骨骼肌肉12.1-烧伤.pptx

Julie 王凤怡
Occupational Terapy Department of Rehabilitation Medcine Centre
West China Hospital, Sichuan University
2016
Burn Injury
目录
CONTENT
Structure of skin
Types of burn
Incidence and prevalence
Introduction
01
Extent and Depth
Classification of Burn
02
Hypertrophic scar & Keloid
Contracture
Management
Complications
04
Medical Management
03
Wound care, Skin graft, Operations
Introduction
PART 01
Structure of skin
Types of burn
Incidence and prevalence
Introduction
Structure of skin
皮脂腺
Introduction
Structure of skin
表皮
皮肤最外面的一层组织,其厚度因身体部位而不同,表皮在掌跖处最厚,在眼睑最薄。它担负着细胞自我更新的重要功能,也就是细胞的新陈代谢。表皮从外向内,依次可以分作4层。
l 角质层
位于表皮的最外部,由扁平的角质细胞组成,如鱼鳞片相互重叠在一起,具有防止水分散失的功能。
l 颗粒层
由3-5层扁平细胞组成,细胞内充满粗大、不规则的透明角质颗粒,具有折射光线的作用,能阻挡阳光中的紫外线,异常时会呈厚茧状。
l 有棘层
表皮层中最厚的一层,由8-12层多角形细胞所构成,细胞之间有淋巴液流通,可供给表皮营养。
l 基底层
位于表皮的最深处,与真皮紧密衔接,连接的截面呈波浪起伏状。基底细胞为称方形或者低柱形,具有细胞分裂能力。除了基底细胞之外,基底层还存在着黑色素细胞。大约每10个基底细胞中就约有一个黑色素细胞,呈树枝状突起。黑色素细胞形成黑色素后,通过树枝状突起将黑色素颗粒输送到基底细胞或者毛发。
Types of burn
• Destruction of the skin caused by
– thermal changes (hot water & steam → scald烫伤, flame, hot fluid (oil, tar), hot metal, extreme cold)
– corrosive liquid腐蚀性液体: alkalis/ acid
– electricity
– radiation
• One of the most painful form of trauma
Introduction
Introduction
Incidence & prevalence
Burn Incidence and Treatment in the US: 2007 Fact Sheet
Survival Rate: %
Severity of Burn Injuries:
Over 1/3 of admissions exceeded 10% TBSA (total body surface area), and 10% exceeded 30% TBSA.
Burn Cause:46% fire/flame, 32% scald烫伤, 8% hot object contact, 4% electrical, 3% chemical, 6% others.
Place of Occurrence:43% home, 17% street/highway, 8% occupational, 32% other
American Burn Association National Burn Repository (2005 report),as reported in American Burn Association Fact Sheet, 2007
Classification of Burn
PART 02
Extent and Depth
Classification of burn: degree & extent
Severity of burn: degree & extent
Degree of burns: 2 system in terms of depth of skin destruction
Assessment by clinical observati