Medical

Published on: November 21, 2013

The Importance of Smoke Detectors

According to the Center of Disease Control and Prevention (CDC), death from fire injury is the third common unintentional cause of fetal home injury. As fire claims the lives of many people each year and destroys properties and belongings; Smoke detectors play a big and important role in preventing such fires. Smoke detectors are devices that detect smoke or other combustion products and when they sense them an alarm will sound alerting people for the danger of fire.

There are two types of smoke detectors:

1- Ionization smoke detectors: this device detects smoke particles emitted from fire whether they are visible or invisible. Smoke changes the electric current which triggers the start of the alarm.

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Published on: November 20, 2013

Z-plasty and Burns

By Larry Kramer

When the skin is burned, contracture scars may form, these contracture scars will affect the range of motion in the affected area and one of the methods used for scar treatment is Z-plasty.

Z-plasty is a surgical procedure used to improve the functional and/or cosmetic appearance of the scars.

Cosmetic Z-plasty is the repositioning the scar so that it more closely conforms to the natural lines and creases of the skin, where it will be less noticeable.

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Published on: July 16, 2013

Third Degree Burns and Keloid Scar (Part I)

By Larry Kramer

Keloid scar is a benign scar composed of dense fibrous tissue formed as a result of an abnormal healing process in response to skin injury, extending beyond the original borders of the wound or inflammatory response. There is little to be done to prevent them and even with its removal there is a possibility of keloid recurrence. Keloid scar may affect the patient both physically and emotionally as it may become a cosmetic problem depending on its location on the body.

Keloid scar can happen in any age and can affect both sexes. The incidance of keloid scar varies among different races, it’s more common among blacks, hispanics and Asians and less common in Caucasians for unknown reasons. Both genetic and enviromental factors play a role in the formation of keloid scar. Keloid scar may form following skin inflamation such as acne vulgaris or skin injury such as second and third degree burns. Keloid may happen may appear months after skin inflammation or trauma but may take up to a year to develop.

Keloid scar can present as a firm nodule which can be skin coloured, hypopigmented (lighter in colour) or erythematous (red in colour) and is often located at the site of the injury (such as burn), wound which could be surgical or non-surgical or other lesion. Most common locations of keloid scar include the shoulders, , chest, sternal area, earlobes and back of the neck. Symptoms of keloid scar may include pain, itching and mobility limitalion if it is located over a joint area.

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Published on: July 2, 2013

Silver Sulfadiazine

By Larry Kramer

Trade names include Silvadene, SSD AF, Thermazene.

Silver Sulfadiazine topical cream is a sulfa drug that is used in the prevention or treatment of skin infections in patients with second and third degree burns; it can also be used for other conditions that will be determined by your doctor. Silvadene has anti-bacterial and anti-fungal properties that work by killing bacteria or fungi and is for external use only.

Before using this drug tell your doctor:

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Published on: June 28, 2013

Burn Scars and Pressure Garments

By Larry Kramer

Some burns can heal without leaving any scars while other burns can leave wound scars after healing. Among the factors that determine the formation of scars is wound severity, superficial minor burns leave no scars when healing while deep severe burns such as second and third degree burns may leave scars after healing. when scars are formed whether they are hypertrophic or Keloids they may be difficult to treat. Cosmetic appearance of the scar form the patient’s main concern despite that hypertrophic scars and keloids may also cause pain, pruritus and pressure and/or contractures.

Treatment of scsars:

Treatment of scars may not be easy and there is a possibility of recurrance of scars even after treatment. Theraputic methods may include:

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Published on: June 26, 2013

Skin Grafting in the Treatment of Third Degree Burns

By Larry Kramer

Skin graft is the process by which a non healing wound or a burn wound is covered by a piece of skin taken either from the patient himself/herself or from cadavers or animls. this procedure is done surgically. Skin graft is either used a temporary wound cover or a permanent one. Some wounds such as third degree burns if left to heal on their own can lead to scarring and contractions.

As the skin is the largest organ in the body and among its functions is playing a major role in protecting the body from fluid loss and help in preventing harmful micro organisims such as bacteria and varuses from entering the body and causing infections therefore its important to cover third degree burns with skin graft as soon as possiblee as uncovered third degree burns are more liable for wound infections and fluid loss from the burn area .

Skin graft is a surgical procedure that is not used for wounds that can heal on itself such as first and second degree burns, it’s used for large and non healing wounds. The skin used for grafting can be taken from another area of the patient body if there is enough undamaged healthy skin available and if the general condition of the patient permit to undergo an additional surgery. This type of graft is call autograft. Another type of skin graft is called Autograft where the skin is obtained from another person who is usually a donor cadaver in which the skin is frozen and stored to be available for use. The last last type of skin graft is called Xenograft where the skin is obtained from an animal which is usually a pig. Autograft can be used as a perminant covering to the damaged area while Allograft and Xenografts are temporary ones as they will be rejected by the immune system of the patient after a short period of time and need to be replaced by Autograft.

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Published on: April 16, 2013

Out Patient Care of Burns (Part II)

By Larry Kramer

Patients with small partial thickness burns can be treated as outpatients. Adults with less than 15% body surface area (BSA) partial thickness burns and children with less then 10% body surface area partial thickness burns can be candidates for outpatient treatment.

Treatment:

A- Emergency treatment:

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Published on: April 4, 2013

Out Patient Care of Burns

By Larry Kramer

Not all burn patients need to be admitted to the hospital for treatment as some of these burn patients can be treated as outpatients including first degree burns and some second degree burns. Small partial thickness burns can be treated in an outpatient setting. Adults with les than 15% body surface area partial thickness burns and children with less than 10% body surface area partial thickness burns can usually be treated safely as outpatients. These patinets after being treated they should have a supportive home enviroment. Abuse or neglect has to be excluded specially with children, smoke inhalation should also be excluded as it is one of the major causes of dealth in burned patients.

What type of burns are eligible to be treated in an outpatient setting:

Adults with less than 15% body surface area partial thickness burns and children with less than 10% body surface area partial thickness burns.

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Published on: April 3, 2013

Poisoning due to Cyanide

By Larry Kramer

Cyanide is a toxic chemical substance that is found in a gas or a salt form. The gaseous form is colorless with a bitter almonds odor. Cyanide can be ingested by mouth, inhaled or absorbed by the skin.

Cyanide is used in the synthesis of some plastic items; it can be used in cleaning metal as well as in other industrial or laboratory settings. Cyanide is also naturally present in some pits and seeds of fruits such as apricots and almonds but it’s in a small amount. Nitroprusside is a drug that may lead to cyanide toxicity if it’s given in an improper dose. During a house fire, cyanide gas is produced due to the combustion of common household materials. Inhalation of cyanide leads to cyanide poisoning. Cyanide can be used in chemical warfare and poisoning.

Cyanide simply works by decreasing the oxygen content of the blood by causing a chemical change that prevent oxygen from getting into the hemoglobin of the red blood cell and this will lead to tissue hypoxia.

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Published on: February 27, 2013

Wound Debridement

By Larry Kramer

Debridement is defined as the process of removing dead tissue and contaminated material from and around a wound to expose healthy tissue.

When the skin gets burned and tissue dies, the dead tissue will naturally fall of as part of the healing process of the skin. In other cases where the burns are more severe, wound debridement will be needed. Dead tissue is a good medium for bacteria to grow and that is why it is important to remove it (bacteria can lead to infection).

Debridement methods are:

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