Cool Under Fire – Burn Surgery Vocabulary

Vocabulary flashcards summarizing essential terms, procedures, and concepts from the lecture “Cool Under Fire: An Introduction to Burn Surgery.”

Eschar

Leathery, stiff, avascular tissue formed by full-thickness (3rd-degree) burns.

Escharotomy

Surgical longitudinal incision through circumferential eschar to relieve pressure and restore perfusion or ventilation; indicated when 5 Ps are compromised.

Compartment Syndrome (Burn)

Ischemic injury from elevated pressure in an extremity or torso due to circumferential eschar; treated with escharotomy (or fasciotomy if deep).

First-Degree Burn

Superficial epidermal injury characterized by dry, red, painful skin without blisters; treated with frequent lotion and NSAIDs.

Superficial Second-Degree Burn

Partial-thickness burn involving upper dermis; moist, red, painful with brisk capillary refill; managed with serial dressings and analgesia.

Deep Second-Degree Burn

Deeper dermal burn that is pale, moist, painful, and has poor capillary refill; may require skin grafting or skin-cell suspension.

Third-Degree Burn

Full-thickness burn appearing white, charred, or leathery; insensate; requires early excision, dermal substitute, and grafting.

Fourth-Degree Burn

Burn extending into muscle, tendon, or bone; demands complex excision, possible amputation, and reconstruction.

Zones of Burn Injury

Three concentric areas: coagulation (irreversible necrosis), stasis (ischemic but salvageable), and hyperemia (inflamed, will recover).

Determinants of Burn Mortality

Age extremes, TBSA size, burn depth, inhalation injury, and comorbidities; missed concomitant trauma is a common early killer.

ARDS Ventilator Strategies (3 Ps + V)

Lung-protective approach: PEEP, Prone positioning, short-course Paralysis, and low-tidal-Volume ventilation.

Burn Resuscitation (ABA Consensus Formula)

Initial fluid guideline: 2 mL LR × kg × %TBSA (adults ≥20 % TBSA); titrate hourly to urine output goals.

Urine Output Goals

Adults 0.5 mL/kg/h; pediatrics 1 mL/kg/h; electrical burns 1–1.5 mL/kg/h—used to adjust resuscitation rate.

The Cs of Burn Resuscitation Failure

Carbon monoxide, Cyanide, Concomitant trauma, Comorbid conditions, Cardiac issues, ‘Can’t pee,’ Calculation error, Congenital heart disease, Compartment syndrome.