Conference Proceedings - School of Nursing & Midwifery - Trinity ...

School of Nursing & Midwifery, Trinity College Dublin: 8 th Annual Interdisciplinary Research Conference
Transforming Healthcare Through Research, Education & Technology: 7 th – 9 th November 2007
Conference Proceedings
After removal of clothing and jewelry, the patient was assess
for burn depth and definitive % T.B.S.A. Burns wounds were then
photographed for documentation. Initial burn wound care consisted
of bedside escharotomies to the circumferential burns of both arms,
removal of blebs and bullae, and hydrotherapy using a shower
gurney with Dial ® liquid soap and warm tap water. Pluronic F68
(poloxamer 188) was applied to full- thickness and deep partialthickness
burns. Polysporin (polymyxin B/bacitracin sulfate)
ointment was applied to superficial partial thickness burns. The antimicrobial
topical agents were smeared onto opened gauze, which
was then layered onto the burn wounds. Fine mesh gauze was used
for face and fingers, with coarse mesh gauze applied to the other
affected areas. The fingers were wrapped with gauze individually.
The anti-microbial dressing layer was then covered with bulky gauze
pads, Kerlix gauze rolls, and held in place with stockingette.
Temporary splints were applied to both hands. The patient
manifested brief facial grimacing following the application of the
Pluronic F68 to areas of partial-thickness burns. The patient was
scheduled to undergo daily wound care, with the first of serial
surgical debridements with autologous skin grafting scheduled for
Day #3.
Burn Case Study #2
Lou, a 28 year old adult married male, returned to the Plastic
Surgery Clinic for follow-up following a 15% T.B.S.A. burn injury
experienced ten days ago. He sustained partial-thickness burns to
the face, chest, and both upper arms. Arm and chest burns were
non-circumferential in nature. The injury occurred during a
barbeque when Lou “fed the flames” with additional lighter fuel on a
windy day. His partial-thickness burns did not require surgical
debridement or skin grafting. The burn wounds are now clean and
healing, without indication of cellulitis. Daily wound care consists of
showering at home with anti-bacterial liquid soap, topical
application of Polysporin, followed by petroleum-impregnated gauze
dressings to promote healing under a moist anti-microbial
environment. The patient now performs his own daily wound care
with his wife’s assistance, and without the routine need for narcotic
as either pre-medication or post-medication. Lou reports the
intensity of his procedural pain as 2-3/10, and the intensity of his
background pain as 0-1/10. He describes his procedural pain as
tolerable and “stinging” in nature. He exhibits no overt physical
indications of pain. He admits to taking Tylenol (acetaminophen)
650 m.g. orally on a P.R.N. basis, and an occasional Percocet (5
m.g. oxycodone/325 m.g. acetaminophen per tablet) tablet orally at
night, for pain. This patient appeared to be coping well with his burn
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