Welcome to Zhengzhou University

BURN
INJURY
Department of Plastic Surgery
The First Teaching Hospital
Zhengzhou University
shiyan
 PLASTIC SURGERY

Mission:
repair deficiency, restore function,
improve appearance
Cure:
congenital malformation,
acquired defect , aesthetic surgery
le:4 courses

n, diagnose( extent,depth) 　　　　　　　　　　　

degree; course of disease; field first aid 　　　　　　

al care: prevention and cure of shock 　　　　　

al care: treatment of the raw surface 　 　

 luoyang

hengyang

jiaozuo beijing
zhengzhou
1. Definition
Thermal Injury
Hurt caused by heat power.
Heat power——
*flame,steam-thermal burn,scald burn
*electric current-electric burn
* strong acid, strong base-chemical burn

* radioactive ray-radiographic inspection

 2. Diagnosis
• Determinations of body • Determinations of
surface area (BSA)- the depth of burn
extent *Three degrees for
1. New rule of Nines
used in large area four classifications
2. Rule of patient’s hand
used in small area *Skin structure

Using combined both of them

Total Body Surface Area
(TBSA)
 Diagnosis :TBSA
New rule of Nines

Location Adu
Hair 3%
Head Face 3%
Neck 3%

Hands 5%
 Diagnosis: BSA
(The Rule of patient’s hand
The area of patient’s hand
covered approximately 1%.
 Using of “New Rule of Nines”and
“The Rule of Patient’s Hand”

New rule of Nines: in large area of burn

The Rule of patient’s hand: in small area of burn

In clinic :Using both of them.

the Depth of burn:
Superficial degree burns
First degree: Erythematous burns
Superficial second-degree: Blisters burns
Deep degree burns
Deep second-degree: Blisters burns
Third-degree: Eschar burns

They are mixed and changeable in patients

First Degree:
Epidermis
Red
Dry or small to moderate
sized blisters
Painful
Erythematous burn
No blisters
3~5 days healing
No scars
Superficial
second-degree
Superficial of dermis

Pink or mottled red

Blister (large) ,moist
weeping surface

Painful
2 weeks healing
No scars
Pigmentation
Deep second Degree:
Deep layer of dermis

anesthetic to pinprick,
hypalgesia
Blisters (small)
painful
3~4 weeks healing,
Dense scars
Third Degree:

-prolonged exposure to
flame,hot object,contact
with hige-voltage
electricity
-Full thickness
-No pain , No blisters ,
Eschars,Insensate surface
-3~4 weeks eschars
issolve ,
-Skin grafting
degree depth manifestation agglutination
First Epidermis No blister 3~5 days
Erythematous burn healing
No scars
Superfi Superfici Blisters (large) 2 weeks
cial II al layer healing,No
of dermis scars
,pigmentation

Deep Deep Blisters (small) 3-4 weeks

II layer of painful healing
dermis hypalgesia dense scars

III hypalgesi No pain . No 3-4 weeks

a blisters. eschars eschars
dissolve
Skin grafting
 Categorization of
Severity of Burns

1.In clinic :
Small area burns ： Adult , II , <15%;
Children , II , <10%;
or III <5%.
Large area burns ： Adult , II ,>15%;
Children , II , >10%;
or III >5%;
or major area burn in
head , face , neck or hands.
 Severity of Burns
2.divided as the severity of burns

Mild Burns －－ Small area

Moderate Burns
　 Severe Burns 　　 Large area
Special Severe Burns
Severity of Burns

Severity Mild Moderate Severe 　 Special Severe

II Degree < 10% 10%-29% 30%-50% >50%

III Degre 　 <5% 5%-9% 10%-19% >20%

 ＮＯＴＥＳ : the patient is complicated with
① shock;
② respiratory tube burns;
③ compound injury;
* Even total area of burns < 30% ,
whose severity of burns is severe degree.
* Even total area of burns < 50% ,
whose severity of burns is special severe degree .
 Inhalation Injury
(respiratory tube burns)
Caused by: Inhalation of smoke,gas
and other irritative or poisoning products.

Effects:heating power,chemical erosion,

poisoning all over the body （ CO ） .
 Diagnose
　　　　　　　　　
1. The spot is always relatively closed
tightly; explosion; 　　　　　　
2. Degree:
above the throat------mild;
big bronchus------moderate;
deep to small bronchus------severe;
 Diagnose
3. Symptom:
Stimulus in airway
charred hairs of nose
hoarse voice
expectorate Carbo Medicinalis
lose one's breath
wheezing rale in lung
deep burn in face,neck,mouth and
nose
Inhalation Injury
(respiratory tube
burns)
Class is over
 e-mail:
rockhy317@sohu.com