minor burns, sunburn, and wounds

burns pathophysiology

Caused by exposure to ultraviolet rays or contact with thermal, electrical, or chemical sources.

● Sunburn

● Thermal Burns

● Electrical Burns

● Chemical Burns

wounds pathophysiology

Injuries that cause breaks in the skin.

● Abrasions

● Lacerations

wound healing process

1) inflammatory phase

● 3-4 days

● Wound is prepared for tissue development

● Hemostasis and inflammation

● Reassess burn after 24-48 hours

2) proliferative phase

● 3 weeks

● Formation of new connective tissue, capillaries, and inflammatory cells

3) maturation or remodeling phase

● Peaks 60 days after injury

● Collagen synthesis and breakdown

local factors that affect healing

● Tissue perfusion

● Inadequate moisture

● Infection

systemic factors that affect healing

● Advanced age

● Stress

● Inadequate nutrition

● Chronic medical conditions

epidermis

● Outermost layer

● Thin, protective barrier

● No blood vessels

dermis

● Middle layer

● Contains blood vessels, nerves, hair follicles, sweat glands

● Provides strength and elasticity

subcutaneous tissue (hypodermis)

● Deepest layer

● Fat and connective tissue

● Insulation, cushioning, energy storage

superficial

● Red/painful, minor swelling

● Epidermis

superficial partial thickness

● Thicker, produces blisters, swelling, blanch with pressure

● Epidermis and superficial dermis

deep partial thickness

● Wet/waxy dry burns, blisters, do not blanch with pressure

● Extend deeper into dermis

full thickness

● Damage to all layers of skin, burns may appear white or charred

which type of burns are able to be self care

superficial and superficial partial thickness

when to refer a burn

• chemical or electrical burns

• burns larger than 2 inches in diameter

• burns covering sensitive areas (face, hands, feet, joints)

• signs of infection (fever, advancing redness)

• fever, extreme pain, other systemic symptoms

• any burn in a child under 2 years old or elderly

• patients with compromised wound healing

• deel partial thickness or full thickness burns

when to refer a wound

• continues to bleed after 10 minutes of pressure

• deep wounds (beyond the dermis) or large lacerations

• puncture wounds

• animal or human bites

• wounds containing foreign matter after irrigations

• signs of infection

• patients with compromised wound healing and/or chronic wounds

• wound was caused. by dirty or rusty object

treatment goals of minor burns, sunburn, and wounds

relieve pain, promote healing, and minimize scarring

minor burns treatment

1. Cool the burn with running cool (not cold) water for the first 20 minutes of injury.

a. Found to be effective up to 3 hours after the incident

2. Cleanse the burn with clean tap water or saline products.

3. Apply soothing lotions to burned area.

4. Cover the burn with a sterile gauze bandage or clean cloth. Wrap burned area loosely.

5. Administer OTC pain reliever

sunburn cause, appearance, and risk factors

Cause: overexposure to UVA/UVB radiation

Appearance: redness, pain, and sometimes blisters

Risk Factors: light skin tone, certain medications (photosensitivity)

sunburn prevention

● Stay out of the sun when UV is the highest (10am-4pm)

● Wear protective clothing

● Apply “broad spectrum” sunscreen with a minimum SPF of 15 (AAP) or 30 (AAD)

● Apply physical sunscreens: zinc oxide and titanium dioxide

Topical Relief: Aloe, cool compress

minor wounds treatment

● Stop the bleeding by applying pressure with a clean towel.

● Irrigate with clean tap water or saline products.

○ Gentle irrigation: uncontaminated wounds

○ Aggressive irrigation: contaminated wounds

● Apply soothing lotions, antiseptics, and/or antibiotics to affected area.

● Loosely cover the wound with a sterile gauze bandage or clean cloth.

● Administer OTC pain reliever

gauze dressings

Cost effective. Highly absorbent. Does not provide a moist environment. Need adhesive to keep in place.

adhesive bandages

Cost effective and typically used for minor wounds. Many do not provide a moist environment

hydrocolloid

Combination of a gel-forming agent and outer water- impermeable layer. Provides a moist environment. Hydrocolloid forms a gel when its in contact with the injury

transparent adhesive films

Thin, elastic, waterproof polyurethane films that are permeable to gas but impermeable to bacteria. Recommended for places with high mobility such as joints

how to minimize scarring

● Keep a moist environment for proper wound healing

● Avoid extensive UVR exposure

● Silicone therapy

how to cleanse minor burns and wounds

topical antibiotics: Bacitracin/neomycin/polymyxin B (Neosporin), Bacitracin/polymyxin (Polysporin)

topical antiseptics: Chlorhexidine gluconate (Hibiclens Skin Cleanser), hydrogen peroxide, povidone- iodine solution (Betadine)

what type of skin should ointments and cremas be used on

ointments on intact skin, creams on broken skin

minor burns and wounds pain management and skin protectants

topical anesthetics: Benzocaine, Lidocaine ** often combined with hydrocortisone

systemic analgesics: Acetaminophen, Ibuprofen

moisturizers: Vaseline (petrolatum), Aloe, Aquaphor

special populations at increased risk of experiencing a minor wound, burn, or sunburn

• older adults

• patients with diabetes

• obesity

• certain medications