【外科学习课件】_7.1 烧伤.pptx

Why Should We Learn Burn? The Etiology, Mechanism and Treatment of Burn ;Etiology of Burns;;;;烧烫伤急救;Penicillin;H?ggstr?m, Mikael. Medical gallery of Mikael H?ggstr?m 2014;Exudation immediately after burns persisting for 24-36 hours;Vasodilation with exudation that has led to an outpouring of fluid with fibrin into the alveolar spaces, along with PMNs.;The actions of neutrophils in the acute inflammatory process.;Inflammation;;Assessment of burn area for children;;;First-degree burns;;Superficial Partial Thickness Burns;Deep Partial Thickness Burns;Third Degree Burns;轻度(mild degree burns) 总面积9％以下的Ⅱ度烧伤 中度(moderate degree burns) 总面积在10％～29％之间或Ⅲ度烧伤面积10％以下 重度(severe degree burns) 总面积在30％～49％之间或Ⅲ度面积在10％～19％之间，或烧伤面积不足30％，但有下列情况之一者：①全身情况严重或有休克；②复合伤(严重创伤、冲击伤、放射伤、化学中毒等)；③中、重度呼吸道烧伤(呼吸道烧伤波及喉以下者) 特重烧伤(major burns) 总面积50％以上或Ⅲ度烧伤面积达20％以上者 ；或已有严重并发症 ;REMOVE ANY SOURCES OF HEAT;Carbon monoxide may present as restlessness, headache, nausea, poor coordination Intubation is generally only necessary for uncionsicous patients, hypoxia patients with severe somke inhalation. Or patients with flame or flash burns involving face and neck. Indication include: pharyngeal burns, air hunger, carbonaceous sputum with hoarseness. If breathing seems to be compromised by tight circumferrential trunk burns, consult with the burn center surgeons immediately.;ESTIMATE PERCENT TOTAL BODY SURGACE AREA BURNED(% TBSA);OBTAIN IV ACCESS;INITIATE FLUID RESUSCITATION;瑞金公式;ASSESS URINE OUTPUT;INSERT NASOGASTRIC TUBE;ESCHAROTOMIES;MEDICATIONS;WOUND CARE;??Wounds management principle ;???Wounds management principle ;创面处理方式 ;创面敷料;;不同烧伤创面的处理;浅度烧伤创面的处理 ;深度烧伤创面的处理;深度烧伤创面的处理;手术去痂法;Tangential excision;The phenomenon of Burn Wound Progression;削痂的目的及适应证 ;切痂术适应症 ;切痂术适应症 ;感染创面的处理原则 ;自体移植皮片的种类 ;名称;按皮片大小分类 ;取皮机 ;;常用游离皮片移植方法;;;;;;;影响皮肤移植成活与否的因素 ;烧伤感染;一般资料; 烧伤感染常见菌的变迁; 烧伤感染病原菌的侵入途径;创面感染;诊断;烧伤创面感染的特征;创面严重感染的征象;;;痂下组织细菌定量的临床意义; 烧伤创面侵袭性感染的病理诊断标准;脓毒性反应的表现;脓毒性反应的表现;全身性感染的处理原则;全身支持治疗;抗生素的应用;抗生素应用时机;常见内脏并发症的防治;特殊原因烧伤;电