Treatment of burns includes:a) No bandage to head & neckb) Immediate application of ice cold waterc) Superficial burns without blister- no need of dressingd) Escharotomy done for peripheral circumscribed lesions
Correct Answer: acd
Description: Management of burn:
Ist degree burn - First degree wounds are minor with minimal loss of barrier function. These wounds require no dressing and are treated with topical salves to reduce pain. Oral NSAID, can be given for pain control.
2nd degree burn - Second degree wounds can be treated with daily dressing changes and topical antibiotics, cotton gauze, and elastic wraps. Alternatively the wounds can be treated with a temporary biologic or synthetic covering to close the wound.
Deep 2nd degree & 3rd degree burns - Deep second degree and third degree burns are treated by excision and grafting. Initially dressing is used to check bacterial proliferation and provide occlusion until surgery is done.
About option 'a' i.e. ' No bandage to head & neck'
There are two methods of burn wound management with topical agents:
1) Open or exposure method
- no dressings are applied over the wound after application of the topical agent to the wound
2) Closed method
- an occlusive dressing is applied over the agent and is usually changed twice daily.
The closed method is the preferred method except for places where it is difficult to apply the dressing material like - face & perineum.
About option 'b' i.e. 'Immediate application of ice cold water'.
Iced water should never be used, even on the smallest of burns. If ice or cold water is used on larger burns, systemic hypothermia often follows, and the associated cutaneous vasoconstriction can extend the thermal damage (Schwartz 8/e,p 192)
Room temperature water can be poured on the wound within 15 minutes of injury to decrease the depth of the wound but any subsequent measures to cool the wound are avoided to prevent hypothermia during resuscitation (Sabiston 18/e, p 566)
Category:
Surgery
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