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Book Details
Abstract
Editor Robert Sheridan and authors review the latest in Management of Burns. Articles will include Reflection: evolution of the field over 50 years, Acute burn procedures and operations, Special injuries and illnesses, Initial evaluation and fluid resuscitation, Critical care of burns, Biology and principles of scar management and burn reconstruction, Management of common post-burn deformities, Burn recovery—physical and emotional rehabilitation, Anesthesia and pain control for burns, Outpatient burn management, Measuring burn outcomes, Burn care in disasters and austere settings, On the horizon--research priorities for the next decade, and more!
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Management of Burns\r | i | ||
| Copyright\r | ii | ||
| Contributors\r | iii | ||
| Contents\r | vii | ||
| Surgical Clinics Of North America\r | xi | ||
| Foreword\r | xiii | ||
| Preface\r | xv | ||
| Reflection | 721 | ||
| Key points | 721 | ||
| Fluid resuscitation | 722 | ||
| Reduction of Resuscitation Volume | 723 | ||
| High-voltage electric injury | 724 | ||
| Acute gastrointestinal stress ulcers | 725 | ||
| Inhalation injury | 725 | ||
| Diagnosis | 725 | ||
| Use of Animal Model | 726 | ||
| Burn wound care | 727 | ||
| Background | 727 | ||
| Exposure Treatment | 727 | ||
| Multidisciplinary Studies and Model Development | 728 | ||
| Clinical Use of Topical Antimicrobial Therapy | 729 | ||
| Burn Wound Excision | 729 | ||
| Biologic Dressings | 730 | ||
| Emergence of Other Microbial Opportunists | 731 | ||
| Burn Wound Biopsy for Diagnosis of Infection | 732 | ||
| Postburn hypermetabolism | 732 | ||
| Metabolic support | 734 | ||
| Nutrition | 735 | ||
| Pharmacologic Agents | 736 | ||
| Organization of burn care | 736 | ||
| ABA | 736 | ||
| Organization of research | 737 | ||
| Improved survival and new outcome goals | 737 | ||
| References | 738 | ||
| Initial Assessment and Fluid Resuscitation of Burn Patients | 741 | ||
| Key points | 741 | ||
| Introduction | 741 | ||
| Initial assessment | 742 | ||
| Referral Criteria | 742 | ||
| History | 742 | ||
| Primary Survey | 743 | ||
| Secondary Survey | 746 | ||
| Fluid resuscitation | 746 | ||
| The Difficult Resuscitation | 748 | ||
| New Approaches | 750 | ||
| Supportive care | 750 | ||
| Triage and transfer | 752 | ||
| Summary | 752 | ||
| References | 752 | ||
| Acute Burn Procedures | 755 | ||
| Key points | 755 | ||
| Introduction | 755 | ||
| Decompression procedures | 755 | ||
| Excision and closure of acute burns | 756 | ||
| The Operating Room Environment | 756 | ||
| Wound Evaluation | 758 | ||
| Determination of Need and Timing of Operation | 758 | ||
| Techniques of Burn Wound Excision | 760 | ||
| Techniques to Minimize Blood Loss | 762 | ||
| Graft Stabilization and Care | 762 | ||
| Donor Site Management | 763 | ||
| Summary | 763 | ||
| References | 763 | ||
| Burn Intensive Care | 765 | ||
| Key points | 765 | ||
| Introduction | 765 | ||
| Resuscitation | 765 | ||
| Hypermetabolic response to thermal injuries | 766 | ||
| Acute kidney injury and failure | 768 | ||
| Hyperglycemia | 770 | ||
| Postburn ventilation | 771 | ||
| Infection control | 773 | ||
| Summary | 774 | ||
| References | 774 | ||
| Special Problems in Burns | 781 | ||
| Key points | 781 | ||
| Introduction | 781 | ||
| Traumatic conditions | 782 | ||
| Blast Injury | 782 | ||
| Fragmentation Injury | 782 | ||
| Crush Injury | 783 | ||
| Degloving Injury | 784 | ||
| Combined Burns and Trauma | 784 | ||
| Environmental exposures | 785 | ||
| Electrical Injury | 785 | ||
| Chemical Injury | 786 | ||
| Radiation Injury | 787 | ||
| Tar Injury | 787 | ||
| Cold Injury | 787 | ||
| Medical and infectious problems | 788 | ||
| Soft Tissue Infections | 788 | ||
| Staphylococcal Scalded Skin Syndrome | 789 | ||
| Purpura Fulminans | 789 | ||
| Toxic Epidermal Necrolysis | 789 | ||
| Epidermolysis Bullosa | 790 | ||
| References | 790 | ||
| Biology and Principles of Scar Management and Burn Reconstruction | 793 | ||
| Key points | 793 | ||
| Basic science of scars | 793 | ||
| Introduction | 793 | ||
| The Cellular Basis of HTS | 795 | ||
| The role bone marrow cells in wound healing and fibrosis | 796 | ||
| The role of the Th1/Th2 paradigm after burn injury | 798 | ||
| Fibroblast heterogeneity and the profibrotic microenvironment | 799 | ||
| The role of toll-like receptors signaling in fibrosis | 799 | ||
| Newly Evolving Therapies Based on the Pathology of HTS | 800 | ||
| IFN treatment | 800 | ||
| Chemokines and CXCR4 inhibitors | 802 | ||
| Other potential therapeutic agents for HTS in the future | 803 | ||
| Current Preventative and Treatment Modalities | 803 | ||
| Prevention of scarring | 803 | ||
| Pressure garment therapy | 803 | ||
| Silicone gel therapy | 804 | ||
| Clinical care of scars | 804 | ||
| Introduction | 804 | ||
| Immediate Burn Care to Improve Reconstruction (Acute) | 805 | ||
| Early Scar Rehabilitation (Intermediate) | 805 | ||
| Late Scar Reconstruction | 805 | ||
| Contracture release and Z-plasty | 805 | ||
| Laser Therapy | 807 | ||
| Background | 807 | ||
| Laser tissue interaction | 808 | ||
| Pulsed dye laser | 808 | ||
| Fractional CO2 ablative laser | 808 | ||
| Timing | 809 | ||
| Laser safety | 809 | ||
| Laser post-operative care | 810 | ||
| Laser Adjuncts | 810 | ||
| Key Points for Lasers | 810 | ||
| Summary | 810 | ||
| References | 811 | ||
| Common Postburn Deformities and Their Management | 817 | ||
| Key points | 817 | ||
| Introduction | 817 | ||
| General principles | 818 | ||
| Classification of Deformities | 818 | ||
| Management Principles | 818 | ||
| Function over form | 818 | ||
| What we think is not what the patient thinks | 818 | ||
| Timing is everything | 818 | ||
| Techniques | 819 | ||
| Scar resection and resurfacing | 819 | ||
| Laser treatment | 820 | ||
| Contracture release | 820 | ||
| Common postburn deformities of the upper extremity | 822 | ||
| Axilla | 822 | ||
| Elbow | 823 | ||
| Heterotopic ossification | 824 | ||
| Hand | 825 | ||
| Thumb | 825 | ||
| Digital Web Spaces | 825 | ||
| Common postburn deformities of the trunk | 826 | ||
| Breast | 826 | ||
| Perineum | 828 | ||
| Postburn deformities of the lower extremity | 828 | ||
| Knee | 829 | ||
| Ankle | 829 | ||
| Foot | 829 | ||
| Soft-Tissue Defects | 829 | ||
| Postburn deformities of the head and neck | 829 | ||
| Eyelids | 829 | ||
| Nose | 830 | ||
| Ear | 830 | ||
| Eyebrow | 831 | ||
| Neck | 831 | ||
| Vascularized composite allotransplantation of the face | 831 | ||
| Indications for Face Transplantation | 831 | ||
| Facial Allograft Donors | 831 | ||
| Donor Matching | 832 | ||
| Donor Procurement | 832 | ||
| Recipient Operation | 832 | ||
| The BWH Clinical Experience | 832 | ||
| Challenges of Face Transplantation | 833 | ||
| Sensitization | 833 | ||
| Salvage options | 833 | ||
| Availability of donors | 833 | ||
| Future Directions | 833 | ||
| References | 836 | ||
| Clinical Applications of Skin Substitutes | 839 | ||
| Key points | 839 | ||
| Anatomy and function of skin | 839 | ||
| Current products | 840 | ||
| Allografts: Gammagraft, GraftJacket | 840 | ||
| Epidermal Equivalents: Epicel | 841 | ||
| Allogenic Skin Equivalents: Apligraf, Dermagraft | 842 | ||
| Dermal Templates: Integra, Terudermis (Japan), Pelnac (Japan), Matraderm (Europe) | 843 | ||
| Xenografts: EZ Derm, Mediskin | 844 | ||
| Clinical Products Not Currently Available: TransCyte, OrCel | 844 | ||
| Discussion | 845 | ||
| References | 847 | ||
| Perioperative Anesthesia Management of the Burn Patient | 851 | ||
| Key points | 851 | ||
| Introduction | 851 | ||
| Pathophysiology | 851 | ||
| Cardiac | 851 | ||
| Pulmonary | 852 | ||
| Renal | 852 | ||
| Central Nervous System | 853 | ||
| Hematologic | 853 | ||
| Infectious | 853 | ||
| Gastrointestinal/Hepatic | 854 | ||
| Endocrine/Metabolic | 854 | ||
| Psychiatric | 854 | ||
| Pharmacology | 854 | ||
| Perioperative management | 855 | ||
| Airway | 855 | ||
| Fluid Management | 855 | ||
| Temperature Regulation | 856 | ||
| Intravenous Access and Monitoring | 856 | ||
| Induction | 857 | ||
| Muscle relaxant | 857 | ||
| Induction agent | 857 | ||
| Maintenance | 858 | ||
| Reconstructive Surgery | 858 | ||
| Pain Management | 858 | ||
| Procedure-related pain | 859 | ||
| Late | 860 | ||
| Summary | 860 | ||
| References | 860 | ||
| Physical and Psychiatric Recovery from Burns | 863 | ||
| Key points | 863 | ||
| Introduction | 863 | ||
| Developmental Considerations Across the Life Cycle | 864 | ||
| Psychiatric risks, complications, and treatment | 864 | ||
| Skin Complications: Effects of Thermal Injury, Skin Regeneration, and Scarring | 865 | ||
| Hypertrophic Scarring | 865 | ||
| Ultraviolet sensitivity and skin pigmentation | 865 | ||
| Bone and Joint Changes | 866 | ||
| Bone metabolism | 866 | ||
| Osteophytes | 867 | ||
| Heterotopic ossification | 867 | ||
| Scoliosis and kyphosis | 868 | ||
| Septic arthritis | 868 | ||
| Subluxation and dislocation | 868 | ||
| Amputation | 869 | ||
| Neurologic injuries | 869 | ||
| Localized Neuropathies | 869 | ||
| Peripheral Polyneuropathy | 869 | ||
| Mononeuritis Multiplex | 870 | ||
| Pruritus | 870 | ||
| Pain complications | 870 | ||
| Cognitive Deficits | 871 | ||
| Metabolic complications | 871 | ||
| Catabolic State and Exercise | 871 | ||
| Temperature regulation | 872 | ||
| Psychosocial issues | 872 | ||
| End-of-Life Care and Ethical Considerations | 873 | ||
| Summary | 873 | ||
| References | 873 | ||
| Outpatient Burn Management | 879 | ||
| Key points | 879 | ||
| Introduction | 879 | ||
| Initial evaluation and selection of patients | 880 | ||
| Initial wound management | 881 | ||
| Topical burn care and dressings | 881 | ||
| Initial pain management | 887 | ||
| Home care instructions | 887 | ||
| Outpatient clinic follow-up | 887 | ||
| Outpatient management of complications | 888 | ||
| Pain | 888 | ||
| Pruritus | 889 | ||
| Infection | 889 | ||
| Outpatient therapy | 890 | ||
| Telemedicine | 890 | ||
| Summary | 890 | ||
| References | 890 | ||
| Burn Care in Disaster and Other Austere Settings | 893 | ||
| Key points | 893 | ||
| Introduction | 893 | ||
| Airway and breathing | 894 | ||
| Burn shock resuscitation | 894 | ||
| Threatened limbs and limb salvage | 895 | ||
| Combined burn-trauma injuries | 896 | ||
| Monitoring adequacy of burn shock resuscitation | 896 | ||
| Burn wound care options | 897 | ||
| Burn surgery in an austere environment | 897 | ||
| The difficulty of uncustomary triage decisions | 898 | ||
| Pain management under austere conditions | 898 | ||
| Palliative care | 899 | ||
| Pediatric considerations under austere conditions | 900 | ||
| Integrating austere burn wound care with realistic downrange resources | 900 | ||
| Aid for burn mass-casualty disaster planning and emergency preparedness | 901 | ||
| Basic Assumptions and Key Background Facts | 901 | ||
| External Regional Mass-casualty Burn Disaster Plan | 902 | ||
| The Internal Burn Center Disaster Plan | 903 | ||
| Triage | 904 | ||
| Training | 904 | ||
| Acknowledgments | 905 | ||
| References | 905 | ||
| Measuring Burn Injury Outcomes | 909 | ||
| Key points | 909 | ||
| Introduction | 909 | ||
| Traditional outcome measurement: mortality | 910 | ||
| Other acute phase burn outcome measures | 910 | ||
| Functional and health-related quality-of-life outcome measures | 911 | ||
| Psychological outcomes | 913 | ||
| Summary | 914 | ||
| References | 914 | ||
| On the Horizon | 917 | ||
| Key points | 917 | ||
| Introduction | 917 | ||
| Controlling inflammation and regulating hypermetabolism | 920 | ||
| Accelerating healing | 921 | ||
| Scar mitigation | 922 | ||
| Eliminating pain | 924 | ||
| Rehabilitation implications | 925 | ||
| Psychological recovery | 926 | ||
| Summary | 926 | ||
| References | 927 | ||
| Index | 931 |