Page 253 - Critical Care Notes

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■ In circumferential burns (burn completely surrounds body part), assess
need for escharotomy, in which an incision is made through a full-thickness
chest wound to decrease constriction, relieve pressure, and restore ventila-
tion (chest) and/or improve blood flow and tissue perfusion.
■ Refer to management of carbon monoxide toxicity in the Respiratory Tab.
Wound Care
■ Cleanse wound as per protocol.
■ Prepare patient for wound débridement (natural, mechanical, chemical, or
surgical).
■ Initiate topical antibacterial therapy:
■ Silver sulfadiazine (Silvadene) 1%
■ Silver nitrate aqueous solution (AgNO 3 ) 0.5%
■ Mafenide acetate (Sulfamylon) 5%–10%
■ Acticoat (silver-coated dressing)
■ Aquacel Ag (silver-coated dressing)
■ Silverlon (silver-coated dressing)
■ Mupirocin (antimicrobial)
■ Clotrimazole cream or nystatin (Mycostatin) if fungal infection is present
■ Diluted Dakin’s solution
■ Petroleum-based ointments (bacitracin, gentamicin, neomycin)
■ A vacuum-assisted closure (VAC) device may be used for wound healing
along with a variety of dressings.
Patient/hospital-specific wound and dressing protocol

MULTISYS