integ

Causes: sunburn, flash, scald

Char: epidermis only, erythema, painful, heals fast (3-5 days) physiologically unimportant

Boiling water, flash flame, steeam

Epidermis and a little dermis

blisters, very red, pain, wet and weepy, heels in 10-14 days, rarely causes permanent skin change

Flame, chemicals

Epidermis, most of dermis, and some skin appendages (sweat glands, sebaceous glands, hair follicles)

pain, red/white/yellow areas, not as weepy as superficial second degree, large blisters, edema, heals in 3-4 weeks, scars

Prolonged exposure to flame, hot water, chemical or electrical burns

Epidermis, dermis, appendages in dermis

white, red, black, or brown. dry, leathery, and firm. thrombosed vessels, minimal pain initially, often requires skin grafting, takes a long time and heals poorly if left alone.

1 - sheet graft - skin applied as a solid sheet

2 - meshed graft - small holes are added to let it stretch to cover a greater area and allow the wound to drain

split thickness skin graft -- epidermis and part of dermis

full thickness skin graft -- epi and all of dermis

improve positioning, pressure relief, decrease edema, maintain or improve ROM, immobilize skin graft, protect exposed joint, tendons, and other structures, assist w ADLs

AROM is most functional

no forceful PROM

no resistive exercises while in hypermetabolic state

superficial partial thickness burns usually do not scar

deep partial and full thickness scar most

kids, bc they're hypermetabolic, so they lay down more scar tissue

(but early healing or grafting can reduce scarring)

erythema, elevated skin level surface (collagen), blanching white upon stretch (myofibroblasts)

• Immature: red, raised rigid
• Semimature: pink, raised, semi-rigid
• Mature: pale, planar, pliable

• pliability
• vascularity
• pigmentation
• height

• positive pressure - constant and controlled, a bit over the capillary pressure of 23mmHg --- this lowers vascularity which decreases myofibroblast activity and collagen synthesis, and it encourages better orientation of the collagen during scarring phase
• apply it 24h/day for about 1 year or until scars are mature!!!
• begin wearing it when wounds are healed/closed

• 75% reduction in FF pressures compared to shoe w orthosis
• 87% down from barefoot

planar ulcerations, charcot's joints, post op reconstruction immobilization, chronic venous stasis wound

acute infection or inflamed tissue, bad edema, wanger grade greater than 2 (or up to 4, debatable), ulceration other than WBA foot

• 0 = no loss of protective sensation, but at risk
• 1 = superficial ulcer
• 2 = full thickness ulcer
• 3 = deep ulcer with or without osteomyelitis, abscess, or joint sepsis
• 4 = gangreen
• 5 = extensive gangrene, needs amputation

10 and 60

early heel rise observable at HS

subtalar pronation, rearfoot eversion, forefoot abd at midstance

recurvatum at knee in mid stance w hip flexion

collapse of midfoot, development of "rocker foot" deformity

• 0 - at risk
• 1 - reversible (has pitting)
• 2 - irreversible (no more pitting bc stuff turned fibrotic and hard)
• 3/4 - elephantiasis (hard, heavy, abnormal shapes)

high protein concentration, therefore hydrophilic

lymphedema is a "high-protein load edema." Only the lymphatic system transports and absorbs high-protein load fluids (lymph fluids). Lymph fluid is essentiall the fluid in the body that can't be transported out of cells via the normal means of osmosis.

edema where there is a buildup of proteins in the interstitium

proteins that aren't reabsorbed into the compormised lymphatic system stay in the body and attract more water, hence, more swelling

congenital

due to aplasia, hypoplasia, or hyperplasia (no, less, more lymphatics)

injury, trauma, radiation therapy, lympy node dissection, skin infections, surgery, cancer, etc.

or in third world countries, cause by parasites

sign of lymphedema: dorsal hump on hand, heaviness, soreness, fatigue, discomfort

distal to proximal gradual onset

Manual Lymphatic Drainage (MLD = massage), compression bandaging, exercises, intensive skin care