The Challenging Patient: Burns and Trauma & Less Common Burn Injuries: 2023 Trauma University-Handout: Less Common Burns

Handout: Less Common Burns

Pdf Summary

This document discusses less common burn injuries and burns that damage more than the skin. It is a presentation by John Griswold, a medical professional, covering various types of burns and their treatments. The document includes case studies of patients with electrical burns and chemical burns.<br /><br />The presentation highlights that electrical burns, especially high voltage injuries, can cause severe damage to deep tissues, including muscles. It emphasizes the importance of closely examining areas of skin contact for signs of deep tissue injury, such as rigid joint contraction and evidence of reduced blood flow to distal tissue.<br /><br />Additionally, the document discusses the risk of acute kidney injury due to the release of myoglobin in electrical burns. It recommends monitoring myoglobin levels and implementing renal protection strategies in cases where levels are above 1000ng/dl.<br /><br />Regarding chemical burns, the document emphasizes the differing effects of acid and alkali burns. Acid burns cause caseation necrosis, which forms a barrier to deeper injury, while alkali burns cause liquefaction necrosis, leading to progressive tissue injury. Treatment for chemical burns involves copious irrigation and removal of any remaining powdered chemical.<br /><br />Furthermore, the document mentions that ingested chemicals can damage the esophagus and gastrointestinal tract. Intraoral burns should prompt an evaluation with an esophagogastroduodenoscopy (EGD) procedure. However, the majority of pediatric patients with head and neck chemical burns do not require endoscopic intervention.<br /><br />Lastly, the document briefly mentions burns combined with internal injuries. It notes that incisions through burn wounds early in the course of treatment have a high risk of surgical site infections, recommending leaving the subcutaneous and skin layers open for secondary closure or using negative pressure wound therapy if possible.<br /><br />Overall, the document provides an overview of less common burn injuries and highlights important considerations for their management.

Keywords

burn injuries

deep tissue damage

electrical burns

high voltage injuries

acute kidney injury

myoglobin levels

chemical burns

acid burns

alkali burns

internal injuries