Continuum of Care of a Patient with Burns

This article or area is currently under construction and may only be partially complete. Please come back soon to see the finished work! (6/05/2024)

Original Editor - User Name

Top Contributors - Ewa Jaraczewska and Jess Bell  

Factors Impacting Recovery

• Diabetes
• Tabacco use
• History of depression
• Limited or lack of social support
• Unknown discharge destination
• Inhalation injury causing acute respiratory distress or even acute respiratory failure

Initial Assessment

1. Burns location and depth
   • a chart called the Lund and Browder. The Lund and Browder is used to calculate total body surface area, or TBSA, and includes areas that are partial- and full-thickness and excludes superficial areas. In looking at Oleksandr's Lund and Browder, we are able to get a good idea of if burns are crossing joints and areas that he may need surgical intervention.
2. Wound assessment without dressing
   • colour, if they are wet or dry, blanchability, and then also assess pain. We know that the less pain there is, the deeper the burn, which indicates that the person is more likely to require surgical intervention for healing.

Preoperative Management

Goals:

1. To increase functional mobility
2. To prevent pulmonary complications
3. Oedema management
4. Initiate proper positioning

Interventions:

• active range of motion
• patient and caregiver education about:
  • activities restrictions and need to increase mobility
  • pain and how to manage it
  • activities restrictions after the surgery

Reconstructive Burn Surgery

Early excision and closure of the burn wound is sometimes described as the greatest advance in the treatment of patients with severe thermal injuries." Reconstructive burn surgery has greatly improved the quality of life for burn patients by restoring function and appearance to the affected areas. This type of surgery may involve skin grafts (Figure 2), tissue expansion, and other techniques to repair damaged tissue and minimise scarring "

General informations:

patient typically undergoes multiple rounds of surgery

various surgical procedures may take up to three to four weeks

Surgical Procedures

• escharotomies
• surgical excision and debridement
• Allograft
  • Cadaver skin
  • Not a terminal grafting technique
  • Use to cover a large area of the burn
  • Patient is allowed to move within 24 hours with no restrictions
• Autograft
  • Any areas that cross joints covered with autograft should be immobilised for the first five days
  • Activity is encouraged. If a patient is immobilised over their wrist and their hand, they should be able to get up and walk

Resources

• bulleted list
• x

or

1. numbered list
2. x