Burn Injury Module: Pathophysiology, Assessment, and Management

A set of vocabulary flashcards covering the pathophysiology, mechanisms, classification, assessment formulas, and clinical management of thermal, chemical, electrical, and inhalation burn injuries.

Burn

A traumatic injury to the skin or other organic tissue primarily caused by heat or exposure to electrical discharge, friction, chemicals, and radiation.

Anatomy of the Skin

The multi-layered bodily covering consisting of the superficial epidermis, the underlying vascular dermis, and subcutaneous fatty tissue, along with deeper structures including fascia, muscle, nerves, and glands.

Coagulation Necrosis

A form of caustic tissue destruction and cellular death caused by contact with acidic chemical agents.

Liquefaction Necrosis

A pattern of caustic tissue injury caused by alkaline chemical burns that liquefies and deeply penetrates cellular structures.

Carbon Monoxide Poisoning

A systemic toxic condition caused by inhaling a colorless, odorless gas from incomplete combustion that exhibits a $200\times$ greater affinity for hemoglobin than oxygen, causing hypoxemia and hypercarbia.

Supraglottic Airway Heat Absorption

The protective physiological mechanism where moist mucosa lining the upper airway structures absorb thermal energy to protect the lower airways from direct thermal injury.

Superficial (Epidermal) Burn

A burn involving only the epidermal layer of the skin, characterized clinically by red skin and pain at the site without blistering.

Partial-Thickness Burn

A burn involving the epidermis and portions of the dermis, characterized by blisters, intense pain, moist and mottled red-to-white skin.

Full-Thickness Burn

A burn that extends through and destroys all layers of the dermis, characterized by hard, charred, dark brown or white skin with little or no pain at the center due to destruction of nerve endings.

Fourth-Degree Burn

A deep burn injury extending completely through all skin layers into underlying soft tissues such as fascia, muscle, or bone.

Classification of Burns by Depth

The clinical grading of thermal wounds according to structural depth of tissue damage, dividing injuries into superficial, partial thickness, and full thickness.

Zone of Coagulation

The central area of a thermal wound nearest the heat source that suffers irreversible tissue necrosis and maximal destruction, marked by clotted blood and thrombosed blood vessels.

Zone of Stasis

The intermediate zone surrounding the zone of coagulation in Jackson's theory, characterized by decreased blood flow and compromised tissue perfusion that can either survive or progress to necrosis.

Zone of Hyperemia

The outermost peripheral area around a burn that exhibits increased blood flow from an inflammatory response and typically recovers spontaneously.

Emergent Phase (Stage 1)

The immediate physiological response stage to thermal injury characterized by pain response, catecholamine release, tachycardia, tachypnea, mild hypertension, and mild anxiety.

Fluid Shift Phase (Stage 2)

The systemic phase lasting $18\text{--}24\,\text{hours}$ (peaking at $6\text{--}8\,\text{hours}$) where inflammatory mediators cause increased capillary permeability, shifting fluids and proteins from intravascular to extravascular space and producing massive edema.

Hypermetabolic Phase (Stage 3)

The systemic response phase lasting days to weeks characterized by a large increase in the body's metabolic rate and nutritional demand to fuel tissue repair.

Resolution Phase (Stage 4)

The final stage of the body's burn response characterized by scar formation, tissue maturation, and rehabilitation toward normal function.

Lund and Browder Chart

The most accurate burn assessment tool for estimating percentage Total Body Surface Area ($\text{TBSA}$) in both children and adults because it accounts for proportional surface area changes across growth.

Wallace Rule of Nines

An expeditious anatomical formula used to estimate adult $\text{TBSA}$ by assigning $9\%$ to the head, $9\%$ to each arm, $18\%$ to each leg, $18\%$ each to the anterior and posterior trunk, and $1\%$ to the genitalia.

Thermal Burn Severity Criteria

A standardized assessment matrix classifying burns into Minor, Moderate, and Critical based on depth, percentage of body surface area ($\text{BSA}$), and anatomical location.

Eschar

The hard, leathery, devitalized product of a deep full-thickness burn comprised of dead and denatured skin.

Escharotomy

A surgical incision through non-elastic eschar performed to relieve compartment pressure, preserve distal vascular perfusion, and enable adequate chest wall excursion during ventilation.

Parkland Burn Formula

A fluid resuscitation calculation: $3\text{--}4\,\text{mL} \times \text{patient weight in kg} \times \%\text{TBSA} = \text{total fluid in } 24\,\text{hours}$, with $\frac{1}{2}$ delivered in the first $8\,\text{hours}$ and the remainder over the subsequent $16\,\text{hours}$.

Curling's Ulcer

An acute stress-induced peptic ulcer associated with severe burns, managed via prophylactic proton pump inhibitors (such as esomeprazole) initiated within the first $6\,\text{hours}$.

Acticoat (Nanocrystalline Silver)

An antimicrobial topical dressing applied to burn sites under a closed dressing (excluding the face and perineum) to prevent invasive infection.