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452
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INDEX
452
pruritus
burn- induced, 388– 9
neuropathic, 316
see also itch
Pseudomonas aeruginosa in-
fection, 152f, 153, 341
antimicrobial
management, 154t
PSQ (Perceived
Stigmatisation
Questionnaire), 228t
psychiatric disorders, 5
psychiatrists, 389
psychogenic pruritus, 316
psychological therapies, 222
pain management
(analgesia), 389
psychology, 389
multidisciplinary team, 44
psychosexual sequelae, peri-
neal & genital burns, 200
psychosocial eects
outcome measures, 228t
stressors in
hypermetabolism, 30– 1
pulmonary system see
respiratory system
pulse absence,
escharotomies, 96
pulse oximetry,
anaesthesia, 127
R
radial forearm ap, neck
contracture surgery, 274
radiation burns, 177– 82
further treatment, 182
immediate
management, 181
localized radiation, 179
military burns, 340
radiation types, 178, 178t
whole- body
irradiation, 180
radiography
(X- rays), 178, 178t
hand burns, 193
radiotherapy, radiation
burns, 178
range of movement
(ROM), 230t
hand burns, 193
ranitidine, 408t
realtime telemedicine, 296
ReCell®, 139
recombinant human growth
hormone (rHGH), 32– 3
reconstruction of
burns, 235– 40
assessment, 238– 9
communication, 236
timing, 240
see also surgery
reductants, chemical
burns, 165t
REE (resting energy
expenditure), 22– 5
referral information, acute
burn injury, 46
rehabilitation
care cost, 301
multidisciplinary team, 44
remifentanil, 387, 398, 395
doses, 414t
intensive care dosing
recognitions, 397t
remote assessment, 293– 8
total body surface
area, 294
see also telemedicine
removal of chem-
icals, chemical burn
management, 168
renal system
critical care, 116
high voltage electrical
burns, 173
Renasys®, 150
Repithel® (liposomal
iodine), 158t
research bodies, 436
research journals, 438
respiratory system
antibiotics, 410
chemical burns, 166
eects of burns, 25– 6
explosive weapon
trauma, 343
high voltage electrical
burns, 173
lung lavage see lung lavage
physiotherapy, 220
see also inhalational injury
resting energy expenditure
(REE), 22– 5
resuscitation
military burns, 340
paediatric burns, 305
quality of, 122
return to
work, 216– 17, 230t
revascularization, skin
grafts, 140
rewarming,
frostbite, 345, 362
rHGH (recombinant human
growth hormone), 32– 3
RIFLE criteria, 116
Ringer’s lactate, 41, 406
rinsing solutions, ocular
burns, 186
risk factors, Haddon
matrix, 11, 11t
risk groups, 4– 5
ROM (range of
movement), 230t
rule of thumb, hand
surface area
estimation, 72f, 194t
Ryan Score (1998), 54
S
SAFE approach, rst
aid, 62
safety goggles, 185
SAGE (Scars, Burns &
Healing), 438
saline irrigation, radiation
burns, 181
sandwich grafts, 142– 3
SAPS (Simplied Acute
Physiology Score), 54
Satisfaction With
Appearance Scale
(SWAP), 228t
scalded skin syndrome
(SSS), 332
clinical presentation, 333t
scalds
denition, 10
incidence, 3t
symmetrical glove and
socking scalds, 313
symmetrical scalds, 313
scalpels, 135
Scar Club, 437
scar hypertrophy, 248
scar manage-
ment, 216–17, 231– 4
contracture, 232
hyperpigmented
scars, 233
hypertrophic scars, 232
hypopigmented scars, 233
iatrogenic scars, 233
interventions, 232
keloids, 232
lasers see laser manage-
ment of scars
mature scars, 232
novel interventions, 233
surgical scars, 233
scar physiotherapy, 222
Scars, Burns & Healing
(SAGE), 438
Schoeld scale, 323t
scoring systems,
burn- specic, 54
SCORTEN scale, 336, 338
SCQ (Social Comforts
Questionnaire), 228t
SDD (systemic di-
gestive tract
decontamination), 410
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Seattle Scar Scale
(SSS), 227t
second- degree burns
(2a), 79
clinical assessment, 83t
see also supercial partial
thickness burns
second- degree burns
(2b), 79
clinical assessment, 83t
see also deep partial
thickness burns
second- degree burns, radi-
ation burns as, 179
sedatives, 402– 3
benzodiazepines, 402
critical care, 113
dosage range, 403, 403t
monitoring, 403, 404t
propofol, 402
selective α2 receptor
agonists, 403
selective α2 receptor
agonists, 403
selenium, 325t, 409, 409t
semi- occlusive polyester
tapes, 149
semi- permanent
micro- pigmentation
tattooing, 370
sensation management,
physiotherapy, 220
Sepsis Related Organ
Failure Assessment
(SOFA), 54
seroma, 140– 1
serotonin, 23t
severe dorsal contractures,
hand, 257
severity of injury, outpatient
management, 287– 8
SF- 36, 228t
shear forces, skin
grafts, 140– 1
shower therapy, bacterial
infections, 152
Silvadene, 142
silver- impregnated
dressings, 148– 9
military burn
infections, 341
silver nitrate solution, 341
silver sulfadiazine, 148– 9
cerium nitrate and see
Flammacerium
infection
management, 158
silver sulphadiazine
infection
management, 158t
simple dressings, local
wound treatment, 290
®
Simplied Acute Physiology
Score (SAPS), 54
single variable outcome
measures, 230t
size of burn
paediatric burn
resuscitation, 305
surgery planning, 132– 3
see also total body surface
area (TBSA)
SJS see Stevens Johnson
syndrome (SJS)
skeletal trauma, hand
burns, 193
skin
chemical burns, 166
surgery preparation, 134
skin grafts, 140– 1
allografts see allografts
appearance of, 248
autografts see autografts
axilla contracture
surgery, 262
bacterial infections
and, 152
contracture
surgery, 246– 7, 282
cultured epithelial autograft
(CEA) see cultured epi-
thelial autograft (CEA)
xing, 135
full- thickness grafts see
full- thickness grafts
hair replacement, 370,
371f, 372f
hand contracture
surgery, 255– 6
hand extensor
surface– extension
contracture, 257
large skin grafts, 280
maturation of, 140
paediatric burns, 309
popliteal fossa contracture
surgery, 280
postauricular grafts, 249
sandwich grafts, 142– 3
take of, 140
skin substitutes, 203– 12
advantages, 204
disadvantages, 204
temporary wound
cover, 206– 7
wound
closure, 139, 208– 11
small burns, surface area
estimation, 70
smoke alarms, 16
smoking, 5
SMTL (The Surgical
Materials Testing
Laboratory), 436
INDEX
Social Comforts
Questionnaire
(SCQ), 228t
social factors
admission to hospital, 291
outpatient
management, 287– 8
social outcomes,
composite tissue
allotransplantation, 381
social re- integration, 216– 17
socioeconomic factors, 5
sodium bicarbonate, 175
sodium hypochlorite
(Dakin’s solution), 158t
SOFA (Sepsis Related Organ
Failure Assessment), 54
solar radiation, 348
sole, contracture
surgery, 283
Sorbsan®, 149
specialised burn unit
referral, 42
spectrophotometry, depth
assessment, 86
splinting, 216– 17
split autografts, 250
split- thickness skin grafts
(STSGs), 249
Alloderm®, 208
management, 233
spontaneous ventilation,
anaesthesia, 128
sprinklers, burn
prevention, 16
SSS see scalded skin
syndrome (SSS)
SSS (Seattle Scar
Scale), 227t
stability, hand burns, 193
Staphylococcus aureus
infection
antimicrobial
management, 154t
military burn
infections, 341
Stenotrophomonas maltophilia
infection
antimicrobial
management, 154t
burn injury type, 153
steroids, radiation burn
treatment, 182
Stevens Johnson syndrome
(SJS), 332
clinical presentation, 333t
STOP acronym, wound
management, 63
Streptococcus spp.
infections, 153
antimicrobial
management, 154t
453
454
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INDEX
454
stress ulcer prophylaxis, 408
drug doses, 408t
histidine H2
antagonists, 408
proton pump
inhibitors, 408
sucralfate, 408
structural analysis, depth
assessment, 86
subdermal burns, 79
see also full thick-
ness burns;
third- degree burns
substance abuse, 5
face transplantation
contra- indications, 381
substance P, itch, 318
succinylcholine
avoidance of, 126
hyperkalaemic
response, 126
sucralfate
doses, 408t
stress ulcer
prophylaxis, 408
Sulfamylon (mafenide
acetate), 158t, 341
sulphur mustard gas, 344
sunburn, 347– 51
articial tanning, 348
erythema, 349
management, 350f, 350
photosensitive
reactions, 349
solar radiation, 348
UV radiation, 348
supercial burns
clinical assessment, 83t
dermal burns, 79
see also supercial partial
thickness burns
supercial partial thickness
burns, 79
clinical assessment, 83t
see also second-
degree burns (2a);
supercial burns
supportive treatments,
frostbite, 362
supraclavicular grafts, con-
tracture surgery, 249
surface area
assessment, 67– 75
initial assessment, 68
see also total body surface
area (TBSA)
surface colour, depth
assessment, 86
surgeons, 242
surgery, 131– 44
benets of earl y
surgery, 132
burn excision, 136– 7
contractures see contrac-
ture surgery
debridement in
frostbite, 345
deep partial thickness
burns, 142
desquamating skin
disorders, 337
equipment, 134– 5
escharotomies see
escharotomies
frostbite treatment, 363
full thickness
burns, 142– 3, 196
hair replacement, 370,
371f, 372f
itch, 317
ocular burns, 189
paediatric burn
excision, 309
pain management
(analgesia), 389
partial- thickness
burns, 142
planning of, 132– 3
preparation, 134– 5
scar management, 233
skin grafts, 140– 1
special anatomical
areas, 143
wound closure, 138– 9
The Surgical Materials
Testing Laboratory
(SMTL), 436
SWAP (Satisfaction With
Appearance Scale), 228t
symmetrical glove and
socking scalds, nonaccidental injury, 313
symmetrical scalds, non-
accidental injury, 313
sympathectomy, frostbite
treatment, 364
synthetic carboxy-
methylcellulose, 149
systemic changes to
burns, 22– 6
systemic digestive tract
decontamination
(SDD), 410
systemic toxicity identica-
tion, chemical burns, 168
T
take of skin g rafts, 140
tangential excision, 136
anaesthesia
considerations, 122
TARN (Trauma Audit and
Research Network), 436
TBSA see total body surface
area (TBSA)
technetium scans,
frostbite, 360
Tegaderm®, 149
telemedicine, 296
cost- eectiveness, 297
depth assessment, 86
medicolegal issues, 296
modes of, 296
Telfa clear®, 148
temperature
postoperative care, 129
surgery, 134
temporary diverting
colostomy, 201
temporary wound dressings
denitive wound dressings
vs., 146
skin substitutes, 206– 7
TEN see toxic epidermal
necrolysis (TEN)
tendo achilles, contracture
surgery, 283
tendons, Integra®, 209
terrorist attacks, 7t
testicular burns, delayed
reconstruction, 202
testosterone,
hypermetabolism, 32– 3
test shave in theatre, depth
assessment, 80
tetanus, 327– 30
childhood immunization
programme, 328
classication, 328
clinically apparent
infections, 329
high- risk injuries, 328
management, 329
prophylaxis, 329, 329t
tetanus immunoglobulin
intramuscular
injection, 329
tetanus- prone injuries, 328
tetanus toxoid intramuscular
injection, 329
tetanus vaccination, 289
frostbite, 345
texture inconsistence,
laser management of
scars, 377
T- helper cells, 334
thermal regulation,
anaesthesia, 129
thermography, depth
assessment, 86
thermoregulation, paediatric
burns, 308
thigh, fasciotomy, 106, 107f
third- degree burns, 79
clinical assessment, 83t
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see also full thickness
burns; subdermal burns
thoracodorsal artery perfor-
ator ap, 274
three E’s, burn
prevention, 12
thromboxaneA2 (TXA2), 23t
frostbite pathophysi-
ology, 358, 359
thumb, escharotomies, 99f
tie- over dressings,
eyelid contracture
surgery, 276– 7
time of injur y, anaesthesia
history, 119
tissue expansion, contrac-
ture surgery, 251
tissue perfusion depth
assessment, 84– 6
tissue plasminogen activator
(tPA), 363
Tissue Viability Society, 436
TNF- α (tumour necrosis
factor α), 24t, 30– 1
tobramycin, 410
tolerance, opioid
analgesics, 386– 7
topical agents
aloe vera in frostbite
treatment, 362
analgesics, 388
antimicrobial agents, 309
fentanyl, 394
local wound
treatment, 290
topical negative
pressure (TAP)
contracture
surgery, 246– 7
wound dressings, 150
Toronto scale, 323t
total body surface
area (TBSA)
anaesthesia, 120
assessment, 70
bacterial infections
and, 152
chemical burns, 166, 168
uid resuscitation, 90
hand burns, 191– 7
hypermetabolism, 30– 1
itch, 317
Lund and Bower
chart, 70, 71f
military burns, 340
newer techniques, 70
palm of the hand, 70
radiation burns, 178
remote assessment, 294
Wallace rule of
nines, 70, 71f
tourniquets, 134
toxic epidermal necrolysis
(TEN), 332
clinical presentation, 333t
management, 336– 7
SCORTEN scale, 336, 338
tPA (tissue plasminogen
activator), 363
trace elements, 409
tracheostomy, 111
tramadol, 396
routes/ doses, 397t
transcriptome analysis, 22– 5
TransCyte
(Dermagraft), 206– 7
transfer of patients, 35– 42
admission and
acceptance, 50
ensuring safe
reception, 47– 8
initial management, 65
referral information, 42
transfer proforma
part 1, 418– 20
part 2, 422– 4
transfusion trigger, 128
trapezoid aps, 272– 4, 274f
plus grafting, 262, 263f
Trauma Audit and Research
Network (TARN), 436
Trichosporonosis
infections, 156
tricyclic antidepressants, 388
Tulle gauze (Jelonet), 146
tumescent tech-
niques, anaesthesia
considerations, 122
tumour necrosis factor α
(TNF- α), 24t, 30– 1
U
ulnar forearm ap, neck con-
tracture surgery, 274
ultrasound, depth
assessment, 86
United Kingdom (UK)
aetiology of burns, 3t
burn incidence, 2
Charities, 437
national network for burn
referral criteria, 426– 8
prevalence of burns, 60
United States (US), aetiology
of burns, 3t
upper eyelids, contracture
surgery, 276
upper limbs
contracture
surgery, 246– 7
escharotomies, 98f,
98, 99f
fasciotomy, 102, 103f
INDEX
urgent contracture
surgery, 244
urinary diversion, perineal &
genital burns, 200
urinary management, peri-
neal & genital burns, 201
urine output, paediatric
burn resuscitation
assessment, 306
UV radiation, 348
harmful eects, 349
UVA, 348
UVB, 348
UVC, 348
V
VABS- SF, 229t
VAC®, 150
Vancouver Scar Scale
(VSS), 227t
VAP (ventilator acquired
pneumonia), 114
varicella zoster virus (VZV)
infection, 156
vascular access,
anaesthesia, 127
vascular changes, frostbite
pathophysiology, 358
vascular integrity, hand
burns, 193
vascular line infection, 115
VAS (visual analogue scale),
itch, 319
vasoconstriction,
frostbite, 358
vasodilatory drugs,
frostbite, 345, 364
vasopressin, 23t, 407, 407t
vasopressors, 407
see also noradrenaline
(norepinephrine);
vasopressin
venous access,
anaesthesia, 127
ventilator acquired pneu-
monia (VAP), 114
Versajet®, 135
vesicants, chemical
burns, 165t
video conferences, 296
video microscopy, 86
viral infections, 156
visual analogue scale (VAS),
itch, 319
vitamin(s), 409
nutrition, 325, 325t
vitamin B12 blood test, 51t
vitamin C (ascorbic
acid), 325t, 409, 409t
vitamin D, 325t
vitamin E, 325t
455
456
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INDEX
456
volar hand, 192
VSS (Vancouver Scar
Scale), 227t
VZV (varicella zoster virus)
infection, 156
W
Wales, burn care
organizations, 295
Wallace rule of
nines, 70, 71f
water jet systems, 135
water, ocular burns, 186
wheelchair assessment and
provision, 216– 17
white phosphorus, 344
WHO see World Health
Organization (WHO)
whole- body irradiation,
180
wigs, 370
workhorse procedures, con-
tracture surgery, 248
World Health
Organization (WHO)
burn incidence, 2
paediatric burns, 304
rehabilitation care
cost, 301
telemedicine
denition, 296
wound care
electrical burns, 175
perineal & genital
burns, 201
wound closure
skin substitutes, 208– 11
surgery, 138– 9
wound cooling, rst
aid, 62– 3
wound dressings
absorbent layer, 149
adhesive layer, 149
admission to hospital,
291
biological dressings, 138
biosynthetic dressings see
biosynthetic dressings
changes in bowel
management, 201
composition, 148– 9
denitive vs.
temporary, 146
see also denitive wound
dressings
infections, 158
interface layer, 148– 9
local wound
treatment, 290
long- term dressings,
309
long- term in paediatric
burns, 309
nanocrystalline silver
dressings, 148– 9
non- adherent
dressings, 148
occlusive polyurethane lm
dressings, 149
silver- impregnated
dressings, 341
simple dressings, 290
temporary wound dress-
ings see temporary
wound dressings
tie- over dressings,
276– 7
topical negative
pressure, 150
The Wound Healing
Society, 436
wound hygiene, perineal &
genital burns, 200
wound infection, 230t
wound sepsis, 114
wrist, contracture
surgery, 270
X
xenografts, 138
X- rays, 178, 178t
frostbite, 360
Y
Y– V plasties
axilla contracture
surgery, 260
foot & ankle contracture
surgery, 282
groin contracture
surgery, 278
hand contracture
surgery, 255
linear contracture
surgery, 248
mouth contracture
surgery, 277
perineum contracture
surgery, 278
popliteal fossa contracture
surgery, 280
wrist contracture
surgery, 270
Y– Z plasties, multiple, 266
Z
zinc, 325t
zinc sulphate, 409, 409t
zone of
coagulation, 21f, 21, 78
zone of hyperaemia, 78
zone of stasis, 21f, 78
Z plasties
ve- ap Z plasty, 254
foot & ankle contracture
surgery, 282
groin contracture
surgery, 278
hand contracture
surgery, 254
multiple see multiple Z
plasties
neck contracture
surgery, 272
perineum contracture
surgery, 278
popliteal fossa contracture
surgery, 280
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