(Sulfamylon), silver sulfadiazine (Silvadene), silver nitrate 0.5% solution, and
nitrofurazone (Furacin).
Third-degree burns are best managed in a designated burn center by a burn
specialist or surgeon.
A list of drugs utilized in the treatment of burns is provided in the Appendix.
Detailed tables show doses, recommendations, expectations, side effects, con-
traindications, and more; available on the book’s Web site (see URL in Appendix).ABRASIONS AND LACERATIONS
The most common skin injuries are abrasions and lacerations that are the result
of accidents such as “road rash.” This is caused by the body scraping along the
roadway such as in a motorcycle accident. Patients who receive an abrasion or
laceration are exposed to the same risk as a burn patient.
The site of the abrasion and laceration must be cleansed very carefully and
treated with topical and sometimes systemic antibiotics and analgesics.
Incomplete cleansing can result in tattoo-type scars.
Lacerations, commonly referred to as cuts, are interruptions in the integrity of
the skin and should be monitored for signs of infection after they are cleaned and
treated with antibiotics. Infection will cause the wound to appear red, swollen,
and have purulent drainage (pus) and persistent pain.
Most minor cuts and abrasions are treated by cleaning the area with hydrogen
peroxide or betadine and the applying a topical antibiotic such as Neosporin.
Some lacerations need to be sutured to close the open areas of the skin or top-
ical skin adhesives are used to bring the edges together. Before suturing, the area
must be flushed with copious amounts of normal saline. Sutures remain in place
for about 7–10 days before they dissolve or are removed.
Puncture wounds do not cause a large area of visible injury to the skin but can
carry a risk of damage to underlying tissues and infection. Puncture wounds
should be cleansed carefully and monitored for signs of infection. The need for
a tetanus toxoid booster immunization should be assessed.Summary
Skin is the largest organ of the body composed of two major layers—the epi-
dermis and dermis. Skin controls body temperature, provides protection against
infection, the environment, and prevents the loss of bodily fluids.(^382) CHAPTER 20 Skin Disorders