![]() Inhalation burns occur as the result of breathing superheated gases, hot liquid or steam, etc. Inhalation burns are the most serious immediate life threat that can present both with or without an accompanying thermal burn. Caused by electrical current passing from electric outlet Caused by exposure to reactive chemicals such as acids Caused by hot solids or items such as a hot cooking item Thermal burns involve the skin and may be seen as any of the following: Classification by cause would be classified as either thermal or inhalation. The three most common characteristics used are cause, depth and extent of the burn. There are multiple characteristics used in the classification of burns. It is imperative for EMS clinicians to understand how heat energy is transferred, how burns are classified and immediate treatment of those burns. As EMS clinicians, we are in a unique position to be able to provide proactive education to patients as we enter their homes. Many of these burn injuries could often be avoided with basic household safety and maintenance. These situations are often stressful for emergency medicine clinicians, not only because of the injury caused by the burn, but because burns are more likely to happen to children and older adults, two age groups that already elicit larger amounts of stress from emergency clinicians. One flap was lost early in the series.It is imperative for EMS clinicians to understand how heat energy is transferred, how burns are classified and immediate treatment of those burns. Facial animation is retained and color matches are excellent. In all cases, facial integrity has been aesthetically restored and, in most instances, with makeup, is near normal in social settings at conversational distances. After restoration of facial form and texture, flesh color make-up and/or tattooing of beard, lips, scars, eyebrows, etc., aid to hide scars and pigment the skin to harmonize with the rest of the face. Adjunctive procedures include tensor fasciae latae slings, intraoperative tissue expansion, suction-assisted lipectomy, and scar management. Three-dimensional imaging is used to assess architectural asymmetries, and bone grafts are aided by computer-generated acrylic models. Seams are placed at junctions of facial components. ![]() Important to outcome is extensive initial intraoperative "sculpting" to simulate normal planes and contours. Flaps represented are free preauricular (1), radial forearm (6), ulnar forearm (1), free scapular (6), ilio-osteocutaneous (2), temporoparietal (8), vascularized forehead island (3), supraclavicular (1), and SMAS (1). The series includes hemiface (2), neck/jaw (5), chin/lower lip (3), cheek/malar (5), peri-orbital (2), nose (3), upper lip (4), and ear reconstructions (4). Since 1985, the author has successfully restored 17 severely disfigured burned faces by replacement of entire aesthetic units with microvascular "prepatterned" composite flaps blended into the facial canvas by cosmetic camouflage techniques. ![]() Criteria for success are (1) an undistracted "normal" look at conversational distance, (2) facial balance and symmetry, (3) distinct aesthetic units fused by inconspicuous scars, (4) "doughy" skin texture appropriate for corrective makeup, and (5) dynamic facial expression. The strategy of modern facial restoration emphasizes enhancement of aesthetic appearance as significantly as mitigation of functional impairment. Although highly specialized burn centers have significantly reduced mortality rates following extensive total body surface area burns, survivors are often left with grotesque facial disfigurement. ![]()
0 Comments
Leave a Reply. |
Details
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |