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11-18-2009, 08:28 PM
(I) Wound oedema :
Duration : Extend from 3 : 4 days.
Cause : It is due to injury to the capillaries loss of plasma from the burnt surface.
Pathology : The amount of plasma loss depends on :
1- Extent of burn : the wider the burn the more the plasma loss .
2- Depth of burn : 3rd degree burn, fluid loss more than other degrees due to maximum capillary injury without its blockage.
Clinical picture :
* Pain : severe Neurogenic shock .
* Hypovolaemic shock due to intense loss of plasma in major burns .
* Pneumonia due to
Thermal injury.
Hypostatic pneumonia.
* Pulmonary oedema due to over hydration therapy and pneumonia. Pulmonary oedema is the commonest cause of death in 1st 48 hs.
(II) Wound infection :
Duration : start from the 4th day to 30 th day .
Source :
1- Invasion of burnt area by skin bacterial flora.
2- Self contamination from mouth and anus .
3- Contamination from environment "cross infection".
Pathology : infection toxaemia increase catabolism.
Clinical Picture :
General symptoms of toxaemia Fever & malaise
Loss of weight due to loss of plasma ,anorexia , catabolism.
On > 10 days Stress ulcers may occur in G.I.T."Curling's ulcer" Haematemesis, Melena
(III) Wound Healing:
(A) Superficial burns heal by epithelization unless infection is occurred "without grafting".
(b) Deep and infected burns heal by G.T. with scar formation "Early graft can prevent"
SOURCE: DR. AYMAN SALEM'S BOOK
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