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2.taller quemaduras.
- 1. Departamento de Cirugía Dr. Julio César Jiménez Dr. Fernando Fco. Uribe Tovar UAG - HAL Quemaduras
- 7. LUGARES MAS AFECTADOS POR QUEMADURAS
- 8. Escaldadura Líquidos Inflama. Explosiones Vehículos Grasa Alquitrán Otros Incendio Casas Frecuencia Mortalidad 22 % 10 % 16 % 6 % 11 % 13 % 10 % 8 % 8 % 5 % 5 % 44 % 23 % 19 % Relación entre Frecuencia y Mortalidad en Quemaduras ---- ----
- 9. Escaldaduras Líquidos Inflamables Aceites y Grasas Fósforos Contacto Eléctricas Incendio Casas Inhalación Otras Causas de Quemaduras en niños 42 % 10 % 7 % 5 % 5 % 4 % 3 % 1 % 30 %
- 18. Caracteristicas clinicas de las quemaduras Quemaduras de Primer Grado Quemaduras de Segundo Grado Superficial Profundo Quemaduras de Tercer Grado
- 39. Areas especiales Cara Cuello Genitales Manos Articulaciones mayores -Axilas -Codo -Rodilla -Tobillos
- 40. Quemaduras de Áreas Especiales
- 47. Preguntas ?
- 54. Férulas y posición del paciente quemado. Posición fisiológica para prevenir deformidades y contracturas. Posición del enfermo es con elevación de miembros y de la cabeza de acuerdo a las áreas afectadas.
- 59. Estimación de Superficie del Área Quemada ( BSA ) para Adultos: Regla de los nueves
- 61. Profundidad de la Quemadura Zonas de Lesión de la Quemadura
- 72. Split Skin Graft Donor Site Management
Notas del editor
- The Wallace Rule of Nines is a convenient method for initial assessment of total burn surface area (BSA) in adults. The body is divided into areas of 9% (or multiples of 9) of the total body surface area and the burn extent is determined accordingly. Practically speaking, burns rarely occur over an ‘even’ body surface area. Thus, a 1% Assessment is a practical method for clinicians to determine the extent of a burn: since the palm of the human hand comprises 1% of body surface area, it can be used to accurately measure the extent of burns which have occurred over many different areas of the body.
- Split-thickness skin grafting is recommended for 3rd- and 4th-degree burns. This procedure involves harvesting skin from an unaffected part of the patient; skin is chosen on the basis of availability, colour match and convenience to patient and physician. Split thickness grafts involve harvesting the epidermis and superficial dermis as the skin graft, leaving behind sufficient dermis and epidermal remnants to allow the donor site to heal by regeneration. Donor sites heal in 10-14 days but they can prove to be quite uncomfortable for patients during this process. There is also a potential for complications, including extreme discomfort, intense pain, leakage of blood and serous fluid and infection. Traditional dressings consist of an open-weave tulle impregnated with petroleum jelly, covered by an absorbent layer of gauze and cotton wool, secured with a crepe bandage. The ideal donor site dressing should: Promote rapid wound healing Reduce pain Provide a barrier to infection Absorb copious amounts of exudate Be easy to handle and apply Be removable without traumatizing the new epidermis Not impede the mobility of the patient Not be antigenic or allergenic Reduce the risk of hypertrophic scarring Be inexpensive and readily available Dressings currently used for the management of donor sites include: Tulle gras , which has been in use for many years. The tulle adheres firmly to the raw surface and remains until healing is complete. Silver sulfadiazine , an antibacterial cream which has proven to be effective in reducing the risk of infection. Calcium alginates promote blood clotting and also promote wound healing by creating a moist environment. However in low exudatin wounds, the dressing does dry out unless an occlusive secondary dressing is used. Film dressings are used to create a moist wound healing environment. Although it has been noted that fluid can accumulate beneath occlusive dressings. Biological dressings made of pig or human skin can be used to dress donor sites.