• heat burns→ liquids, hot solids, flame→ closed space burns
• chemical burns→ corrosive substances
• electrical burns

• ACTH → ↑Mineralcorticoids
• ADH
• beta-endorphins
• catecholamins
• TSH
• cortisone
• glucagon

catabolic hypermetabolism:

• ↑endogenous glucose synthesis
• proteic hypercatabolism

• serotonine
• kinins
• prostaglandins
• necrolides
• leukocyte release

suppression→makesbody prone to endogenous or exogenous infection

rule of nine 📷; rule of palm (1%) 📷

1. extinguish fire
2. drop cloths, rings etc
3. cool out the tissues but avoid hypothermia!
4. chemicalburns→ maybe washing out with saline

• tetanus prophylaxis
• surface and depth evaluation
• resuscitation, cervical immobilisation

1. lesions of airway→inspiration trauma (hoarseness of voice, burn in mouth)
2. thorax lesions
3. unconscious patient (CO intox?)

• re-evaluation of patient (surface+depth + prognosis index)
• neurologic test Lab, blood gases, radiologic evaluation
• iv fluids
• monitoring

just remember some of them

1. III degree
2. inhalation
3. burn >20% body surface (>10% if <10y or >50y)
4. at specific locations
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5. Electrical + Chemical burn
6. comorbidities
7. homeless

1. cool out (not hypothermia❗)
2. wound cleaning
3. topical desinfectants (in III degree)
4. special dressings (tegaderm 📷, opsite) (not on face→just topics)

1. early excision and grafting → deep + large (>30% Surface Area)
2. tangential excision 📷→ use dermatome
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Tangential excision: The term refers to the removal of the necrotic surface of a burn by taking repeated parallel slices using a skin graft knife, as opposed to using a scalpel to excise burned skin and subcutaneous tissue together.

3. excision to fascia 📷 → only in full thickness burns and wound infections, or failed first skin graft
4. seriate excision → well delimitate burns, repeat every week until all the whole region is grafted

• regarding healing-process:
• late healing
• hypertrophic, retractable scar
• itching
• multiorgan failure
• ulcerations + Marjolin ulcer
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Marjolin's ulcer:
• Aggressive ulcerating squamous cell carcinoma that occurs in previously traumatized, chronically inflamed, or scarred skin.
• Commonly associated with chronic wounds: including burn injuries, varicose veins, venous ulcers, ulcers from osteomyelitis, and post-radiotherapy scars.