later Reconstruction of Hand Burn
| Main Author: | Saputro Doso, Iswinarno |
|---|---|
| Format: | Proceeding PeerReviewed Book |
| Bahasa: | eng |
| Terbitan: |
, 2006
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| Subjects: | |
| Online Access: |
http://repository.unair.ac.id/45269/1/karil.7%20oke.pdf http://repository.unair.ac.id/45269/7/peerreview_validasi7.pdf http://repository.unair.ac.id/45269/ |
Daftar Isi:
- Reconstruction of the burned hand often presents a fomidable challenge. The need for reconstruction is the result of several contributing factors acting Independently or In concert. They Include the severity of the initial Injury, Involvement of specific structures, adequacy 0f initial care, prior management of burn wound. the quality of hand therapy, and the motivation and reliability of the patient and caregivers. Deep second- and third-degree burns of the hand that are part of a large total body burn lead to other problems. First, in an effort to save a criticalty ill patient, clinicians often neglect the hands. Once the patient' survival is assured. the neglect is recognized but it is too late. and damage almady has been done. Early elevation of extremity successfully reduces edema that can Interfere with active end passive range of motion, leading to stiffness. If circumferential burns and marked edema suggest impaired vascular flow. ear1y escharotomy of the wrist, Intrinsic muscles, and digits can salvage digit length and prevent intrinsic muscle ischemia nad fibrosis that could lead to fixed intrinsic minus deformities. A generation of new dressings has made Superficial second degree burns a "non problem-. As long as dessification and infection are pre-vented, healing should occur expeditiously In these burns, without longterm sequelae. Deep second-degree burns with or without large total body surface injury can be more complicated. Successful treatment of a deep second-degree burn of the hands nonsurgically In an outpatient requires an intelligent. cooperative patient. If not possible. it Is far better to admit the patient end tangentially excise or dermabrade the burned tissue during surgery, saving unburned dermis and covering the wound with split-thickness skin graft.