骨科英文书籍精读（174）｜手外伤（13）
MANAGEMENT OF BURNS
Generally, hand burns should be dealt with in a specialized unit. Superficial burns are covered with moist non-adherent dressings; the hand is elevated and finger movements are encouraged. Partial thickness burns can usually be allowed to heal spontaneously; the hand is dressed with an antimicrobial cream and splinted in the position of safety.
Full thickness burns will not heal. Devitalized tissue should be excised; the wound is cleaned and dressed and 2–5 days later skin-grafted. Full thickness circumferential burns may need early escharotomy to preserve the distal circulation. Skin flaps are sometimes needed in sites such as the thumb web which are prone to contracture. The hand should be splinted in the position of safety; K-wires may be needed to
maintain this position.
Electric burns may cause extensive damage and thrombosis which become apparent only after several days. The patient may of course need resuscitation (treating cardiac anomalies and myoglobinuria). The arm needs to be monitored and fasciotomy with debridement of dead tissue is often needed.
Chemical burns should be irrigated copiously for 20 or 30 minutes, usually with water or saline but sometimes with a specific reagent (calcium gluconate for hydrogen fluoride burns, soda lime or magnesium solution for hydrochloric acid, mineral oil for sodium).
---from 《Apley’s System of Orthopaedics and Fractures》
重点词汇整理：
moist/mɔɪst/adj. 潮湿的；湿润的；多雨的；含泪的n. 潮湿
antimicrobial /,æntimaɪ'krobiəl; ,æntaɪ'krobiəl/n. 杀菌剂，抗菌剂adj. 杀菌的，抗菌的
Devitalized tissue失活组织
Devitalize/diˈvaɪtəlˌaɪz/v. （使）失去生命，衰弱
the wound is cleaned and dressed and 2–5 days later skin-grafted. 伤口清洗、包扎，2-5天后植皮。
circumferential /sərˌkʌmfəˈrenʃəl/adj. 圆周的
escharotomy焦痂切除术
eschar/'eskɑ/n. [外科] 焦痂（烧伤后的疮痂）
thumb web拇指蹼
prone to 有…倾向的
contracture/kənˈtræktʃər/n. [医] 挛缩
thrombosis /θrɑːmˈboʊsɪs/n. [病理] 血栓形成；血栓症
resuscitation/rɪˌsʌsɪˈteɪʃn/n. 复苏；复兴；复活
myoglobinuria/,maiə'gləubənjuəriə/n. [临床] 肌红蛋白尿；[临床] 肌红蛋白尿症
fasciotomy /fæʃi'ɔtəmi/n. [外科] 筋膜切开术
debridement /di'bri:dmənt/n. [外科] 清创术；扩创术
copiously /'kəupiəsli/adv. 充裕地；丰富地
reagent /riˈeɪdʒənt/n. [试剂] 试剂；反应物
calcium gluconate 葡萄糖酸钙
hydrochloric acid盐酸
百度翻译：
烧伤处理
一般来说，手部烧伤应在专门的单位处理。浅表烧伤覆盖着潮湿的非粘附性敷料；手抬高并鼓励鱼鳍移动。局部烧伤通常可以自然愈合；手部涂上抗菌霜，并在安全位置用夹板固定。
全层烧伤不会愈合。切除失活组织，清洗包扎伤口，2-5天后植皮。全层周围烧伤可能需要早期切痂，以预服务于远端循环。在拇指蹼等容易挛缩的部位，有时需要皮瓣。手应该用夹板固定在安全位置；可能需要使用K形钢丝保持这个姿势。
电灼伤可引起广泛的损伤和血栓形成，几天后才变得明显。病人当然需要复苏（治疗心脏异常和肌红蛋白尿）。手臂需要监控，经常需要筋膜切开术和坏死组织清创术。
化学烧伤应充分冲洗20或30分钟，通常用水或盐水，但也可使用特定试剂（葡萄糖酸钙用于氢氟酸烧伤，苏打石灰或镁溶液用于盐酸，矿物油用于钠）。