Fractures in combination with burns
Traumatology / / August 12, 2017
Burns, combined with mechanical damage are complex and difficult kind of injury.
mutual burdening syndrome manifested clinical symptoms of severe burn patients, especially burn shock and traumatic shock in seemingly "neshokovyh" mechanical damage, as well as delayed fusion of the bone fragments and recovery of locomotor system function.Sharply (3-4 times) increases the risk of development of purulent infection increases mortality.
most unfavorable is the combination of burning and mechanical trauma (crushing of soft tissues, fractures) in one or more limbs.mutual burdening syndrome fully expressed only in severe thermomechanical damages in mild burns and minor mechanical damage mutual burdening syndrome usually does not develop a common reaction, but the risk of developing infectious complications, such as in closed fractures, above.
burn injuries may arise from the flames of the fires, ignition of flammable materials from gas explosions, from contact with hot objects, molten metal, with
There are 4 degrees of burns:
I degree is characterized by hyperemia and edema of the skin;
II - the formation of bubbles;
IIIA - dermal lesions maintaining epithelial islands in the sebaceous, sweat glands and hair follicles sprout layer of the skin is affected not completely;
IIIB degree is characterized by lesions of all layers of the skin with its complete necrosis;
IV - skin lesions and underlying tissue (fat layer, muscle, bone).
Burns I, II, IIIA powers attributed to the surface at which the skin repairs itself (without kozhnoplasticheskih operations).Burns IIIB and IV relate to the deep, demanding mandatory use of different kozhnoplasticheskih operations.
severity of the condition affected depends mainly on the area of deep burns;superficial burns, accompanying the deep, have a negative impact on the affected during burn shock and to a lesser extent during the acute toxemia.Determine the exact degree of burns completely in the first day is not possible.For deep burn characteristic pallid skin, charring, sealing tissue with a clear picture of the saphenous veins, pain and loss of tactile sensitivity.Knowledge of the nature of the thermal agent and the duration of its effect significantly clarifies the diagnosis.In practice, it is important to know the total area burned and the area of a deep burn (at least approximately).
area burn is determined using the "nines" rule: the surface of the head and neck is 9%, each of the upper limb - 9%, each of the lower extremity - 18%, the chest and abdomen - 18% back - 18%, perineum and external genitaliabodies - 1%.
area burns on a small surface of the body is more convenient to define the way the palm.Palm area adult is 1-1.2% of the total surface of the skin.By applying his hand to burn surface, determine the lesion area with certain tolerances.The same method is more convenient to measure the area and unaffected areas with extensive burns, occupying almost the entire surface of the body.
- First aid for burns injuries complicated
- Treatment of fractures complicated burns
have suffered only burns with deep lesion area of 10-15%, burn disease develops, an early manifestation of which (in the first two days) is a burn shock.
When combined lesions deep burn even half the area (5-8%) will significantly burden the severity of the condition affected, especially when massive blood loss and extensive crushing of soft tissue.
outlooks burn injury is determined by the "hundreds" rule: if the sum of the age (in years) and the total burn area (%) of greater than 100, a poor prognosis.Perlomy, traumatic brain injury, damage to internal organs of the abdomen, chest, pelvis, and irradiation by ionizing radiation at a dose of 2 Gy worsen prognosis and with less severity of burn injury.
Burn airway severity conditionally corresponds to 10% of the body surface.