Medical

Published on: September 11, 2014

Pressure Ulcers (Part I)

Also knows as bedsores, pressure sores and decubitus ulcers. Are areas of skin and underlying tissue damage that happens when the skin and underlying tissue over a bony prominence is compressed between that bony prominence and an external surface for a prolonged period of time, the unrelieved pressure on the skin and underlying tissue will lead to compression of the blood supply to that area, as a result of the decreased blood supply and oxygen the skin begins to die forming an ulcer. Friction of the skin created by the body sliding over a bed sheet, etc contributes also to the skin injury and the formation of ulcer, too much moister such as sweat and urine may also contribute to the formation of an ulcer. Although pressure ulcers can happen anywhere in the body, the hip, heal and buttocks are common sites.

Risk factors for pressure ulcers:

Persons at a high risk of developing pressure ulcers are those who are immobile due to an injury or an illness. Any injury or illness that leads to immobility or causes the patient to be bedridden for a long time will increase the risk of pressure ulcers.

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Published on: September 10, 2014

Burn Wound Care at Home

By Larry Kramer

Wound care at home is an important factor in the continuation of wound healing. A patient may come home with unhealed areas that still require wound care.

Dressing change and bathing:

It is important to wash the hands with soap and water before and after dressing changes.

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Published on: August 15, 2014

Smoke Inhalation Injury

By Larry Kramer

Smoke inhalation injuries are caused by inhalation or exposure to hot gaseous products of combustion, this can cause serious respiratory complications, and it is the primary cause of death in victims with indoor fires.

In these injuries diagnosis is not always easy and symptoms may not appear until 24-48 hours after the exposure, that’s why it is important to immediately evaluate any person with suspected smoke inhalation.

Children under the age of 11 and adults over the age of 70 are most vulnerable to the effect of smoke inhalation; firefighters are at a great risk for smoke inhalation because of their occupation.

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Published on: August 13, 2014

Burns And Itching

By Larry Kramer

Most patients who suffer from burn injuries usually experience itching at some point during the healing process. Itching is one of the most problematic and distressing issues that the patient’s experience. It can vary in severity from one patient to the other and it can be severe that it interferes with sleeping, eating, moving and quality of life.

Itching usually starts during the healing process. It is usually worse at night, probably due to decreased movement and pain. It is increased with anything that increases the temperature of the body, for example activity on hot weather (because of the increase of histamine release which is one of the mediators for itching).

Itching can be decreased by:

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Published on: July 24, 2014

Global View of Burned Patients

By Larry Kramer

Burns are one of the most devastating and serious injuries that can happen in a person’s life, not for the victim only but for the relatives as well. Depending on the severity of burns, some of them may need to be referred to the hospital for treatment such as second and third degree burns

The initial contact of the victim with the burn service starts usually with the Emergency Department, and perhaps it’s the only injury that need specialist treatment by a team of medical, surgical and nursing personnel who have a specific specialization. The Emergency department may be confusing for both the patient and the relatives; on the other hand the arrival of the patient to the emergency department is one of most dramatic events in the surgical practice.

Sometimes an atmosphere of tension is created in the emergency department due to the pain and fear of the patient and his/her relatives, the magnitude of the injury and the visibility of the damage therefore it’s important for the patient and the relatives to stay calm as much as they can and to interact with the medical and surgical team treating the patient as they play an important role in the healing process of their patient.

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Published on: July 15, 2014

Laser Skin Burns After Hair Removal

By Larry Kramer

Laser hair removal is one of the medical procedures used to remove unwanted hair from the skin. Laser simply works by distinguishing color differences between the hair and the skin, it goes and hits the darker color area which is the hair, leading to heating of the hair follicle and destroying it making it unable to grow new hair.

This procedure has become more popular over the years, and although laser hair removal is relatively safe in the hands of an experienced technician, side effects may occur. These side effects may range from skin swelling and redness to skin burns and even scaring (replacement of normal skin with fibrous tissue).

Skin burns occur either due to the prolonged use of the laser on specific areas or may result when the intensity of heat is too high. The skin will absorb the laser energy which may lead to skin burns. These burns are usually minor burns but severe burns may also occur ( Second degree burns and third degree burns). Seek medical attention if the burn doesn’t heal or it takes a long time healing.

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Published on: July 14, 2014

Keloid Scar

By Larry Kramer

A keloid scar is a type of scar that results in an overgrowth of tissue at the site of healed skin injury due to aggressive healing process. This type of scar grows and extends beyond the site of injury unlike hypertrophic scar. They occur as a result of the body’s continuous production of collagen which is a fibrous protein after the healing of the wound.

They often appear red or pink in color as compared to the surrounding normal skin. They are firm, rubbery lesions; they may appear shiny or as fibrous nodules. Keloid scars may be accompanied by severe itching, pain and may limit mobility if they are extensive. They may vary in size and some types may increase in size. They may occur anywhere on the body although some areas are more susceptible to form keloid scars such as the deltoid region. They occur more often in darker skinned patients.

Treatment:

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Published on: July 11, 2014

Skin Graft

By Larry Kramer

It is a surgical procedure which involves the placement of a piece of healthy skin in areas where the skin is damaged. It is usually done in an operating room under local or general anesthesia depending on the size of the graft.

Skin grafts can be classified into:

Autografts: where the skin for the graft is taken from the same person.

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Published on: July 10, 2014

Burns And Fluid Replacement

By Larry Kramer

When a person is burned and depending on the severity of burn, the blood vessels including the capillaries may be affected. Combined with the release of chemical substances into the blood, this will lead to increased capillary permeability to fluids, leading to the leaking of fluids from the blood vessels into the tissues. The higher the percentage of burned skin, the more severe the loss of fluid will be and the greater the dehydration will be.

Fluid replacement is one of the important objectives in the initial treatment of burned patients. The amount of fluid needed and the method of fluid given depends on the surface area of the skin burned as well as other factors. There are many formulas used for fluid resuscitation; one of them is called the Parklund Formula in which after the amount of fluids is calculated, it is given through an IV route and the type of fluid is usually Ringer Lactate. Urine output (0.5 ml/kg/hour in adult and 1 ml/kg/hour in children) is one of the methods used to evaluate adequate fluid resuscitation.

Fluid is replaced to prevent hypovolemic shock and other associated complications such as kidney failure.

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Published on: July 9, 2014

Nutrition And Burns

By Larry Kramer

One of the important components of burn care is nutritional support, nutrition is important for the recovery and healing process of a burned patient. After a burn injury and depending on the severity, the body reacts by increase production of certain hormones which will cause the body to need more nutrition accompanied sometimes with alteration in the carbohydrate, protein and fat breakdown.

There are many ways to assess the nutritional needs of the patient taking into consideration the age, body weight, the percentage of body surface burned, and other factors. The Curreri formula is used for adults and children, Harris-Benedict formula is used for adults and the Galvaston formula used for children. Dietitians and doctors will assess, monitor, and adjust nutrition frequently as patients condition improves or deteriorates.

There are different ways of delivering these nutrients to the patient, depending on the burn and the patient’s condition. The patient may be fed by mouth, through the veins, the intestinal tract through a tube or a combination of more than one method.

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