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1.Briefly describe the three major layers of skin that make up healthy skin The three layers that make up healthy skin: Epidermis, Dermis and Hypodermis. Epidermis is composed of keratinized, stratified squamous epithelium. This layer provides a thick, water proof protective covering over the underlying skins.

The dermis layer is composed of primarily of dense, irregular, fibrous connective tissue that is rich in collagen and elastin. The dermis contains blood vessels, nerve ending, and epidermally derived cutaneous oranges such as sweat glands, sebaceous glands and hair follicles. The last layer is Hypodermis this layer is composed primarily of loose dead skin. The fat layer provides cushioning and insulation for underlying organs.

2.Briefly describes the extent of damage seen in first-degree burns, second-degree burns, and third degree burns. First degree burns only epidermis is damaged and skin is red and swollen. Second-degree burns epidermis and upper dermis are damaged. Third-degree burns destroys entire skin layer; burned area is painless and the burn is gray-white or black.

3.Why was the girl relatively pain-free when she woke up?
Due to having third-degree burns on 15% off her body and since third degree burns are painless her body was probably numb and in shock as well. Since the second degree burns aren’t as deep she may feel pain in these areas because the nerves are still intact.

4.Explain why this patient’s blood pressure was so low and her heart rate was so high upon arrival at the emergency room. Due to the burns she lost her water tight protective covering and significant shift of water from her blood stream due to having low blood volume her heart has to work harder (high heart rate) to try and pump more blood.

5.Why was it important to immediately administer intravenous fluids to this girl? She will need IV fluids to replace the fluid she lost due to the burns covering her body. She could go into shock without them and then her organs will not get blood and body will slowly start shutting down.

6.What is a broad-spectrum” antibiotic, and why did she need it? Do bacteria normally colonize healthy skin? Due to the skin being burned so badly and it being open to all kinds of bacteria forming a broad spectrum should take care of any infection she may get. She would get them topical and IV to make sure she was protected both ways. 7.Why was skin-grafting necessary in this patient? (why not just let the skin heal on its own) Due to the skin being severely damages it’s going to take a long time to heal. The skin graft will help prevent infection and speed up the healing process.

8.Describe the series of events that occur in skin, which is healing with the help of a skin graft? The skin will have to first have all of the dead and burned skin removed and topical antibiotics will be placed on to prevent infection then the graft will be placed over the skin to reduce the infection and shock risks and the skin will slowly start healing on its own.

9.Why are bedridden patients at risk for developing decubitus ulcers? Due to the patient being bedridden and immobile they often lie in the same position for long periods of time without being moved and the pressure on the skin can cause a sore and infection. If left untreated can cause serious problems and may result in surgery.

10.Why did the patient lose so much weight despite being on a very high-calorie diet? Do to the major trauma her body needs the calories to try and keep up with the functions to help her body heal. If anything she would probably need double her normally calorie intake to help in this process. 11.What long-term problems may the patient have as a result of extensive scar tissue formation over her trunk and right elbow? The long term scar tissue on her thoracic region may result in breathing problems later in life as well as the scar tissue on her elbow may limit mobility.

References:

  • Kanitakis, Jean. “Anatomy, histology and immunohistochemistry of normal human skin.” European journal of dermatology: EJD 12.4 (2002): 390-9.
  • Lee, Vivian, et al. “Design and fabrication of human skin by three-dimensional bioprinting.” Tissue Engineering Part C: Methods 20.6 (2013): 473-484.
  • Winter, K. G. “An outline of the techniques available for the measurement of skin friction in turbulent boundary layers.” Progress in aerospace sciences 18 (1979): 1-57.

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