11 ,12 However, well-documented side effects such as dermal atrophy and skin hypopigmentation, especially in African American patients, make corticosteroid treatment questionable from a cosmetic perspective. 11 ,12 Corticosteroids are believed to decrease excessive collagen synthesis through attenuating fibroblast and keratinocyte hyperactivity. Hypertrophic scars can be effectively treated with long acting injected corticosteroids such as triamcinolone acetonide. 11 Scars may contract leading to impaired mobility of the affected region, and hypertrophic and keloid (i.e., fibrous tissue) scars result from inappropriate collagen tissue outgrowth in response to the wound healing process. 6 ,7 ,10Īs mortality rates secondary to severe burn wounds have decreased over time, a major component of burn wound care is treating burn scars which can lead to mental, physical, and social distress. 7 ,9 Since both second and third degree burns destroy the epidermal regenerative cells of the stratum basale, both injuries will be replaced with scar tissue. 6 ,7 These burns often overtly appear on a spectrum from white to black and are likely to not be as painful as they may have destroyed dermal nerve fibers. 6 ,7įull thickness, or “third-degree”, burns involve all layers of the skin and may involve underlying subcutaneous muscle and bone. Even though dermal nerve fibers often remain intact, most second-degree burns induce extreme pain. superficial dermis versus deep dermis), the less likely it will blanch with pressure. The deeper a burn penetrates the dermis (i.e. 6 ,7 The dermis can be further subcategorized into a superficial, or “papillary”, level, and a deep, or “reticular”, level. Partial thickness, or “second-degree”, burns involve the epidermis as well as the dermis and are classically characterized by blister formation with possible blood vessel exposure. 6 ,7 Although these types of lesions are often both erythematous (i.e., reddened) and painful, they typically heal well with the use of topical anti-inflammatory agents such as aloe vera agents that promote skin-regeneration without scarring. Superficial, or “first-degree,” burns are commonly associated with sun-bathing or salon-tanning and involve only the top epidermis of the skin. 1–5īurn wounds are generally classified by their extent of skin layer involvement since this information is important to understand to order varying degrees of intervention. 1 Although the medical literature indexed on PubMed regarding severe burn injuries secondary to pressure cooker explosions has remained minimal, the complexity of burn care coordination management has appeared in multiple articles. 1 As pressure builds, the cooker lid is designed to remain secured through both locking and safety valve mechanisms. at a standard pressure of about 15 pounds per square inch. 1 These airtight utensils intended for quick cooking operate by bringing boiling water from 100 O C. This paper discusses the critical opportunities posed for more extensive burn patients’ physicians to first categorize the extent of burn wounds and initiate subsequent specialty care in other settings.įound in approximately one-fifth of households, pressure cookers are one of the most commonly used cooking devices in the United States. Partial and full-thickness burn injuries generally warrant immediate clinical (i.e., body surface area burn assessment, fluid resuscitation, empiric antibiotics) as well as ongoing (burn center referral, debridement procedures, active scar management, provision of psychological support) treatment needs. Upon her arrival to the second author’s family medicine clinic, a multi-specialty wound recovery plan was initiated since her first urgent care visit treatment had been minimal without prophylactic antibiotic therapy or placement of a burn center referral. The authors first saw the patient during a primary care office visit a week after her initial injury when she first went to a local urgent care clinic. The example patient described in this report was an African American female in her early 30s who presented during the summer of 2020 after suffering varying levels of second-degree burns to her bilateral upper torso and left wrist (i.e., approximately 10%, total body surface area). When second-degree (i.e., “partial-thickness”) burns result from pressure cooker explosions, wounds involving near to or greater than 10% of total body surface area typically require multidisciplinary treatment, with burn center referral for proper wound care, potential fluid resuscitation, and eventual scar management. Although pressure cookers are very common kitchen utensils used in the United States, only a few cases of serious injuries secondary to pressure cooker explosions have been reported in the medical literature.
0 Comments
Leave a Reply. |
Details
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |