Pathophysiology

Pathophysiology Study Guide

are more appropriate because they bypass impaired circulation • Tetanus toxoid immunization, if needed • Monitor core body temperature with either cooling or heating blankets • Debridement of burns to cleanse away old or dead tissue. This procedure is painful and can cause blood loss and an increase metabolic demands. Skin grafting may also be necessary with: o Biosynthetic dressings: A synthetic dressing that replicates the skin o Autografts: Grafts made from the patient’s own skin taken from another part of the body o Biologic dressings: Transplanted from a human cadaver or other mammal and used to cover large burn areas • Burns must be cleansed daily with normal saline, soap and water, or wound cleanser. They may also need a topical agent, such as Silvadene, and be covered lightly with gauze. Wound care should be performed one to two times a day. • The injured body part must be elevated and pressure should be kept off of wound areas to allow for healing. The physician may perform an escharotomy to prevent compartment syndrome. • Bowel functions should be monitored and a high calorie diet should be given for tissue repair. This includes total parenteral nutrition, if necessary. Vitamins, minerals and electrolytes are important factors for tissue repair and healing. • Medications, such as H2 blockers, can be given to prevent gastric ulcers. • If there are facial burns, use care with access to mirrors. It is important to allow individuals with these types of burns to talk about body image disturbances. Community support groups for burn patients can be a helpful coping strategy. Rehabilitation Phase This phase begins when the burn size is less than 20% TBSA and some self-care begins. Range-of- motion and extension exercises can help prevent contractures. The degree of scarring may vary based upon genetics and exposure of the healed skin to the sun. It is recommended that sun exposure be limited for one year to prevent hyperpigmentation. Lotions and antihistamines may relieve the itching associated with healing skin. Skin Disorders Skin, just like other tissues in the body, is influenced by pathological changes, including hereditary, benign, inflammatory, neoplastic, endocrine, traumatic, hormonal, and degenerative processes. However, skin reacts to infections, diseases, and disorders differently than other tissues in the body. Inflammatory Response The skin response to injury by releasing chemical mediators, like histamine, peptides, and fatty acids is known as inflammation. The morphological appearance of skin caused in many skin diseases, like acne, psoriasis, lupus, and acute allergic contact dermatitis, is due to the inflammatory response of

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