burns of the integument
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Burns of the Integument. tissue damage inflicted by intense heat, electrical, radiation, or certain chemicals all of which denature cell proteins - PowerPoint PPT PresentationTRANSCRIPT
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Burns of the Integument
• tissue damage inflicted by intense heat, electrical, radiation, or certain chemicals all of which denature cell proteins
• immediate threat is loss of body fluids containing proteins and electrolytes – as fluid seeps from burned surfaces leads to dehydration which then leads to renal failure and circulatory shock
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• infection becomes next threat and is the leading cause of death in burn victims
• burned skin is sterile for 24 hours – then bacteria, fungi, and other pathogens can easily invade areas where skin barrier has been destroyed and multiply quickly in the nutrient rich environment of dead tissue
• immune system becomes deficient within 1 – 2 days after severe burn
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First Degree• Only epidermis damaged• Heals within 2-3 days
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Second-degree burns affect both the (epidermis) and (dermis) causing redness, pain, swelling and blisters.
Affect sweat glands, and hair follicles.
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• Third-degree burns affect the epidermis, dermis and hypodermis, causing charring of skin or a translucent white color, with coagulated vessels visible just below the skin surface. These burn areas may be numb.
• Healing from third-degree burns is very slow due the skin tissue and structures being destroyed.
• Third-degree burns usually result in extensive scarring.
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Rule of Nines
The most common method for determining total body surface area (TBSA) of the burn for individuals 8 years of age +
Using this method, the body is divided into 11 sections of 9% or multiples of 9%, with the genitalia accounting for the final 1%.
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Rule of Nines
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Burns are considered critical if• over 25% of body has 2nd degree burns• over 10 % of body has 3rd degree burns• there are 3rd degree burns on face, hands, or
feet• facial burns introduce possibilities of burned
respiratory passages which can swell and cause suffocation
• joint injuries are trouble because scar tissue limits movement
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Skin Graft• must remove burned skin,
area is flooded with antibiotics, covered temporarily with synthetic membrane, animal (pig) skin, cadaver skin, or amniotic sac membrane
• Healthy skin is transplanted to burned site from donor site on patient to prevent rejection
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• rate of epidermal cell replacement slows – decrease heal time• skin thins – bruising increases and other injuries – decrease
heal time• glands diminish activity causing dry, itchy skin• sweat glands cause trouble with thermoregulation – die in
heat• elastin fibers clump and degenerate - wrinkles• collagen becomes fewer and stiffer - wrinkles
this effect is increased with prolonged exposure to wind and sun
• decrease in # blood vessels and ability to constrict blood vessels – disrupts homeostasis & lowers heal time
• fat layer diminishes- sagging skin &causes intolerance to cold, no heat regulation, and lack of color (pale)
• all of decreasing elasticity of skin and loss of subcutaneous tissue leads to wrinkles
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• fewer lymphocytes delay wound healing• melanocytes decrease in # and activity resulting in
less production from UV radiation therefore an increase in cancer rates “liver spots”
• sensitivity to pain and pressure decrease because of decrease in # of receptors – example food on mouth, sore on feet
• # hair follicles dropped by 1/3 at age of 50 and continues to decline resulting in hair thinning also loss of luster (protein in diet) and graying
no way to stop – can slow down process by shielding skin from sun, good nutrition, plenty of fluids, and cleanliness