*The treatment of deep burns of the limb, besides healing the wounds, should involve prevention of complications and functional recovery. The topical products that can be used vary from case to case, according to  the needs of the lesion, the possibilities of the service and the team's experience.

They can be used: silver
sulfadiazine with cerio nitrate, enzymatic ointment
(collagenase, fibrolynosin), hydrocolloid, hydrogel, linoleic
acid, ricinoleic acid, bioperoxoil, Aloe vera, elicine, papain, albumin, non adherent gauzes, synthetic or biological membranes, dermic
regeneration main, calcium and
sodium alginate ecc. 
The change period will depend on the chosen product.

It is in treating a surgical wound it cleans. 
They can be used: non adherent gauze, synthetic membranes, biological membrane (for example frog's
skin, pig's intestine)  and others.

1. first degree or superficial: characterized by eritema and pain, an example is the excessive solar exhibition. 

2. second degree 
 - superficial – epidermis and partial derme = identified by the formation of bubbles and the lesion is painful. Agent common hot liquids. 
 - deep – epidermis and derme = formation of necrotic and fibrinous slough. It is painful. It can leave sequels scars. 

3. third degree or deep – it reaches all the elements of the skin could also involve deep plans. It doesn't present pain because the necrosis is besides total nervous terminals.

*- Should bubbles be broken? Some say that yes and others that not!

- Dressing open or oclusive? Generally in the face and genital are left exposed, in the other areas they are shut. 

- Ointments and its associations: This checked that some ointment in contact with secretions loses its effectiveness. Everything will depend on the degree of cellular destruction. To control the bacterial density in extensive burns is fundamental in the prevention of invasion of pathogenic microorganisms.

- The use of local antiseptic:
It is known that the tensoative soaps, due to the hydrofilic and lipofilic compositions alters the superficial cellular tension, could have citolitic action. 
The use of PVPI (polivinilpirrolidone) and clorexidine as antiseptic of open lesions, besides being citotoxic to the healing cicatrization, it can have the bactericide action neutralized in the presence of organic matter and necrosis. 
It is important to remind that each case is a case! Everything will depend on the need and convenience of each one.

The surgical procedure of  decompressive fasciotomy of the limbs.
On burns that involve all its circumference it should be routine conduct.
This technique avoids the installation of the  compartimental syndrome.
The hyperbaric oxigentherapy (HBO) is indicated.

In hyperbaric oxigentherapy some mechanisms are of matter it interests, for example: 
  a) microbicide action of anaerobic germes or microbiostatic direct or indirect action; 
  b) biochemical action in reactions in which the oxygen moves toxicant substances; 
  c) physiologic effects of outlying vasoconstriction and anti-oedematogenic; 
  d) sinergic effect facilitating the action of sistemic antibiotic.

Hyperbaric
Oxygentherapy

CONTROVERSY IN THE
WOUNDS TREATMENT

DRESSING and COVERINGS

Cellulose Acetate Steam Pesrmeabiity


Dressing Frog's Skin

Dressing Pig's Intestine
Derivated

FIRST-AID
CUTANEOUS WOUNDS

Surgical Wound Fasciotomy

 

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