Rangel-Gaspar H.

Language: Spanish
References: 9
Page: 25-29
PDF size: 128.55 Kb.

ABSTRACT

The Crush or Compartimental Syndrome has been defined upon observing the consequence of ischemia extended in the extremities in cases of severe trauma or in thorax injuries or extremities with circular burns that limit pulmonary expansion in the thorax and cause respiratory insufficiency and in limbs, ischemia and segmentary necrosis that is prevented through fasciotomies or escharotomies, also indicated in the thorax to permit a greater extent of respiratory movement. The deep second degree burns conform this syndrome by reducing the vascular perfusion due to edemas between the rigid crust of the burn and the inextensible fascia of underlying muscular layer. The consequence if the burnt tissue is not eliminated is hypoxia for hypoperfusion and ischemia and metabolic acidosis that produce necrosis of the epithelial cells of the undamaged dermis and consequently the deepening of the burn. The preventive management of this syndrome, requires dermo abrasion of the crust produced by the burn in the early phase, to favor the perfusion of undamaged epithelial cells, which permit the repairing of affected tissue in spontaneous form without requiring grafts.

REFERENCES

1. MacMillan BG. Dressings. In: Artz–Moncrief-Pruitt, Burns. A team approach. Philadelphia: WB Saunders, Chapt 13, 1979: 113.

2. Suter PM et al. Bronchoalveolar levels of tumor necrosis factor and its inhibitors, interleukin 1, interferon and elastase in patients with adult respiratory distress syndrome after trauma, shock or sepsis. Am Rev Resp Dis 1992; 145: 1016.

3. Rangel GH. Clasificación etiológica de las lesiones térmicas. Cir Plast 1996; 6: 103-104.

4. Sánchez VL. Estudio comparativo de la epitelización en áreas donadoras de injertos de piel de espesor parcial medio, después de aplicación de vendaje hidrocoloide “Duoderm” y papel microporado fino. UNAM Tesis Profesional de Posgrado 1994.

5. Rivas-Torres MT, Amato D, Arambula-Alvarez IH, Kuri-Harkuch W. Control clinical study of donor sits and deeppartial tickness burns treated wrm cultured epidermal allografts. Plast Reconstr Surg 1996; 98: 279-287.

6. González-Ulloa M. Modificación del esquema de la piel. En: González-Ulloa M. Quemaduras Humanas. México: Interamericana, 1960: 25.

7. Arévalo JM, Lorente JA. Los pacientes quemados críticos presentan hipoxia de la mucosa gástrica intestinal que se relaciona con el daño por inhalación y la mortalidad. Cir Plast Iberolatinoam 2000; 26: 189-195.

8. Gracia V. Les Brûles: Débridement Immédiat para abrasion au papier de sable et excision au dermatome. Brux Med 1970; 50: 909-922.

9. Lorthioir J. Traitment des brules. buxelles. Acta Chir Belg 1962; (suppl 2): 9-91.