Preliminary deliquescence, shedding or insect bite-like changes of eschar on burn wounds
Introduction
Introduction After the burn, the skin is destroyed as a natural shield against microbial invasion, and the necrotic skin tissue is a good "medium" for microbial growth and reproduction. Therefore, burn wounds are extremely susceptible to infection. In recent years, shock mortality has decreased significantly due to the improvement in the level of burn shock treatment. Burn infections have become the leading cause of death from severe burns. Prevention and treatment of burn infection is the key to burn treatment. Anxiety premature deliquescence, shedding, or a change in insect bite indicates a local infection.
Cause
Cause
Local infection due to burns. Local infections can be caused by many conditions.
1, burn wound path
Due to the existence of a large number of necrotic and degenerative tissues in burn wounds, bacterial colonization is inevitable. When the bacteria are confined to the surface exudate or liquefied necrotic tissue, the effect on the whole body is small, but if it invades adjacent living tissue and reaches a certain amount of bacteria, systemic symptoms will occur, generally called "burn wound invasiveness". Infection, or "burn wound sepsis." Debridement can reduce the number of bacteria in the wound, and local use of sensitive external medicine can also control the invasion of bacterial wounds and invasive infection.
2, intestinal infection
The strains of early sepsis are sometimes different from those of the wounds at that time, and they are bacteria resident in the intestines. Therefore, the path of intestinal infection has been proposed very early, and this hypothesis has recently been confirmed.
3, suppurative phlebitis
Large-area burn patients have occasionally found venous inflammation due to prolonged intravenous transfusion, and suppurative thrombophlebitis often becomes a focal point of systemic infection. Since the infected lesion is relatively concealed, the right source of bacteria enters the blood without being detected. The importance of phlebitis as a source of infection after burns should be taken seriously. An autopsy suggests that the veins of the indwelling catheter often have thrombosis or pus, which is undetected during life.
4, deep muscle tissue necrosis
Muscle necrosis due to various reasons is easy to induce infection, and sometimes even gas gangrene threatens the life of the patient. Common causes of deep muscle necrosis are: 1 III degree burns caused by muscle necrosis; 2 ring eschar caused by progressive muscle ischemia and necrosis; 3 electric burn often caused deep muscle necrosis; 4 burn combined with crush injury; 5 secondary to Muscle necrosis of vascular embolism.
5, respiratory infection
Inhalation injury causes varying degrees of respiratory congestion, edema, and necrosis of the endotracheal membrane leading to respiratory infection and spread, becoming a source of infection. In addition, due to the limitation of chest irritability, prolonged bed rest, sputum falls and causes respiratory infections, especially in children and elderly patients.
6, iatrogenic infection
Infections caused by improper medical procedures cannot be ignored. Common ones are:
1 infusion, blood transfusion pollution.
2 infection caused by improper management of the respiratory tract after tracheotomy.
3 retrograde infection caused by indwelling catheter.
4 respiratory infection caused by aspiration caused by feeding and vomiting.
Examine
an examination
Related inspection
Urine routine white blood cell count (WBC) blood routine
Diagnosis is based on local symptoms of wound infection, medical history after burns, and the like. Premature deliquescence, shedding, or insect bite-like changes in burn wounds are an indication of local infection.
Diagnosis
Differential diagnosis
The viscous secretion of the sweet scent of burn wounds: After the burn, the skin is destroyed as a natural shield against microbial invasion, and the necrotic skin tissue is a good "medium" for microbial growth and reproduction. Therefore, burn wounds are extremely susceptible to infection. In recent years, shock mortality has decreased significantly due to the improvement in the level of burn shock treatment. Burn infections have become the leading cause of death from severe burns. Prevention and treatment of burn infection is the key to burn treatment. The viscous secretion of a sweet scent on a burn wound belongs to Pseudomonas aeruginosa infection.
Burning wounds light brown thin secretions: burns appear wounds light brown thin secretions are hemolytic streptococcal infections.
Burn wounds, fecal odor secretions: burn wounds, fecal odor secretions are anaerobic infections.
Light yellow viscous secretions from burn wounds: The appearance of light yellow viscous secretions is the key to judging S. aureus infection.
Dark gray or black necrotic spots on burn wounds: dark gray or black necrotic spots on the wound surface. Necrotic plaques often occur in wounds infected with Gram-negative bacilli.
Burn wounds are pale or pyrophoric: burns are pale or burnt yellow is a burn of III degree. Third degree burns: involving the entire layer of the skin even subcutaneous fat, muscles, internal organs. The wound is pale or burnt yellow, no pain, no blistering, feeling disappears, and the texture is tough like leather. After 3 to 4 weeks, the granule tissue was left behind after the eschar was shed, and the scar was left behind, and the skin function was lost, causing deformity.
