TY - JOUR TT - Management of the Patient with 87% TBSA Burn: Case Report AU - Özer, Fırat AU - Garipoğlu, Gökçen AU - Dal, Demirhan AU - Zor, Fatih AU - Kara, Sevgi AU - Günal, Emine AU - Işık, Selçuk PY - 2014 DA - April JF - Türk Plastik Rekonstrüktif Ve Estetik Cerrahi Dergisi JO - turkplastsurg PB - Türk Plastik Rekonstrüktif ve Estetik Cerrahi Derneği WT - DergiPark SN - 1300-6878 SP - 22 EP - 29 VL - 22 IS - 1 KW - Majör yanık KW - multidisipliner yaklaşım KW - morbidite N2 - Treatment of the major burn patient requires multi- disciplinary approach because of the high mortality and morbidity rates. In this study the management of the patient with 87% TBSA burn is presented. The patient diagnosed as 87% flame and inhalation burn was hospitalized at the first post burn day. Fluid resuscitation was begun after first evaluation. The burn area which was preformed dressing daily could be closed with autograting and auto-homografting. The patient, who was performed with empirical antibacterial treatment, was treated with antibacterial and antimicotic after Acinetobacter baumannii and Candida parapsilosis were determined with blood culture. He was begun to be received mechanic ventilation since at the post burn 3th day and he was extubated at the post burn 87th day. Rehabilitation which was performed to prevent contracture and deformities in the early stage and it was sustained for ambulation and regain the functional motions. He was discharged at the post burn 157th day. We control the patient two months interval at the first year and six months intervals at the latter two years. No complication was seen and he maintained his social life without any help. Major burn as a trauma, has high mortality and morbidity rates. It requires additional treatments like prevention sepsis and infection, treatment of inhalation injury, nutrition and rehabilitation as well as fundamental treatment like fluid resuscitation, wound dressing and surgical treatment. For this reason multi- disciplinary approach is crucial principal of the treatment for increasing survival rate. CR - Evans EI,Purnell OJ, Robinent PW, et.al. Fluid and electrolyte re- 1. CR - quirements in severe burns. Ann Surg 1952;135:804-17. CR - Baxter CR, Marvin JA, Curreri PW. Fluid and electrolyte therapy 2. CR - of burn shock. Heart Lung 1973;2:707-713 CR - Curreri PW, Rİchmond D, Marvin JA, et. al. Dietary requirements 3. CR - of patients with major burns. J Am Diet Assoc 1974;65:415-7. CR - Lindberg RB, Pruitt BA Jr, Mason AD Jr. Topical chemotherapy 4. CR - and prophylaxis in thermal injury. Chemotherapy 1976;3:351-9. CR - Janzekovic Z. A new concept in the early excision and immedi- 5. CR - ate grafting of burns. J Trauma 1975;15:42-62. CR - Burke JF, Bandoc CC, Quinby WC. Primary burn excision and 6. CR - immediate grafting: a method for shortening illness. J Trauma 1983;23:1001-4. CR - Herndon DN, Barrow RE, Rutan RL, et. al. A comparison of con- 7. CR - servative versus early excision therapies in severly burned pa CR - tients. Ann Surg1989;209:547-53. CR - Nugent N, Herndon ND. Diagnosis and treatment of inhalation 8. CR - injury. Total Burn Care. p262-72. CR - McCall JE, Cahill TJ.Respiratory care of the burn patient. J Burn 9. CR - Care Rehabil 2005;26(3):200-6. 10. Deveci M, Sengezer M, Er E, Selmanpakoğlu N. Yanık mortalite CR - analizi.1998;6:2 Türk Plastik, Rekonstrüktif ve Estetik Cerrahi Dergisi 11. Driessen JJ, Booij LH, Vree TB, et. al. Midazolam as a se CR - dastive on regianal anaesthesia. Arzneim Forscl V. Drug CR - Res.1981;31:2245-7. 12. Parker J. Ketamine: review of featured prothocol. J Burn Care Re CR - habil. 1987;8:146-8. 13. Curreri PW, Rİchmond D, Marvin JA, et. al. Dietary requirements CR - of patients with major burns. J Am Diet Assoc 1974;65:415-7. 14. Lindberg RB, Pruitt BA Jr, Mason AD Jr. Topical chemotherapy CR - and prophylaxis in thermal injury. Chemotherapy 1976;3:351-9. gal, antitubercular and miscellaneous anti-infective agents. Clin CR - Pharmacokinet. 2011 Nov 1;50(11):689-704. 46. Shirani KZ, Pruitt BA Jr, Mason AD Jr. The influence of inha CR - lation injury and pneumonia on burn mortality. Ann Surg 1987;205:82-7. 47. Ronald P, Mlcak H, David H. Respiratory care. Total Burn Care. 281-91. CR - Mesanes MJ, Legendre C, Lioret N, et.al. Using bronchoscopy CR - and biopsy to diagnose early inhalation injury. Macroscopic and CR - histologic findings. Chest 1995;107:1365-9. 49. Jackson D, Topley E, Cason JS, et al. Primary excision and graft CR - ing of larger burns. Ann Surg 1960;152:167-89. 50. Berkowitz, RL. Scalp scalp, the integument covering the top of CR - the head. It consists of three layers of tissue: the skin, an under CR - lying layer of tissue and blood vessels, and the occipitofrontalis CR - muscle stretching from the eyebrows to the back of the head: In CR - search of the perfect donor site Ann Plast Surg 1981;7:126-7. 51. Alexander JW, MacMillan BG, Law E, et. al. Treatment of severe CR - burns with widely meshed skin autograft and widely meshed CR - skin allograft. J Trauma 1981;21:433-8. 52. Curerri P, Richmond D, Marvin J, et al. Dietary requirements of CR - patients with major burns. J Am Diet Assoc 1974;65:415-7. 53. McCall JE, Cahill TJ. Respiratory care of the burn patient. J Burn CR - Care Rehabil. 2005;26:200-6. CR - Rodvold KA, Yoo L, George JM. Penetration of anti-infective CR - agents into pulmonary epithelial lining fluid: focus on antifun UR - https://dergipark.org.tr/tr/pub/turkplastsurg/issue//250775 L1 - https://dergipark.org.tr/tr/download/article-file/217443 ER -