January 8, 2013

Third Degree Burns and Tissue Expansion

Tissue expansion is a procedure that allows the body to grow extra skin. It is done by inserting a silicone balloon expander under the skin near the area to be repaired (such as scars happening after burns) and then gradually filling the balloon with salt water over time causing the skin to stretch and grow (keeping the skin under tension causes new cells to form).

Tissue expansion is used in conditions such as breast reconstruction surgery, repairing burns, scars, large birth marks, hairy areas such as the scalp (the extra skin is still able to grow hair).

After the skin stretches the scaring is surgically removed and the expanded skin is extended to meet healthy un-scarred skin.

The advantage of this procedure is that it provides a good match of color, texture and hair bearing quality. The expanded skin has a smaller risk of dying because the skin remains attached to the donor's area blood and nerve supply. Scars are often less apparent because the skin is not removed from one area and transferred to another.

The main disadvantage of the procedure is related to the length of time needed to grow/stretch the skin which may be as long as three to four months. The expander during the expansion process appears as a bulge. Frequent visits to the surgeon are required for salt water injection to expand the balloon. There are risks related to the anesthesia and the surgery such as infection and bleeding.

The silicone balloon expander is inserted by a plastic surgeon under the skin in an initial surgery followed by salt water injection through a period of time than the expander is removed and the new tissue is put in place. During this process most patients feel temporary discomfort which can be controlled by medication prescribed to you by your physician.

You should contact your physician if you see any indication of wound infection. You have to avoid applying any undue pressure to the area around the tissue expander such as poking it or wearing tight clothes over the area.

Tissue expansion can be an effective method to make scars that result from burns less noticeable; it is not a replacement for skin graft. Skin grafts are usually done when the tissue is destroyed in severe burns.

This information is not intended nor implied to be a substitute for professional medical advice; it should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. Call 911 for all medical emergencies.

December 6, 2012

Fire Prevention and Safety

Fires and burns are one of leading causes of household injuries. Simple things can be done to prevent or decrease these risks of fires and the resulting burns which include:


  • Have a proper escape plan in case of an emergency.

  • Make sure that a smoke detector is installed and it is working properly.

  • Check the smoke detector every year.

  • Make sure that you have a working, fully charged fire extinguisher.

  • Make sure that your water heater is set to 120 degrees or less to avoid scalds, install radiator cover, and isolate exposed steam pipes.

  • Fire places and burning candles should never be left unattended, dispose of cigarettes, and matches carefully; never place anything that may burn near a water heater, space heater, stove top, or near a furnace,

  • If a kitchen fire occurs, don't panic, know how to handle it and put it out. For oven fires, close the door and turn off the oven. For a stovetop fire, use a lid to smother it.

  • Children should be taught never to play with matches, lighters, or gasoline; they should never be allowed to handle fireworks; never leave young children alone; place pots on the rear burner of the stove and turn the handles inward out of the reach of children; make sure that the stovetop is clean as residue grease can catch fire; make sure that the stove is turned off when you are finished; children should be taught what to do if they smell smoke of hear the smoke alarm.

  • Never place electric cords under rugs or bedding. Heat or sparks from these cords may cause a fire.

  • Always check electrical cords for signs of wear and replace cracked or frayed cords to avoid shock and fire. Don't overload outlets or power strips, and cover unused outlets with plastic plugs.

  • When dealing with chemical substances, protective clothing should be used; all chemical substances should be stored in tamper proof containers out of reach of children; chemicals should never be stored in food or drink containers; different products that contain toxic chemicals should not be mixed together as they may give off toxic fumes; avoid using potentially toxic substances in the kitchen or around food.

  • If your clothes are on fire, stop, drop and roll.

  • In case there is a fire in a building, you should move to the floor where the air is cool and clear because hot air carrying harmful gasses will rise up.

  • Know the emergency phone numbers for your area. In most places it is 911. Teach children the emergency number and post it near each phone.

This information is not intended nor implied to be a substitute for professional medical advice; it should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. Call 911 for all medical emergencies.

November 29, 2012

Burn Wound healing and Laughter

Laughter is free, it has many positive effects on the physical and mental health and no known negative side effects. Laughter binds people together, infact it's the shortest distance between two people.
A team of researches from the University of Leeds, UK, found laughing habits in people suffering from wounds can accelerate healing compared to using advanced technology.

The effect of laughter may include:

  • Laughter stimulates the release of endorphines, when the endorphins level increase in the brain, the pain perception decreases leding to a decrease in pain.
  • When we laugh, the diaphragm will move leading the blood to move more smoothly throughout the body icreasing the ability of the body to use oxygen and this may lead to faster healing of the wound.
  • Laugh raises the activity and number of natural killer cells (NK cells). NK cells are cells attack and play a major role in rejection of viral infected cells and some types of tumor cells. NK cells are part of the immune system.
  • Helps prevent heart disease ( astudy done in the University of Maryland Medical Center)
  • An increase in Immunoglobulin A (IgA) antibody which help to fight upper respiratory tract infection. There are five types of Immunoglobulins in our body (IgA, IgG, IgM, IgE, IgD).
  • An increase in immunoglobulin G (IgG) antibody, they are the most common type of antibodies in our body and play an important role in fighting viral and bacterial infections, they also cross the placenta (the only Ig that has this ability) and help in protecting the fetus.
  • An increase in immunoglobulin M (IgM) which are the first antibody type produced in response to an infection.
  • An increase in T helper cells, therse are the cells attacked by HIV virus.
  • An increase in gamma interferon which regulates the body's ability to turn on the immune system.
  • An increased in in complement 3 which is part of our immune system that helps antibodies pierce through infected or dysfunctional cells inorder to destroy them.
  • An increase in number and activation of T cells as well as an increase in the ratio of helper/suppressor T cells.
  • An increase in the number of B cells, they are the cells which make all the immunoglobulins.
The effect of laughter on stress:
  • Lowers dopamine level which is associated with elevated blood pressure.
  • Lowers epinephrine.
  • Lowers growth hormone level in the blood.
  • Lowers cortisol level.
  • Lowers other stress hormones.
  • Lowers blood pressure and heart rate after initial short rise.
  • Reduces anxiety and fear.
  • Relaxes our muscles.
  • improves mood.
A stronge immune system is important in burn wound healing. Laughter boosts the immune system and increases the number of immunoglobulins which help fight infections. Infection is the most common complication of burns and is the major cause of death in burn victims. Make use of this easy to use strong medicine as it will not only make you happy, but will make everyone around you happy, it's contagious.

This information is not intended nor implied to be a substitute for professional medical advice; it should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. Call 911 for all medical emergencies

See also The effect of stress on the skin, Burn wound care at home.


November 27, 2012

Third Degree Burns and Keloid Scar (Part II)

There is no treatment that can cure and remove keloid scars 100 percent. Patients who have family history of keloid scar or previous history of keloid scar have high possibility of keloid recurrence more then others. Keloid scar may be treated by one or more of the following methods:

Surgery:

It may be the most effective way to remove large keloids. Surgery can be used by itself or with other treatment methods to decrease the possibility of recurrence as there is a possibility of keloid recurrerence an example is using surgery and steriod injection into the keloid scar or using surgery and other treatment methods to decrease recurrence rate.

Laser therapy:
Laser treatment is healpfull when the keloid scar is thin as the laser bean works on the surface of the keloid scar, it's less effective when the keloid scar is thick. Your physician will discuss with you the best method of treatment of your keloid.

Cryosurgery therapy:

Cryosurgery which is freezing of the keloid scar is usually used for small scars only as it causes freezing of the scar and as a result blanching of the skin underneath the scar.

Radiation therapy:

Radiation therapy can be used alone as a treatment method but is more effective within 7 days of after surgical keloid removal.The risk of developing cancer from radiation is small as the radiation device used for this treatment emits smalllow radiation dose.

Creams, Pasts and Gels:

Creams, Gels and Pasts are most effective when the keloid scar is newly formed but still its effectivenes is limited even with newly formed keloid scars.

Silicone sheets:

Silicone sheets can be taped on to the keloid scar. You need to wear the sheets constantly for several weeks or several months.

As keloid scars differ in shape, size and causation from one person to another, the response to treatment also differ among different individuals therefore what might work for one person may not work for you and vise versa.

The combination of two or more treatment methods is usually more effective than using one method by itself and the recurrence is less when combining two or more methods together.

This information is not intended nor implied to be a substitute for professional medical advice; it should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. Call 911 for all medical emergencies.

November 6, 2012

Endotrachial Intubation

It is a medical procedure in which a tube is placed into the trachea to open the airway, remove blockages and to provide oxygen, medication or anesthesia. It may be attached to a machine called a respirator that will breathe for the patient while the tube is still in place. Airway control and mechanical ventilation are often necessary in the treatment of severe burn injuries.

Swelling in the upper airway is a major concern in any person with a burn injury. Swelling may lead to acute respiratory insufficiency, in children the airway is smaller therefore they are more prone to develop airway obstruction from burn. Swelling and damage to the airway may be caused by inhalation of the gases and fumes caused by combustion and/or the effect of heat on the tissue (see smoke inhalation). The extent of the damage to the airways is not directly related to the severity of skin burns and in some cases it may become the greatest therapeutic problem in a gravely burned patient.

Although obstruction of the upper airways caused by edema (swelling of the tissue) may happen acutely, it may not be present until the edema is sufficient enough to produce clinical evidence of impaired airway patency which may take 12-18 hours. Therefore it is important to monitor the patient for any difficulty in respiration even though the patient may not have any problems initially.

Extensive face and neck burns increase the risk of airway compression and the need for early endotracheal intubation. Deep face burns may lead to airway obstruction due to intraoral edema which will in turn decrease the clearance of intraoral secretions and impair the protection of the airway from aspiration. Deep neck burns will increase the risk of airway compression and the need for early endotracheal intubation due to the external compression of the larynx by the swollen neck.

A decision will be made by the treating physician after initial assessment as to whether or not the airway can be managed safely without an endotracheal tube. The treating physician will also make the determination of how long the patient will be intubated and when the tube is taken out depending on the condition of the patient.

When the patient is intubated, he/she may stay in bed for a prolonged period of time, this may increase the risk of developing Deep venous thrombosis (see Deep venous thrombosis part I, II) which is the main cause of pulmonary embolism, these patients are given prophylactic measures to decrease the risk of deep venous thrombosis (medications and compression devices). Make sure that these devices are worn all the time and if they are disconnected (to walk or visit the restroom), make sure that they are reconnected when the patient returns to his/her bed.

This information is not intended nor implied to be a substitute for professional medical advice; it should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. Call 911 for all medical emergencies.

October 9, 2012

Visiting a Burned Patient In The Hospital

Burned patients need all the support they can get from family, relatives and friends. A burn injury is one of the most painful traumas a patient can ever experience.

One of the major concerns and challenges a burned patient faces is infection, (see wound infection). Burn centers have strict guidelines regarding infection control, depending on the patient's condition. When visiting a patient with burns, you should know the visiting hours and the number of visitors allowed which may be limited depending on the patient's condition.

Visitors may be required to wear a gown, mask, cap and gloves when visiting the patient. The nurse will give you instructions on the protective clothing to decrease the risk of infection. Look for any signs outside the patient's door that will tell you if you have to wear these protective garments when entering the patient's room. It's important to follow these instructions. You have to wash your hands prior to entering and after leaving the patient. Avoid visiting the patient if you have an active cold or an infection and inform the nurse about it if you do visit.

For children to see the patient, permission may be required from the nurse. They may also have to wear the protective garments as well. It's important to keep a quiet atmosphere while visiting the patient. It is also important to know the resting period of the patient, the treatment periods and burn team round periods to avoid as you may be asked to leave the burn unit during these times.

Although it's hard to see your loved one suffering, it's important to keep a positive attitude in front of the patient encouraging him/her and raising the patient's spirit.

This information is not intended nor implied to be a substitute for professional medical advice; it should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. Call 911 for all medical emergencies.

October 3, 2012

Tracheostomy

It is a surgical procedure, in which a hole is created through the front of the neck and into the windpipe (trachea). A breathing tube (trach tube) is placed directly into the trachea through the opening to help the patient with breathing and to remove secretions from the lungs.

The condition that necessitated tracheostomy and the overall health of the patient will determine how long the tracheostomy will stay. A tracheostomy is usually temporary but some patients may need them for a longer period of time or even permanently.

Patients of all ages may need tracheostomy. It can be done on an emergency basis such as when there is trauma to the neck or on an elective basis. The type of anesthesia used for the procedure is general anesthesia.

Indications:

Among the conditions that tracheostomy may be used for:

  • Airway injuries from smoke, steam or chemical burns.
  • Congenital (inherited) abnormality of the larynx or trachea.
  • Neck cancers that affect breathing.
  • Severe face or neck injury.
  • Severe allergic reactions or infection.
  • Airway blocked by a large object.
  • Spinal cord injuries.
  • Long-term coma.
  • Patients who need to be on ventilators (see Mechanical Ventilator part I, II) for more than 1-2 weeks.

Risks associated with tracheostomy may include:

  • Risks related to anesthesia such as reactions to medication.
  • Risks related to surgery such as bleeding and infection.
  • Scarring of the trachea.
  • Blockage of the tracheostomy from dried secretions and mucous.
  • Nerve damage.
  • Failure of the closure of tracheostomy after the removal of tube.

A therapist will work with the patient once the tracheostomy is mature to regain the ability to swallow normally. Some patients may need swallowing tests to make sure that they can swallow safely before starting normal swallowing. During the period where the tracheostomy is maturing, patients will be fed by other methods such as through a vein or through a tube that goes through the mouth or nose to the stomach.

As for talking, a speech therapist will work with the patient after the maturity of the tracheostomy to help him/her to use his/her voice clearly; one of the options is to use a speech valve that is attached to the tracheostomy tube.

When there is no longer a need for tracheostomy (temporary one), the tube will be removed eventually and healing will occur leaving a minimal scar.

Some Patients will be discharged home having a tracheostomy, they and their families will be taught how to take care of their tracheostomies at home. These patients should adhere to the safety precautions that they were taught such as exposure to water. It is recommended that a tracheostomy opening be covered by a loose covering when the patient is outdoors.

This information is not intended nor implied to be a substitute for professional medical advice; it should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. Call 911 for all medical emergencies.

October 2, 2012

Tap Water and Scald Burns (part III)

One of the most common causes of burn injuries is scald injury. Hot water scalds is a common cause of scald injury in which a short exposure time can result in severe burns depending on the water temperature. Most scald burns happen in the home from exposure to hot water in the sink, showers or bathtubs. Scald burns can also happen at restaurants and other places. Scald burns can happen to anyone, the severity depends on the temperature of the liquid and the duration of exposure.
Clinical features of scald burns:
Clinical features of scald burns depend on the severity of burn whether it's a first,second or third degree burn. Clinical features may include:

  • Redness of the skin
  • Pain (may be absent in third degree burns as the nerves responsible for sensation may be destroyed)
  • Swelling of the affected area
  • Blisters (may develop in second degree burns)
  • Peeling if the skin in the affected area
  • White, stiff, waxy or charred skin (may happen in third degree burns)
Treatment:
  • Avoid panicking and remove the victim from the source of burn as soon as possible.
  • Cool the burned area immediately under running cool water for 10-30 minutes. Never use ice, any greasy substance or cream as this may lead to more damage
  • Seek medical assistanace
  • Keep the victim as comfortable as possible
  • Remove any watch, jewelry or clothing from the affected area; don't try to remove anything that is stuck to the burned area as this may lead to more damage
  • Cover the burned area with clean, non fluffy material to keep it clean and protect it from infection. Avoid breaking the blisters and avoid using adhesive dressings
  • Treat associated symptoms like shock
When to seek medical assistance:
  • When the victim is over 60 years of age or under 5 years of age
  • When the victim is pregnant
  • When there is pre-existing conditions such as lung disease, heart disease, compromised immune system
  • When the burn is large, deep, or if blistering is present
  • When the burn is located on the face, neck, hands, feet, joints, limbs, genital area, buttocks or around the upper body
  • When there is signs of infection which may include increase redness, increase pain, increase swelling, fever, foul odor discharge, pus, non healing wound after several weeks or there is new unexplained symptoms
  • When the victim has diffeculty breathing or has inhaled smoke or fumes

This information is not intended nor implied to be a substitute for professional medical advice; it should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. Call 911 for all medical emergencies.

September 27, 2012

Tap Water and Scald Burns (part II)

Hot water scalds can cause severe burn injuries leading to lengthy hospital stay that may result in scaring and permanent disfigurement or even death. As the majority of these scalds injuries happen at home it's important to follow certian measures that may prevent these types of burn injuries which are common in elderly, young children and people with disabilities.

Prevention of tap water scald injuries may include:

  • Setting water heater thermostats at a temperature not higher than 120°F (49°C), the safest water to bathe is about 100°F (37°C)
  • Educating parents and caregivers about the consequences and complications of hot water scald injuries
  • Constant adult supervision of young children, children with disabilities and elderly who have difficulty in removing themselves from hot water while in bath water or near facets.
  • Filling tub with cold water first then add hot water, check the temperature of sink or bath water before allowing children contact with it.
  • Don't bathroom tub unattended while it's filling and never leave older sibling with a younger one alone in bath water or near faucets
  • Facing children away from tap handles in a bathtub or sink while bathing them so that the child can't reach the handle and turning the handle to the cold position when not in use
  • Keeping bathroom door closed when not using it and not using it as a play area
  • In elderly and unsteady people install grab bars and non slip mats in the showers or tubs
  • If there is difficulty or a problem with standing unassisted than use a shower chair when showering or bathing.
  • Elderly and People who need assistance have to be provided with a way to call for help like a bell or a whistle in case of emergency
  • To prevent sudden fluctuations in water temperature while someone is showering avoid running water, flushing the toilet or using a machine that uses water
  • Installing a master thermostatic mixing valve at the water heater and thermostatic mixing valves in bathrooms
  • Installing an anti scald devices which are inexpensive, simple to install on most existing taps and can be found in pluming and hardware stores. These devices are heat sensitive and interrupt or stop the flow of water when its temperature reaches a predetermined temperature generally 110-114° but before reaching 120°F (49°C)
This information is not intended nor implied to be a substitute for professional medical advice; it should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. Call 911 for all medical emergencies.


September 25, 2012

Tap Water and Scald Burns (part I)

One of the most common causes of burn injuries is scald injury. Hot water scalds is a common cause of scald injury in which a short exposure time can result in severe burns depending on the water temperature. Most scald burns happen in the home from exposure to hot water in the sink, showers or bathtubs. Scald burns can also happen at restaurants and other places. Scald burns can happen to anyone, the severity depends on the temperature of the liquid and the duration of exposure.

Scald burns can happen to anyone but there is a vulnerable population which can be affected that includes young children, elderly people and people with disabilities. Many people are unaware that it needs a short exposure period to hot tap water to cause serious burns. People at high risk of developing scald burns are:

  • Young children have thinner skin, this results in deeper and more severe burns. Children have greater body proportion that is exposed to a scalding substance.
  • Elderly people have thinner skin leading to deeper and more severe burns. Elderly people may also have other medical conditions that make them more liable to fall in the bathtub as well as decreased sensation of heat and poor microcirculation leading to slow release of heat from the burned tissue.
  • People with physical and cognitive disabilities
  • Crowded families and families with low socioeconomic status
  • Single parent and parents with poor education.
As a standard, the maximum temperature of water delivered to the tap by residential water heaters is 120 degree Fahrenheit (48 degree Celsius).

Temperature/scald burn:

113°F (45°C) lead to second degree burn in 2 hours and third degree burn in 3 hours
116.6°F (47°C) lead to second degree burn in 20 minutes and third degree burn in 45 minutes
118.4°F (48°C) lead to second degree burn in 15 minutes and third degree burn in 20 minutes
120°F (49°C) lead to second degree burn in 8 minutes and third degree burn in 10 minutes
124°F (51°C) lead to second degree burn in 2 minutes and third degree burn in 4.2 minutes
131°F (55°C) lead to second degree burn in 17 seconds and third degree burn in 30 seconds
140°F (60°C) lead to second degree burn in 3 seconds and third degree burn in 5 seconds

Hot beverages like coffee and tea are usually served at 160-180°F (71-82°C) and can cause instant burns when falling on the skin, these burns will require surgery.

This information is not intended nor implied to be a substitute for professional medical advice; it should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. Call 911 for all medical emergencies.


September 20, 2012

Intentional Burns

Intentional burns are less frequent than accidental burns but can happen. They are either burns that are caused by the person to him/herself or burns caused by one person to another one. Children and elderly are susceptible to abuse by burns. In children scald and contact burn injuries are the most common type of intentional burn injury. These injuries have a higher death rate than accidental burns and require a longer stay period in the hospital. Elderly cases are reported with much less frequency than children due to embarrassment or fearing that the person who is causing the injury will repeat it again. Things that raise a suspicion of abuse are:

  • The story given doesn't go along with the injury that happened.
  • Giving different explanations about how the accident happened.
  • There are multiple injuries and this is not the first one.
  • The shape and location of the injury may give an indication that it's an induced injury.
For elderly people suspected to have an induced burn injury, they should be reported. For children with suspected abuse, a call should be made to report it to the police, child protective services, and /or a doctor. If you are the one who is exposed to the injury you should look for help. If you are taking care of a child and you can't control your anger seek help. If a person you know is the one who is exposed to the insult than try to seek help for him/her.

If a person is causing burns to his/herself, a psychological evaluation and treatment may be needed.

This information is not intended nor implied to be a substitute for professional medical advice; it should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. Call 911 for all medical emergencies.

September 11, 2012

Severe Burns and Cellulitis (Part II)

Predisposing factors:

  • Burns (second degree and third degree burns).
  • Skin diseases such as boils, eczema and psoriasis.
  • Weak immune system such as in AIDS and patients using immunosuppressive drugs.
  • Diabetes. (feet burns in diabetic patients)
  • Old age.
  • Diseases affecting the circulation of blood to the lower limbs such as varicose veins.
  • I.V drug abusers.
  • Varicella.
  • Dense populations who share hygiene facilities and common living quarters such as nursing homes, homeless shelters and college dormitories.
Clinical features:
  • The area affected is red, tender and swollen.
  • Increased warmth in the affected area.
  • Regional enlargement of lymph nodes may be present.
  • Fever, headache, nausea and chills may be present.
  • Red streaking visible in the skin proximal to the area of cellulitis may be seen.
  • Abscess.
  • Ulceration.
Diagnosis:
  • No work up is needed in uncomplicated cellulitis and the diagnosis is based on the clinical features.
  • In complicated cases, cases with generalized sepsis and when any of the predisposing factors are present, the following tests may be done: Complete blood count, Blood culture, Blood urea nitrogen and creatinine level, US and others.
Treatment:

Cellulitis is potentially serious as it spreads quickly and can lead to more serious complications. If it is not treated, the infection can spread to the blood or lymph nodes and in rare cases the infection can spread to the fascia which is the deep layer of tissue causing a disease called Necrotizing Fasciitis (flesh eating bacteria) which is a medical emergency that can lead to death. Treatment of cellulitis include:

  • Rest of the affected area.
  • Antibiotics: either oral or intravenous depending on the severity of cellulitis, the presence of risk factors and presence of complications.
  • Pain killers.
  • Debridement of the dead tissue.
  • Hyperbaric oxygen therapy may be used in some cases.
Prevention:

Prevention is done by taking a good care of cuts, wounds and burns, if you develop signs and symptoms of cellulitis, seek medical help quickly to avoid complications. (see burn wound care at home)

This information is not intended nor implied to be a substitute for professional medical advice; it should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. Call 911 for all medical emergencies.

September 6, 2012

Severe Burns and Cellulitis (Part I)

The skin is the first line of defense against infection, it is composed of three layers, the epidermis, the dermis and the subcutaneous tissue layer (see the skin). Infection is the leading cause of death among hospitalized patients with burns. Normally the surface of the skin contains a mixture of microorganisms called normal skin flora, these flora live on the surface of skin and cause no disease unless the skin is damaged and/or the immune system is compromised. (see wound infection)

Cellulitis is an infection of the dermis and the subcutaneous tissue layer of the skin, cellulitis can be caused by normal skin flora or by exogenous bacteria, where in most cases the skin has previously been broken such as:

  • Second degree and third degree burns which lead to blister formation that can open and become infected.
  • Cracks in the skin.
  • Cuts in the skin.
  • Sites of intravenous catheter insertion.
  • Surgical wounds.
Cellulitis can affect any part of the skin but it commonly affects the skin on the face or the lower legs.

Causes:
The most common bacteria causing cellulitis is Group A Streptococcus and Staphylococcus aureus, both of them are part of the normal flora of the skin and are harmless when they are on the outer surface of the skin but cause infection when they enter the skin. Group A Streptococcus is found on the skin and the throat while Staphylococcus aureus is found on the skin and the mucosa (lining) of the nose and mouth. Other exogenous bacteria can cause cellulitis and in some cases people get cellulitis without a break in the skin.

Kramer and Pollack, LLP; are VERY well versed in all aspects of representing burn injury victims. They have handled a multitude of burn injury cases ranging from hot water scald burns, to stove tipping cases to explosion cases. They are competent, experienced and very thorough

This information is not intended nor implied to be a substitute for professional medical advice; it should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. Call 911 for all medical emergencies.


August 30, 2012

People's Reaction To Scars

One of the challenges that a burn survivor faces after discharge is the reaction of society to his/her scars. According to George Pessotti a burn survivor and the author of Reasons for Living, "most people mean no harm when they stare or ask questions. They're simply curious; they want to know what happened to you for different reasons"

The face is the mirror of the person, the first thing that most people look at when they see a person is the face, and it gives clues about the person like background, age and mood. Scarring of the face after a burn injury may lead to psychological and social difficulties for the patient.

Burn survivors deal with scars differently, each will cope with it in his/ her own way, some will try to move on with life and forget what happened as much as they can. Others will isolate themselves from the community, live their lives in the shadow or turn to drugs and alcohol.

In addition to the physical trauma some have to deal with the loss of their home, income and may be grieving the loss of a family member (in the fire). It's not uncommon that the patient may experience different emotions like anger, anxiety, fear, frustration, self guilt and depression. The road to recovery may be long but there will always be light at the end of the tunnel. Patients are encouraged to speak with family, close friends, attend support groups, and seek counseling if they need it.

The human brain works in an amazing way. Positive thinking can lead to better coping skills and decreased negative stress. If you put positive thoughts in your brain the results will be positive and vice versa. Simply focus on the solutions and not the problem as the problem has happened and can't be changed but the solution is in your hand. When you see people looking at your scars in a strange or suspicious way, explain to them what happened.

This information is not intended nor implied to be a substitute for professional medical advice; it should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. Call 911 for all medical emergencies.

August 28, 2012

Dermabrasion

Is a surgical procedure involving the removal (sanding) of the damaged top layer of the skin using a specialized instrument called a dermabrader. This procedure is used for scars as well as other skin conditions such as wrinkles and tattoos.

Dermabrasion improves the appearance of the scar or other skin abnormality as a new layer of skin will replace the skin that has been treated. This procedure won't entirely remove the scar or other abnormality but it will improve its appearance by softening the edges of the scar or other lesion.

The procedure can be done in a surgeon's office or in an outpatient surgical facility. After the procedure the skin will be swollen, red and tender. Swelling gradually subsides within 2-3 weeks. You may feel some burning, itching, aching or discomfort for a while after the surgery. Pain medication, antibiotics and anti-swelling medications can be prescribed. Ointment and special dressing will help speed the healing process and your physician will give you instructions on how to care for the wound. Healing usually occurs within seven to ten days.

At first the new skin that is formed is pink in color but will gradually return to its normal appearance. The skin pinkness will largely fade within 2 to 3 months. The new skin should closely match the surrounding skin when full color returns. You can resume your normal activities within 2 weeks. Any activity that can cause injury to the area that has been treated should be avoided. You should also avoid sports for 4 to 6 weeks. Sun protection is also important to avoid pigment alteration. Avoid exposure to sunlight both direct and indirect for at least 6 months and use sunscreens on a regular basis when outdoors.

Skin color changes in the form of increased pigment (darker) or decreased pigment (lighter) after treatment is one of the complications of dermabrasion.

You should contact your doctor if:


  • The redness and swelling persists in the treated area as this could be a sign of a scar forming.

  • There is discharge or yellowish crusting as this may indicate an infection.


This information is not intended nor implied to be a substitute for professional medical advice; it should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. Call 911 for all medical emergencies.