc.Thermalin

2、jury:fireorflame/hotorboilingwater/fluid/stream(scalding)/hotsubjects/hotgrease,etc.Localskinormucosalinjuryandtissue/organsinjuries(wholebody)TypesofBurns(III&four-Method)SuperficialBurn(FirstDegree):red/dry/painfulPartial-thicknessBurns(SecondDegree):Superficialdeepred/whitewith

3、blistersFull-thicknessBurn(ThirdDegree):escharSuperficialBurn(FirstDegree)Ⅰ度red/dry/painfulPartial-thicknessBurns(SecondDegree)浅Ⅱ度Superficial:redwithblistersPartial-thicknessBurns(SecondDegree):深Ⅱ度deep:redandwhitewithblistersFull-thicknessBurn(ThirdDegree)Ⅲ度escharElectricalBurnDet

4、erminationofSeverity(I)Theextentofburnestimated:100%TBSA(totalbodysurfacearea)1%(plummethod)rulesofninesandtens(Wallace’s)Thedepthofburnassessed:IIIdegreesandfourtypesRespiratorytractinjuryinburns(inhalationinjury):complicatedornotDeterminationofSeverity(II)Minorburninjury:<15%(adu

5、lts)/10%(children)TBSA<2%TBSA(IIIdegree)Moderateburninjury:<30%(adults)/20%(children)TBSA<10%TBSA(IIIdegree)Severeburninjury:>30%(adults)/20%(children)TBSA>10%TBSA(IIIdegree)withcomplications,suchas…Majorburninjury:>50%(adults)/30%(children)TBSA>20%TBSA(IIIdegree)PathophysiologyofT

6、hermalInjuryVascularpermeability:↑increasedEdemaLossofintravascularfluidandproteinCirculatingvolume:↓decreasedHypoproteinemiaCellenergyandmembranepotential:↓HemodynamicstabilityMetabolicResponsetoBurnsPain/stress/sepsis,etc.Mediatorsofinflammation,cytokinesandendotoxinTheevaporativ

7、ewaterloss:↑Hypermetabolism:↑increasedmetabolicrateNutritionalsupportClinicalStagesofBurnPatientsFluidexudation(shockstage):36-48hoursInfectionstage:burnhematosepsis/burnwoundsepsissystemicinfectionStageofwoundrepair:superficialdegreeburndeepdegreeburnPrinciplesofburnmanagement:QOL

8、(qualityoflife)First-aidof