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Handbook of Burns; Volume 1: Acute Burn Care.

Tác giả: Jeschke, Marc G.; Kamolz, Lars-Peter; Sjưberg, Folke; Wolf, Steven E.

Chủ đề:

Chủ đề: Handbook; Medicine; Burn; Burn treatment

Nhà xuất bản: Springer

Năm xuất bản: 2012

Loại tài liệu: Book

Mô tả vật lý: 486 p.

Định danh: 978-3-7091-0347-0

Ngôn ngữ: en

Đọc trực tuyến

This volume covers the entire spectrum of acute burn treatment. Individual chapters deal with basic aspects of different burn mechanisms as well as the acute care of burn patients. Pre-hospital management, critical care and basic concepts of burn surgery related to the acute phase, as well as the use of skin and skin substitutes in early stages of therapy are addressed in this volume. Chapters on supportive therapies such as optimizing nutrition and fluid homeostasis, infection control and treatment, respiratory support and pain management complete the comprehensive approach to the patient in this early stage of treatment, while chapters on epidemiology, prevention and disaster management enable the reader to evaluate the given information in a broader context.

Cover page
Title Page
Preface
Table of Contents
List of contributers
History, epidemiology, prevention and education
A history of burn care
- Black sheep in surgical wards
- Toxaemia, plasmarrhea, or infection?
- The Guinea Pig Club
- Burns and sulfa drugs at Pearl Harbor
- The Cocoanut Grove fire of 1942, and beyond
  - Burn center concept
  - Shock and resuscitation
  - Wound care and infection
  - Burn surgery
  - Inhalation injury and pulmonary care
  - Nutrition and the Universal Trauma Model
  - Rehabilitation
- Conclusions
- References
Epidemiology and prevention of burns throughout the world
- Introduction
- Epidemiology
  - The inequitable distribution of burns
- Cost of fires and burns
  - Cost by age
  - Cost by mechanism
- Limitations of data
- Risk factors
  - Race and ethnicity
  - Socioeconomic factors
  - Age-related factors: children
  - Age-related factors: the elderly
  - Regional factors
  - Gender-related factors
  - Intent
  - Comorbidity
- Agents
  - Residential fires
  - Non-electric domestic appliances
  - War, mass casualties, and terrorism
- Interventions
  - Smoke detectors
  - Hot water temperature regulation
  - Residential sprinklers
  - Lamps and stoves
  - Fireworks legislation
  - Childrens sleepwear
  - Fire-safe cigarettes
  - Acid assaults
  - Burn care systems
  - Burns first aid treatment
- Conclusions and recommendations
  - Smoke alarms
  - Surveillance
  - Gender inequality
  - Transition away from open fires and kerosene appliances
  - Community surveys
- Role of the World Health Organization
- Acknowledgements
- References
Prevention of burn injuries
- Burns prevalence and relevance
- Introduction
- Burn injury risk factors
  - WHO?
  - HOW?
  - WHERE?
- Burn prevention types
- Burn prevention: The basics to design a plan
- Target-specific burn prevention strategies
  - Flame burns
  - Prevention of scald burns
- Conclusions
- References
Burns associated with wars and disasters
- Introduction
- Wartime burns
  - Epidemiology of burns sustained during combat operations
  - Fluid resuscitation and initial burn care in theater
  - Evacuation of thermally-injured combat casualties
  - Definitive management of burned casualties at USAISR
  - Care of host-nation burn patients
- Disaster-related burns
  - Epidemiology
  - Treatment of disaster-related burns
  - The American Burn Association (ABA) disaster management plan
- Summary
- References
Education in burns
- Introduction
- Surgical education
  - Background
  - Simulation
  - Education in the internet era
  - Rotations as courses
- Mentorship
  - Hierarchical mentorship
  - Peer mentorship
  - What is a mentor
- Implementation
- Interprofessional education
  - Approaches to interprofessional education
  - What is interprofessional education
- References
European practice guidelines for burn care: Minimum level of burn care provision in Europe
- Background
  - Introduction
  - Burn injury and burn care in general
- Foreword
- Conclusion
- References
Pre-hospital and initial management of burns
Pre-hospital, fluid and early management, burn wound evaluation
- Introduction
  - Modern care
- Early management
  - At the accident
  - At a local hospital stabilization prior to transport to the Burn Center
- Transportation
- References
Medical documentation of burn injuries
- Introduction
  - Contents of an up-to-date burns registry
  - Medical documentation of burn injuries
  - Shortcomings in existing documentation systems designs
- Burn depth
  - Burn depth as a dynamic process
  - Classification based on healing time
  - Classification of burn depth
  - Non-clinical methods to classify burn depth
- Burn extent
  - Basic principles of determining the burn extent
  - Methods to determine burn extent
- Computer aided three-dimensional documentation systems
  - Methods used by BurnCase 3D
  - Creating a comparable international database
  - Results
- Conclusion
- Financing and accomplishment
- References
Pathophysiology of burn injury
- Introduction
- Local changes
  - Burn depth
  - Burn size
- Systemic changes
  - Hypovolemia and rapid edema formation
  - Altered cellular membranes and cellular edema
  - Mediators of burn injury
- Hemodynamic consequences of acute burns
- Hypermetabolic response to burn injury
- Glucose metabolism
- Effects on the renal system
- Myocardial dysfunction
- Effects on the gastrointestinal system
- Effects on the immune system
- Summary and conclusion
- References
Anesthesia for patients with acute burn injuries
- Introduction
- Preoperative evaluation
- Monitors
- Pharmacology
- Perioperative fluid management
- Postoperative care
- References
Diagnosis and management of inhalation injury
- Effects of inhaled gases
  - Carbon monoxide
  - Cyanide toxicity
- Introduction
- Upper airway injury
- Lower airway injury
- Diagnosis
- Other treatment issues
- Resuscitation after inhalation injury
- Conclusions
- Prognosis
- References
Respiratory management
- Airway management
  - (a) Endotracheal intubation
  - (b) Elective tracheostomy
- Bronchial hygiene and chest physio-therapy
- Chest escharotomy
- Inhaled heparin/N-acetylcystine (Heparin-NAC)
- Conventional mechanical ventilation
  - Introduction
  - Low tidal volume and limited plateau pressure approaches
  - Pathophysiological principles
  - PEEP
  - Permissive hypercapnia
  - The open-lung approach
  - Lung recruitment maneuvers
- Unconventional mechanical ventilation strategies
  - High-frequency percussive ventilation (HFPV)
  - High-frequency oscillatory ventilation
  - Airway pressure release ventilation (APRV)
- Ventilator associated pneumonia (VAP)
  - (a) Prevention
  - (b) Treatment
- References
Acute burn care and therapy
Organ responses and organ support
- Burn shock and resuscitation
- Introduction
- Individual organ systems
  - Central nervous system
  - Peripheral nervous system
  - Pulmonary
  - Cardiovascular
  - Renal
  - Gastrointestinal tract
- Post-burn hypermetabolism
- Conclusion
- References
Critical care of thermally injured patient
- Introduction
- Oxidative stress and Inflammation
  - Oxidative stress control strategies
- Fluid and cardiovascular management beyond 24 hours
- Other organ function/dysfunction and support
  - Respiratory system and inhalation injury
  - The nervous system
  - Gastro-intestinal system
  - Renal failure and renal replacement therapy
- Endocrine changes
  - Stress response (Fig. 2)
  - Gonadal depression
  - Low T3 syndrome
- Glucose control
- Thermal regulation
- Metabolic modulation
  - Oxandrolone
  - Propranolol
  - Recombinant human growth hormone
  - Insulin
- Electrolyte disorders
  - Calcium
  - Calcium, phosphate and magnesium
  - Chloride
  - Sodium
- Bone demineralization and osteoporosis
- Micronutrients and antioxidants
- Conclusion
- References
- Thrombosis prophylaxis
Treatment of infection in burns
- Clinical management strategies
- Introduction
- Pathophysiology of the burn wound
- Diagnosis and management of specific infections
  - Burn wound infection
  - Catheter related infections
  - Cellulitis
  - Impetigo
  - Tracheobronchitis
  - Urinary tract infection
  - Pneumonia
  - Sepsis in the burn patient
- The microbiology of burn wound infection
  - Gram-positive organisms
  - Sources of organisms
  - Gram-negative organisms
  - Infection control
- Pharmacological considerations in the treatment of burn infections
  - Topical antimicrobial treatment
  - Gram-positive bacterial infections
  - Systemic antimicrobial treatment (Table 3)
  - Enterococcal bacterial infections
  - Gram-negative bacterial infections
- Treatment of yeast and fungal infections
  - Azole antifungals
  - The Polyenes (Amphotericin B)
  - Echinocandin antifungals
  - Nucleoside analog antifungal (Flucytosine)
- Conclusion
- References
Acute treatment of severely burned pediatric patients
- Initial management of the burned child
- Introduction
- Fluid resuscitation
- Sepsis
- Inhalation injury
- Burn wound excision
- Burn wound coverage
- Metabolic response and nutritional support
- Modulation of the hormonal and endocrine response
  - Recombinant human growth hormone
  - Insulin-like growth factor
  - Oxandrolone
  - Propranolol
- Glucose control
  - Insulin
  - Metformin
  - Novel therapeutic options
- Conclusion
- Long-term responses
- References
Adult burn management
- Epidemiology and aetiology
- Introduction
- Classification
- Pathophysiology
- Assessment of the burn wound
  - Depth of burn
  - Size of the burn
- Initial management of the burn wound
  - Burn blisters
  - First aid
  - Escharotomy
  - General care of the adult burn patient
- Superficial partial thickness wound
  - Biological dressings
  - Biological/Semi biological dressings
  - Topical antimicrobials
  - Exposure
  - Other dressings
- Deep partial thickness wound
  - Total wound excision
  - Serial wound excision and conservative management
- Full thickness burns
  - Excision and autografting
  - Topical antimicrobials
  - Large full thickness burns
  - Serial excision
- Donor sites
- Mixed depth burn
- Techniques of wound excision
- Blood loss
  - Antibiotics
- Anatomical considerations
- Skin replacement
  - Allograft
  - Autograft
  - IntegraR
  - MatridermR
  - Other skin replacements
  - Cultured skin substitutes
- Rehabilitation and outcome
- Skin graft take
- Future care
- References
Burns in older adults
- Burn injury epidemiology
- Introduction
- Pathophysiologic changes and implications for burn therapy
  - Aging
  - Comorbidities
- Acute management challenges
  - Burn excision
  - Fluid resuscitation
  - End of life decisions
  - Pain and sedation
- Summary of key points and recommendations
- References
Acute management of facial burns
- Anatomy and pathophysiology
- Introduction
- Management
  - General approach
  - Airway management
- Facial burn wound management
  - Initial wound care
  - Topical agents
  - Biological dressings
- Surgical burn wound excision of the face
- Special areas and adjacent of the face
  - Eyelids
  - Lips
  - Nose and ears
  - Scalp
  - The neck
- Wound closure
- Catastrophic injury
- Post healing rehabilitation and scar management
- Outcome and reconstruction
- References
- Summary
Hand burns
- Initial evaluation and history
- Introduction
- Escharotomy and fasciotomy
- Initial wound management
- Surgical management: Early excision and grafting
- Tissue flaps
- Amputation
- Skin substitutes
- Hand therapy
- Secondary reconstruction
- References
Treatment of burns established and novel technology
- Introduction
- Partial thickness burns
  - Synthetic and bio-synthetic membranes biobrane,awbat, suprathel
  - Biological membranes amnion and others
  - Xenograft
- Full thickness burns
  - Dermal analogs
  - Keratinocyte coverage
  - Facial transplantation
  - Gene therapy and growth factors
  - Tissue engineering and stem cells
- Conclusion
- References
Wound healing
- History of wound care
- Types of wounds
- Mechanisms of wound healing
  - Hemostasis
  - Inflammation
  - Proliferation
  - Epithelialization
  - Remodeling
  - Fetal wound healing
  - Stem cells
- Abnormal wound healing
  - Impaired wound healing
  - Chronic non-healing wounds
  - Hypertrophic scars and keloids
- Conclusions
- References
Pain management after burn trauma
- Introduction
- Significance of pain management
- Pathophysiology of pain after burn injuries
  - Inflammation-related pain
  - Neuropathic pain
  - Nociceptive pain
  - Sympathetically Maintained Pain (SMP)
- Pain rating and documentation
- Pain management and analgesics
  - Form of administration [21]
  - Pharmacokinetics in severe burns
- Non-opioids (Table 1)
  - Paracetamol
  - Metamizole
  - Non-steroidal antirheumatics (NSAID)
  - Selective cyclooxygenasis-2-inhibitors
- Opioids (Table 2)
  - Strong opioids
  - Weak opioids
- Other analgesics
  - Ketamine (see also intensive care unit and analgosedation)
  - Anticonvulsants (Gabapentin and Pregabalin)
  - Antidepressants with analgesic effects
- Pain management without analgesics
  - Adequate communication
  - Psychological techniques [65]
  - Transcutaneous electrical nerve stimulation (TENS)
- Regional anesthesia
- Particularities of burn pain
  - Breakthrough pain
  - Wound pain
  - Intervention-induced pain
- Dressing change of large burn wounds and removal of clamps in skin grafts
- Necrosectomy and skin grafting
- Dressing change in smaller burn wounds, baths and physical therapy
- Intensive care unit
  - Hypermetabolism
  - Monitoring [92]
  - Opioid-induced hyperalgesia and opioid tolerance
  - Psychic stress factors
  - Risk of infection
- Mental aspects
- Postoperative pain
- Sedation monitoring
  - Analgesia monitoring (see Fig. 2)
- Analgosedation (Table 3)
  - Sedation
  - Analgesia
- References
Nutrition support for the burn patient
- Background
- Case presentation
- Patient selection: Timing and route of nutritional support
- Determining nutritional demands
  - What is an appropriate initial nutrition plan for this patient?
- Formulations for nutritional support
- Monitoring nutrition support
  - Optimal monitoring of nutritional status
- Problems and complications of nutritional support
- Conclusion
- References
HBO and burns
- Historical development
- Scientific background supporting the use of HBO in thermal burns
- Conclusion
- Contraindications for the use of HBO
- References
Nursing management of the burn-injured person
- General definition and description
  - Incidence
  - Prevention
  - Classification
- Introduction
- Pathophysiology
  - Severity factors
  - Local damage
  - Fluid and electrolyte shifts
  - Cardiovascular, gastrointestinal and renal system manifestations
- Types of burn injuries
  - Chemical
  - Thermal
  - Electrical
  - Smoke and inhalation injury
- Clinical manifestations
  - Subjective symptoms
- Diagnostic findings
- Possible complications
- Clinical management
  - Non-surgical care
  - Surgical care
- Coordination of care: Burn nursings unique role
  - Nursing interventions: Emergent phase
  - Nursing interventions: Acute phase
  - Nursing interventions: Rehabilitative phase
- Ongoing care
  - Infection prevention and control
  - Rehabilitation medicine
  - Nutrition
  - Pharmacology
- Conclusion
- References
Outpatient burn care
- Indications for inpatient treatment
  - Patient age
  - Depth of the burn
  - Pre-existing conditions
  - Total burned body surface area (TBSA)
  - Accompanying injuries
  - Special injuries
- Introduction
  - Accident causes
  - Care structures
  - Epidemiology
- Treatment
  - Initial treatment
  - Local treatment
  - Pain therapy
  - Course of treatment
- Complications
  - Infections
- Follow-up care
- References
Non-thermal burns
Electrical injury
- Introduction
- Pathophysiology
- Initial assessment and acute care
- Diagnosis
- Low voltage injuries
- Wound care
- Lightning injuries
- Complications
- References
Symptoms, diagnosis and treatment of chemical burns
- Affection of different organ systems
  - Respiratory tract
  - Eye
  - Gastrointestinal tract
  - Hematological signs
  - Nephrologic symptoms
  - Skin
- Chemical burns
  - Decontamination
- Specific agents
  - Nitric acid
  - Hydrofluoric acid
  - Sulfuric acid
  - Caustic soda
  - Phenol
- Summary
- References
Necrotizing and exfoliative diseases of the skin
- Introduction
- Necrotizing diseases of the skin
  - Cellulitis
  - Staphylococcal scalded skin syndrome
- Autoimmune blistering diseases
  - Epidermolysis bullosa acquisita
  - Necrotizing fasciitis
  - Purpura fulminans
- Exfoliative diseases of the skin
  - Stevens-Johnson syndrome
  - Toxic epidermal necrolysis
- Conclusion
- References
Frostbite
- Classification
  - Mechanism
  - Causes
  - Diagnosis
  - Rewarming
  - Risk factors
  - Treatment
- Escharotomy and fasciotomy
  - Prognosis
  - Research
- Surgery
- Sympathectomy
- tPA
- Vasodilators
- References
Subject index