By John A. Clarke
The analysis, analysis and selection of assorted different types of therapy of burn wounds relies principally at the actual visual appeal of the wound itself and of the encircling tissue. This atlas bargains a variety of illustrations of universal and weird burns, as a result of a number of brokers. The accompanying captions supply an creation to the identity and category of burns. Outlines of the suitable administration are provided for every form of harm, with prior to, in the course of and after remedy sequences the place worthy.
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Extra resources for A Colour Atlas of Burn Injuries (Chapman & Hall Medical Atlas Series, 9)
5% solution) applied as a wet dressing is considered the best prophylaxis, but is expensive and time-consuming to apply, leads to staining, and can cause serious metabolic problems from the loss of chloride ions and methaemoglobinaemia . Silver sulphadiazine cream can be incorporated in a dressing or 'buttered' onto the surface (Fig. 25). Sulphamylon (or mafenide) can penetrate the eschar, but is often painful to apply and can result in metab olic problems due to carbonic anhydrase inhibition.
Dressings may help to keep the number of colonizing organisms to manageable levels but do not eradicate them. Surgical excision should be considered. Fig. 7 Prevention of invasive sepsis. The red flare around this exposed eschar indicates local cellulitis fol lowed closely by invasive sepsis Infection in such an exposed wound is likely to be streptococcal and should be treated by high doses of penicillin , early wound exci sion and delayed grafting . Fig. 8 Flamazine dressing. (a) Dirty dressings have been removed and wound swabs taken .
Fig. 16 Tube insertion. A large tracheostomy tube is inserted and connected via the adaptor to the anaesthe tic circui t, and its cuff is inflated until an air seal is obtained . Fig. 17 Skin grafting. The graft is applied to the raw area and dressed . The strong stitch at the tip of the Bjork flap is passed through the graft and subcutaneous tissue at the inferior edge of the stoma . The flange of the tra cheostomy tube is st itched to surrounding skin and held in place with the customary two tapes passed around the neck for extra security.