Gold standards for primary care of burn management

Yıl 2009, Cilt: 36 Sayı: 3, 219 - 225, 01.09.2009

Fatih Zor Nail Ersöz Yalçın Külahçı Emin Kapı Mehmet Bozkurt

Öz

Every year, about 2.5 million people are affected from burns in the world. In our country there is no reliable database related to this subject. There are ongoing studies about the epidemiology of burns in Turkey. After burn injury had represent many various complications, such as myocardial infarction, cardiac deficiency, acute hypertension, endocarditis, thromboembolism, pulmonary edema, pneumonia, respiratuar failure, renal failure, gastric ulcus, ileus, sepsis, coagulopathy and anemia. Such complications can preventable or treatable. In this respect, preventive management in the first step burn treatment had very importantly in burn cases. Skin is a barrier which protects evaporative heat loss. In cases of acute burn, hypothermia occurs related to skin loss. For these cases, care must be taken to keep the patient warm. In addition fluid resuscitation is very important in these cases. Furthermore, the damaged tissues are highly susceptible to infection in burned patients. Burn care and rehabilitation includes challenging and complex procedures. Briefly, treatments of burn cases require a multidisciplinary and meticulous approach.

Anahtar Kelimeler

Burn, first step, treatment

Birinci basamak yanık tedavisinde altın standartlar

Öz

Dünyada her yıl 2.5 milyon insan yanıktan etkilenmektedir. Ülkemizde bu konuyla ilgili kesin bir veri tabanı bulunmamaktadır. Ancak son zamanlarda Türkiye\'de yanık epidemiyolojisi ile ilgili sağlıklı istatistiksel veriler elde edilmeye çalısılmaktadır. Yanık yaralanması sonrasında miyokard infarktüsü, kalp yetmezliği, akut hipertansiyon, endokardit, tromboemboli, pulmoner ödem, pnömoni, solunum yetmezliği, böbrek yetmezliği, gastrik ülser, ileus, sepsis, koagülopati, anemi gibi çok çesitli komplikasyonlar gözlenebilir. Bazı komplikasyonlar önlenebilir ya da tedavi edilebilir özelliktedir. Bu nedenle yanık olgularında ilk basamak tedavide alınacak tedbirlerin önemi oldukça büyüktür. Deri, vücut yüzeyinde olusan fark edilmeyen sıvı kaybını önleyen bir bariyerdir. Akut yanıklı olgularda, deri yüzeyi kaybına bağlı olarak ısı kaybı ortaya çıkar. Bu olgularda, vücut sıcaklığının korunmasına yönelik girisimler önem tasır. Ayrıca sıvı resusitasyonu oldukça önemlidir. Yanıklı olgularda bir diğer özellik, akut dönemde hasarlı dokuların enfeksiyona oldukça yatkın olmasıdır. Yanık bakımı ve tedavisi, oldukça zor ve kompleks prosedürler içerir. Bu bakımdan, yanık olgularının tedavisi titiz ve multidisipliner yaklasımlar gerektirmektedir.

Anahtar Kelimeler

Yanık, birinci basamak, tedavi

Kaynakça

• Monafo WW, Bessey PQ. Total Burn Care, 2nd edn. Hern- don DN, Ed. London, United Kingdom: WB Saunders, 2002.
• William WM. Initial management of burns. N Eng J Med ; 335:1581-1586.
• Priti P, Sylvia A, Vasquez BS, et al. Topical antimicrobials in pediatric burn wound management. J Craniofasc Surg 2008; : 913-922.
• O’Brien SP, Billmire DA. Prevention and management of outpatient pediatric burns. J Craniofasc Surg 2008;19:1034
• Forjuoh SN. Burns in low- and middle-income countries: A review of available literature on descriptive epidemiology, risk factors, treatment, and prevention. Burns 2006;529-537.
• Gomez M, Cartotto R, Knighton J et al. Improved survival following thermal injury in adult patients treated at a regional burn center. J Burn Care Res 2008;29:130-137.
• Barret-Nerin JP, Herndorn DN, Marcel D. Principles and Practice of Burn Surgery. New York: 2005.
• Stal D, Cole P, Hollier L. Nonoperative management of complex burn injuries. J Craniofasc Surg 2008;19:1016-1019.
• Ramzy PI, Barret JP, Herndon DN. Thermal Injury. Crit Care Clin 1999;15-18.
• Brandt CP, Coffee T, Yurko L, Yowler CJ, Fratianne RB. Triage of minor burn wounds: Avoiding the emergency de- partment. J Burn Care Rehab 2000;21:26-28.
• Bezuhly M, Gomez M, Fish JS. Emergency department management of minor burn injuries in Ontario, Canada. Burns ;30:160-164. Tiffany BG, Warren LG. Acute burns. Plast Reconst Surg ;121:311-319. Sheridan R. Outpatient burn care in the emergency de- partment. Pediatric Emerg Care 2005;21:449-459.
• Shula PC, Sheridan RL. Initial evaluation and management of http://www.emedicine.com/med/topics3401.htm
• Tompkins D, Rossi LA. Care of out patient burns. Burns ;30:7-9. Heimbach D, Engrav L, Grube B, Marvin J. Burn Depth: A review. World J Surg 1992;16:10-15.
• Morgan ED, Bledsoe SC, Barker J. Ambulatory manage- ment of burns. Am. Fam Physician 2000;62: 2015-2026.
• Kagan RJ, Warden GD. Care of minor burn injuries: An analysis of burn clinic and emergency room charges. J. Burn Care Rehabilitation 2001;22: 337-340.
• Menters DM, Jenkens ME, Warden GD. Outpatient burn management. Nurs Clin N Am 1997;32:343-364.
• Monafo WW, Bessey PQ. Total Burn Care. 2nd edn Hern- don DN, Ed. London: WB Saunders, Wound care. 2002.
• Atiyeh BS, Gunn SW, Hayek SN. State of the art in burn treatment. World J Surg 2005;29:131-148.
• Pruitt BA Jr, McManus AT, Kim SH, Goodwin CW. Burn wound infections: current status. World J Surg 1998;22:135
• Barret JP, Heggers JP. Color Atlas of Burn Care Barret JP, Herndon DN, Eds. London. UK: WB Saunders, Wound care. Tompkins R, Burke J. Progress in burn treatment and the use of artificial skin. World J Surg 1990; 14:819-824.
• Villapalos JL, Jeschke MG, Herndon DN. Topical man- agement of facial burns. Burns 2008;34:903-911. adres: