UNIT 5 Nursing management of patient with burns, reconstructive and cosmetic surgery
➤ The skin is the largest organ of the body.
➤ It works with connective tissues to protect the body, regulate temperature, and facilitate sensory perception.
🔹 Made of stratified squamous epithelium
🔹 Avascular (no blood vessels)
🔹 Cells include:
🔹 Layers (Superficial to Deep):
🔹 Strong, flexible connective tissue
🔹 Contains:
🔹 Two Layers:
🔹 Also called subcutis or superficial fascia
🔹 Composed of:
Connective tissues support, bind, and protect organs and tissues.
➤ Cartilage – flexible support (types: hyaline, fibrocartilage, elastic)
➤ Bone – rigid support and mineral storage
➤ Blood – transport of gases, nutrients, hormones
| 🧩 Function | 📝 Description |
|---|---|
| 🔰 Protection | Barrier against pathogens, UV rays, dehydration |
| 🌡️ Thermoregulation | Sweat glands, blood vessel dilation/constriction |
| ✨ Sensation | Touch, pressure, pain, temperature via nerve endings |
| 💧 Excretion | Sweat removes urea, salts |
| 🔄 Metabolism | Vitamin D synthesis under sunlight |
| 🩹 Healing | Wound repair via epidermal regeneration and collagen remodeling |
| 🚨 Condition | ❗ Overview |
|---|---|
| Eczema 🧴 | Inflammatory skin reaction causing itch, redness |
| Psoriasis 🧠 | Autoimmune; rapid skin cell turnover |
| Scleroderma 🧊 | Autoimmune disease causing skin thickening |
| Lupus 🌙 | Connective tissue autoimmune disease |
| Cellulitis 🦠 | Bacterial infection of skin and connective tissue |
✅ Skin = Epidermis + Dermis + Hypodermis
✅ Major skin cells: keratinocytes, melanocytes, Langerhans, Merkel
✅ Connective tissue provides structure, elasticity, support
✅ Functions include: protection, sensation, temperature regulation, synthesis
✅ Disorders may involve infections, inflammation, autoimmunity
➤ Establish rapport and empathy with the patient.
➤ Ensure privacy and confidentiality.
➤ Use open-ended questions, followed by specific inquiries.
➤ Be non-judgmental especially in cosmetic/reconstructive cases.
➤ Name, Age, Sex, Address, Contact Number
➤ Marital Status, Occupation, Education Level
➤ Date of Admission, IP/OP number
➤ Burn: “Patient complains of burns over the right arm for 2 hours…”
➤ Reconstructive: “Patient presents for post-trauma facial reconstruction…”
➤ Cosmetic: “Patient wants to undergo rhinoplasty for cosmetic reasons…”
➤ Time and date of injury
➤ Cause: Thermal, Chemical, Electrical, Radiation, Scalds
➤ Location and extent (rule of nines or Lund-Browder)
➤ First aid received?
➤ Associated symptoms: Pain, blisters, breathing difficulty
➤ Clothing ignition? Inhalation injury suspected?
➤ Any contaminants (grease, chemicals, tar)?
➤ Type of deformity or defect (congenital or acquired)
➤ Cause of defect: Accident, trauma, burns, tumor removal
➤ Date of primary injury or previous surgeries
➤ Current symptoms: Functionality, appearance issues
➤ Impact on activities of daily living (ADLs)
➤ Area of concern (e.g., face, breast, abdomen)
➤ Reason: Self-esteem, post-pregnancy, aging changes, etc.
➤ Previous cosmetic procedures?
➤ Psychological motivation (screen for body dysmorphia)
➤ Expectations and outcome clarity
➤ Diabetes, Hypertension, Epilepsy
➤ Cardiac, Renal, Liver issues
➤ Allergy history (especially to anesthesia or medications)
➤ Immunization status (especially tetanus in burn patients)
➤ Any surgeries (especially plastic, reconstructive, or emergency)
➤ Complications in past procedures
➤ Healing tendencies (e.g., keloids, hypertrophic scars)
➤ Current medications
➤ Use of steroids, anticoagulants, or immunosuppressants
➤ Herbal or over-the-counter drug use
➤ Genetic disorders (e.g., cleft lip/palate, syndromes)
➤ Family history of poor wound healing or keloid formation
➤ Smoking or alcohol use
➤ Occupation: exposure to hazards or chemicals
➤ Nutritional habits
➤ Home environment (especially in burn cases – fire safety)
➤ Support system at home
➤ Body image issues
➤ Anxiety or depression
➤ Social pressure or expectations
➤ Support from family/spouse
➤ Diet type: vegetarian/non-vegetarian
➤ Recent weight loss or gain
➤ Protein intake (important in wound healing)
➤ Appetite and fluid intake
➤ Menstrual regularity
➤ Pregnancy or lactation status (some surgeries contraindicated)
➤ History of postpartum changes (e.g., seeking abdominoplasty)
| 🩺 History Element | 🔍 Relevance to Treatment |
|---|---|
| 🔥 Burn Cause & Extent | Guides fluid resuscitation, wound care, and surgery |
| 🧬 Past Diseases | Affects healing, anesthesia risk |
| 💊 Drug History | Interferes with coagulation, immunity, or healing |
| 🧠 Psychological Profile | Determines eligibility for cosmetic procedures |
| 🍽️ Nutrition | Crucial for pre/post-operative healing |
| 💉 Surgical History | Risk of scarring, anesthesia complication |
✔️ Maintain dignity and respect for all patients, especially in cosmetic cases
✔️ Provide emotional support
✔️ Educate patient on procedure, risks, aftercare
✔️ Ensure consent and realistic expectations
✅ Wash hands, wear PPE (especially in burn cases)
✅ Ensure privacy and dignity
✅ Use systematic head-to-toe approach
✅ Prioritize life-threatening conditions first
✅ Document all findings carefully
✅ Assess vital signs first in any emergency or acute situation
✅ Assess for inhalation injury:
✅ Temperature, Pulse, BP, Respiratory Rate
✅ Monitor for hypovolemic shock signs: ↓ BP, ↑ HR
✅ Use Rule of Nines or Lund-Browder Chart
✅ Classify depth:
✅ Note:
✅ Check:
✅ Assess ROM (Range of Motion) of affected joints
✅ Pain level (0–10 scale)
✅ Neurological: check for sensation and reflexes
✅ Redness, swelling, purulent discharge
✅ Foul odor
✅ Local warmth
✅ Fever or chills
✅ Check for:
✅ Peripheral pulses
✅ Skin color and temperature
✅ Compare with unaffected side
✅ Sensory function
✅ Motor function
✅ Facial symmetry
✅ Risk for pressure ulcers or infections
✅ Presence of wounds, ulcers, dry skin
✅ Overall hygiene and self-care ability
✅ Skin texture, tone, elasticity
✅ Nutritional status
✅ Hydration and anemia (via signs or labs)
✅ Assess BMI, physical fitness
✅ Swelling, bruising, pain level
✅ Infection signs at incision site
✅ Seroma/hematoma presence
✅ Drain output and dressing status
| 🩺 Assessment Element | 💡 Clinical Relevance/Management |
|---|---|
| ABCs in burns | Immediate airway support if compromised |
| Burn depth & surface area | Guides fluid resuscitation, dressing, surgery |
| Surgical wound status | Detects complications like infection or graft failure |
| Pain assessment | Basis for analgesic management |
| ROM & mobility | Start physiotherapy early to prevent contractures |
| Skin turgor, nutrition | Nutritional intervention & wound healing support |
| Cosmetic expectations | Guides psychological prep and counseling |
✔️ Monitor vital signs regularly in acute burn or post-surgery phase
✔️ Use sterile techniques for dressing changes
✔️ Educate patient on wound care, signs of complications
✔️ Provide psychosocial support, especially in cosmetic/reconstructive patients
✔️ Report any signs of infection, fluid imbalance, or graft failure promptly
| 🔠 Step | 🔍 What to Assess | 📌 Purpose |
|---|---|---|
| 🅰️ Airway | Burn around mouth, nose, singed nasal hair, hoarseness, carbonaceous sputum | Rule out inhalation injury or obstruction |
| 🅱️ Breathing | Respiratory rate, depth, oxygen saturation, cyanosis, chest movement | Assess for smoke inhalation, need for oxygen/ventilation |
| 🅲️ Circulation | Pulse, BP, capillary refill, peripheral perfusion, skin color | Risk of hypovolemia, shock, fluid resuscitation required |
| 🅳 Disability | Consciousness (AVPU/GCS), pupil reaction, motor response | Early signs of hypoxia, head injury, CO poisoning |
| 🅴 Exposure | Remove clothing, assess burn area, depth, and signs of associated trauma | Evaluate total body surface area (TBSA) and severity |
| 🔥 Burn Type | 🔬 Tissue Involved | 📋 Appearance | 🤕 Sensation |
|---|---|---|---|
| 🔴 Superficial (1st°) | Epidermis only | Red, dry, blanching | Painful |
| 🟠 Partial-thickness (2nd°) | Epidermis + partial dermis | Blisters, moist, red | Very painful |
| ⚫ Full-thickness (3rd°) | All dermis, may extend to fat | White/brown/black, leathery | Painless (nerve damage) |
✅ Use the Rule of Nines (Adults) or Lund-Browder Chart (Pediatrics)
| 📍 Body Part | 🔢 % TBSA (Adult) |
|---|---|
| Head & Neck | 9% |
| One Upper Limb | 9% |
| One Lower Limb | 18% |
| Front of Trunk | 18% |
| Back of Trunk | 18% |
| Perineum | 1% |
➡ Example: Burns on front of trunk + one arm = 27% TBSA
🧠 Critical in facial burns or enclosed-space fire injuries:
🩺 Consider early intubation if suspected.
✔ Use standard scales:
✅ Monitor for signs of hypovolemia:
🔹 Use Parkland Formula for fluid resuscitation:
💧 4 mL x body weight (kg) x TBSA (%)
→ Give ½ in first 8 hours, ½ in next 16 hours
✅ Electrical Burns:
✅ Chemical Burns:
✅ Pediatric Burns:
| ✅ Assessment Domain | 🔎 Details |
|---|---|
| ABCs | Airway patency, breathing, circulation |
| Cause | Thermal, chemical, electrical, radiation |
| TBSA | Rule of Nines or Lund-Browder |
| Depth | Superficial, partial-thickness, full-thickness |
| Pain | Use appropriate scale |
| Fluid Loss | Signs of dehydration/shock |
| Inhalation Injury | Soot, hoarseness, stridor, respiratory difficulty |
| Wound Status | Size, color, presence of eschar or discharge |
| Infection | Redness, swelling, pus, odor |
| Psychological Status | Anxiety, trauma, coping level |
➤ Fluid & electrolyte balance is vital for cellular function, tissue perfusion, and organ activity.
➤ Losses may occur through:
✔ Recent vomiting, diarrhea, burns, surgery, trauma
✔ Fluid intake vs. output
✔ Diuretic or laxative use
✔ Fever, sweating, fluid restriction
| 🚨 Sign | 🩺 Clinical Finding |
|---|---|
| Skin Turgor | ↓ Elasticity; tenting of skin |
| Mucous Membranes | Dry, sticky |
| Eyes | Sunken, dark circles |
| Fontanelles (Infants) | Sunken |
| Thirst | Increased |
| Heart Rate | Tachycardia |
| Blood Pressure | ↓ Hypotension (orthostatic if mild) |
| Weight | Sudden loss (>1 kg/day = fluid loss) |
| Urine Output | ↓ Output; dark, concentrated urine |
| Capillary Refill | Delayed (>2 sec) |
| Temperature | Low-grade fever possible in dehydration |
| 🧪 Test | 🔍 Finding in Fluid Loss |
|---|---|
| Hematocrit (Hct) | ↑ (hemoconcentration) |
| Serum Sodium (Na⁺) | ↑ in dehydration; ↓ in overhydration |
| Serum Potassium (K⁺) | ↑ or ↓ depending on cause |
| BUN/Creatinine Ratio | ↑ (pre-renal azotemia) |
| Urine Specific Gravity | >1.030 (concentrated) |
| Serum Osmolality | ↑ in dehydration |
| ✅ Assessment Area | 🧠 What to Check |
|---|---|
| Fluid Intake/Output | Balance chart (intake vs. urine, drains) |
| Vital Signs | HR, BP, Temp – monitor for trends |
| Skin & Mucous Membranes | Turgor, moisture, color |
| Weight | Daily, same time, same scale |
| Mental Status | Confusion, restlessness |
| Edema or Sunken Eyes | Fluid overload vs. dehydration signs |
| Lab Values | Electrolytes, BUN, Creatinine, Osmolality |
| ECG Monitoring | Especially in K⁺ or Ca²⁺ imbalance |
🔹 Children & elderly are more vulnerable to dehydration
🔹 Burn patients have rapid fluid & electrolyte shifts – monitor hourly
🔹 Daily weight is the most accurate non-invasive indicator of fluid balance
🔹 Always correct underlying cause of fluid/electrolyte loss
🔹 Severe imbalances can cause seizures, arrhythmias, coma
➤ The body maintains fluid and electrolyte balance to support vital functions like:
➤ This balance is achieved through the interaction of intake, distribution, and excretion mechanisms regulated by hormones, kidneys, and cellular transport systems.
| 🧍♀️ Compartments | 💧 Description |
|---|---|
| Intracellular Fluid (ICF) | ~66% of total body fluid; inside cells |
| Extracellular Fluid (ECF) | ~33%; includes: |
| ➤ Interstitial fluid (between cells) | |
| ➤ Intravascular fluid (plasma) | |
| ➤ Transcellular fluid (CSF, synovial, etc.) |
| 💉 Hormone | 🧪 Action |
|---|---|
| ADH (Vasopressin) | ↑ Water reabsorption in kidneys, ↓ urine output |
| Aldosterone | ↑ Na⁺ reabsorption → water follows Na⁺ |
| ANP | ↓ Na⁺ & water reabsorption, ↓ BP |
| RAAS (Renin-Angiotensin-Aldosterone System) | Regulates BP and fluid volume |
➤ Movement of water from low solute concentration to high solute concentration
➤ Maintains equilibrium between ICF and ECF
➤ Movement of electrolytes from high to low concentration across membranes
➤ Passive process – no energy needed
➤ Uses ATP energy to move electrolytes like Na⁺, K⁺ against concentration gradient
➤ e.g., Sodium-Potassium Pump maintains cell electrical function
⬆️ Plasma osmolality or ⬇️ BP
↓
Hypothalamus stimulates:
➤ Thirst center (↑ fluid intake)
➤ Posterior pituitary (releases ADH)
↓
Kidneys reabsorb water
↓
Blood volume & pressure normalize
✔ Monitor I&O (Intake & Output)
✔ Assess vital signs & weight daily
✔ Check for signs of dehydration or overload
✔ Interpret lab values (Na⁺, K⁺, Ca²⁺, Mg²⁺)
✔ Educate patients on fluid restrictions or replacements
| ⚙️ Mechanism | 📘 Function |
|---|---|
| Thirst | Stimulates fluid intake |
| ADH | Conserves water |
| Aldosterone | Retains Na⁺ and water |
| ANP | Excretes Na⁺ and water |
| Kidneys | Filter, reabsorb, or excrete fluids/electrolytes |
| Osmosis | Balances water between ICF and ECF |
| Active Transport | Maintains electrolyte gradients |
➤ Burns are injuries to the skin and underlying tissues caused by heat, chemicals, electricity, radiation, or friction.
They result in varying degrees of tissue destruction, fluid loss, infection risk, and potential systemic complications depending on depth, extent, and cause.
➤ Caused by direct contact with flames, hot surfaces, steam, or hot liquids
Examples:
➤ Result from exposure to strong acids, alkalis, or corrosive substances
Examples:
➤ Caused by electrical current passing through the body
Examples:
➤ Caused by exposure to ionizing radiation
Examples:
➤ Caused by rubbing or scraping the skin against a rough surface
Examples:
➤ Caused by extreme cold damaging the skin and underlying tissues
Examples:
| 💥 Type | ⚠️ Cause/Source | 📝 Examples |
|---|---|---|
| 🔥 Thermal Burns | Contact with heat (dry or moist) | Flame, scalds from hot liquids, steam, hot metals |
| 🧪 Chemical Burns | Strong acids/alkalis or corrosives | Bleach, battery acid, industrial chemicals |
| ⚡ Electrical Burns | Electric current passing through the body | Lightning, electric wire contact, faulty appliances |
| ☢️ Radiation Burns | Exposure to radiation or UV rays | Sunburn, cancer radiation therapy, nuclear exposure |
| 🌀 Friction Burns | Abrasion + heat due to rubbing motion | Road rash, treadmill injury |
| ❄️ Cold Burns | Extreme cold/frostbite | Exposure to snow/ice, liquid nitrogen |
| 🩻 Burn Degree | 🧬 Tissue Involved | 👁️ Appearance | 🤕 Sensation | 🕒 Healing |
|---|---|---|---|---|
| 🔴 1st-Degree (Superficial) | Epidermis only | Red, dry, painful, no blisters | Painful | 3–6 days |
| 🟠 2nd-Degree (Partial Thickness) | Epidermis + part of dermis | Blisters, red, moist, swollen | Very painful | 10–21 days (may scar) |
| ⚫ 3rd-Degree (Full Thickness) | Entire dermis and potentially subcutaneous tissue | Dry, white or charred, leathery skin | Painless (nerve damage) | Months, needs grafting |
| ⚫🟥 4th-Degree | Skin + muscles, bones, tendons | Charred, black, eschar, exposed tissues | Painless | Requires surgery, grafts, amputation |
➤ Based on % of Total Body Surface Area (TBSA) burned using:
| 📌 Severity | 🧮 % TBSA Involved | 🩺 Example |
|---|---|---|
| 🔵 Minor Burns | <10% (adults); <5% (children) | Superficial or small 2nd-degree burns |
| 🟡 Moderate Burns | 10–20% (adults); 5–10% (children) | Deeper partial-thickness over larger areas |
| 🔴 Major Burns | >20% TBSA or burns on face, hands, feet, genitalia | Full-thickness or electrical/inhalation injuries |
| 🩻 Type | 🔍 Details |
|---|---|
| Inhalation Burns | Burns to airway from smoke, hot gases → life-threatening |
| Circumferential Burns | Burns that encircle a limb or chest → impair circulation or breathing |
| Compartment Syndrome | Pressure buildup under burned skin → requires fasciotomy |
| Contact Burns | Burns from touching hot objects → localized deep injury |
| 🔥 Type | 🧪 Cause | 🎯 Target Tissue | ⚠️ Key Danger |
|---|---|---|---|
| Thermal | Heat | Skin layers | Fluid loss, infection |
| Chemical | Acids/alkalis | Skin, eyes, lungs | Deep penetration, delayed damage |
| Electrical | Current | Skin + internal organs | Arrhythmias, muscle damage, renal failure |
| Radiation | UV/X-rays/nuclear | Skin cells | Cell mutation, delayed injury |
| Friction | Abrasion + heat | Epidermis/dermis | Skin shearing, bleeding |
| Cold (Frostbite) | Freezing | Skin + underlying tissue | Necrosis, gangrene |
Burns cause direct tissue injury leading to local and systemic responses based on the extent, depth, and cause of the burn. The body reacts with inflammatory, vascular, and immune changes that can result in shock, organ failure, or death if not treated.
🛑 This is the most life-threatening phase without fluid resuscitation.
bashCopyEditBurn → Cell damage → Inflammation → ↑ Capillary permeability
↓ ↓
Fluid shift → Edema → ↓ Intravascular volume → Burn Shock
↓ ↓
Electrolyte imbalance ↓ Organ perfusion → Multi-organ failure
↓
Immunosuppression → ↑ Infection risk
| 🔍 Aspect | 📘 Summary |
|---|---|
| Local effects | Tissue necrosis, blistering, eschar |
| Vascular response | Capillary leak → edema → hypovolemia |
| Electrolyte changes | ↑ K⁺ (from damaged cells), ↓ Na⁺ |
| Burn shock | Due to massive plasma loss |
| Systemic impact | Can affect lungs, heart, kidney, liver |
| Healing phase | Hypermetabolism, risk of contractures |
| 🔥 Burn Degree | 🧬 Tissue Damage | ✅ Symptoms |
|---|---|---|
| 🔴 1st-Degree (Superficial) | Epidermis only | Redness, mild swelling, pain, no blister, dry surface |
| 🟠 2nd-Degree (Partial Thickness) | Epidermis + dermis | Blisters, intense pain, wet/weeping surface, swelling |
| ⚫ 3rd-Degree (Full Thickness) | Entire dermis | Painless (nerve destroyed), white/charred skin, leathery |
| ⚫🟥 4th-Degree | Skin + muscle/bone | Exposed tissues, black/charred skin, loss of function |
| ⚠️ System | 😷 Symptoms |
|---|---|
| Cardiovascular | Tachycardia, hypotension, weak pulses |
| Respiratory | Hoarseness, cough, dyspnea, stridor (if inhalation burn) |
| Renal | ↓ Urine output, dark or reddish urine |
| GI | Nausea, vomiting, paralytic ileus |
| Neurological | Anxiety, confusion, decreased consciousness |
| Metabolic | Fever, hyperglycemia, weight loss |
➤ Increased redness, swelling
➤ Purulent discharge, foul odor
➤ Delayed healing
➤ Fever, leukocytosis
➤ Skin graft failure
| 🩺 Area | 🔎 Exam Focus |
|---|---|
| Skin | Color, texture, blisters, eschar, edema |
| Vital Signs | BP, HR, Temp, RR (shock or infection?) |
| Respiratory | Air entry, hoarseness, chest wall expansion |
| Circulation | Capillary refill, pulse, cyanosis, perfusion |
| Urine Output | < 0.5 mL/kg/hr → suspect hypovolemia/AKI |
| 🔬 Test | 📘 Purpose |
|---|---|
| CBC | Detect infection, anemia |
| Electrolytes (Na⁺, K⁺) | Assess fluid and electrolyte imbalance |
| BUN/Creatinine | Assess renal function |
| Blood glucose | Check for stress-induced hyperglycemia |
| ABG | Detect respiratory compromise (especially inhalation) |
| Carboxyhemoglobin level | If carbon monoxide poisoning suspected |
| Wound culture | If signs of infection present |
| Myoglobinuria (urinalysis) | In electrical burns (muscle breakdown) |
| 📷 Test | 📝 Use |
|---|---|
| Chest X-ray | Evaluate inhalation injury or pulmonary edema |
| Bronchoscopy | Confirm airway burns or soot in bronchi |
| CT/MRI | Evaluate deep tissue involvement (in major burns) |
| ECG | Monitor for arrhythmias in electrical burns |
| ⏱️ Phase | 📝 Actions |
|---|---|
| 🔰 Airway | Ensure patency, oxygen therapy, consider early intubation in inhalation burns |
| 🫁 Breathing | High-flow humidified oxygen, monitor SpO₂, ABGs, chest movement |
| ❤️ Circulation | Initiate fluid resuscitation (Parkland Formula), monitor vital signs |
| ❄️ Cool Burn | Cool water (not ice) for <10 minutes, remove clothing/jewelry |
| 🚫 Pain Control | IV opioids (e.g., morphine), avoid IM injections |
| 💉 Tetanus Prophylaxis | Administer tetanus toxoid booster if needed |
🧪 Parkland Formula (for burns >15–20% TBSA):
sqlCopyEdit4 mL x Body weight (kg) x % TBSA = Total fluid in 24 hrs
→ ½ in first 8 hrs, ½ in next 16 hrs (from time of injury)
✅ Monitor:
| 💉 Topical Agent | 🧪 Use |
|---|---|
| Silver sulfadiazine | Common topical antimicrobial |
| Mafenide acetate | Penetrates eschar well, may cause metabolic acidosis |
| Bacitracin | Used on face |
| Antiseptic soaks | Betadine, chlorhexidine |
🔄 Dressing Types:
➤ Systemic antibiotics only if:
| 🍽️ Supportive Care | 📝 Guidelines |
|---|---|
| High protein & calorie | Due to hypermetabolic state |
| Oral/enteral nutrition | Start early within 24–48 hrs if able |
| Vitamins | Vitamin A, C, zinc for wound healing |
| 🔍 Type | 🧼 Purpose |
|---|---|
| Mechanical | Use of tools to remove dead tissue |
| Enzymatic | Topical enzymes (e.g., collagenase) |
| Surgical (Tangential) | Layer-by-layer excision of necrotic skin |
| 🔬 Type | 💡 Use |
|---|---|
| Autograft | Patient’s own skin – preferred |
| Allograft | Human donor skin (temporary) |
| Xenograft | Animal skin (usually pig) – temporary |
| Synthetic Skin | Bioengineered dressings, e.g., Integra® |
✅ Used for full-thickness burns or when natural healing is delayed.
| 🩺 Medical | 🛠️ Surgical |
|---|---|
| Airway, oxygen, fluid resuscitation | Escharotomy, fasciotomy |
| Pain relief, wound care | Surgical debridement |
| Topical antimicrobials | Skin grafting (auto-, allo-, xeno-) |
| Nutrition and infection prevention | Reconstructive plastic surgery (as needed) |
| DVT, GI, and glucose management | Functional correction (contracture release) |
1️⃣ Emergent (Resuscitative) Phase
2️⃣ Acute Phase
3️⃣ Rehabilitation Phase
Focus: Preserve life, prevent complications (shock, respiratory failure), and initiate wound care.
| 🛑 Focus Area | 📝 Interventions |
|---|---|
| Airway and Breathing | – Elevate head of bed – Administer humidified oxygen – Assist with intubation if needed |
| Fluid Resuscitation | – Start IV line(s) with large bore cannula – Use Parkland formula for fluids – Monitor urine output hourly (goal ≥0.5 mL/kg/hr) |
| Vital Signs Monitoring | – Monitor BP, HR, RR, SpO₂ – Watch for signs of hypovolemic shock |
| Pain Management | – Administer IV opioids (e.g., morphine) – Monitor sedation and respiratory status |
| Wound Care | – Do not apply ice – Cover burns with clean dry sheet initially – Maintain sterile technique in dressing |
| Infection Prevention | – Hand hygiene – Isolation precautions if needed – No visitors during high-risk period |
| Psychological Support | – Reassure patient and family – Explain procedures |
| Documentation | – TBSA % burned – Location, depth, color, presence of blisters/eschar |
Focus: Prevent infection, continue wound care, promote healing, maintain nutrition
| 💉 Focus Area | 📝 Interventions |
|---|---|
| Wound Management | – Assist in debridement – Apply topical antimicrobials (e.g., silver sulfadiazine) – Perform dressing changes using aseptic technique |
| Pain Control | – Administer pain meds before dressing change – Use relaxation, distraction techniques |
| Nutritional Support | – Provide high-calorie, high-protein meals – Monitor albumin, weight, fluid balance – Encourage oral intake or enteral feeding |
| Monitor Labs | – Na⁺, K⁺, BUN/Creatinine – WBC for infection – Blood glucose in hypermetabolic state |
| Prevent Complications | – Monitor for pneumonia, sepsis – Perform ROM exercises to prevent contractures |
| Emotional & Psychosocial Care | – Allow patient to express feelings – Begin involving patient in self-care – Offer spiritual support if desired |
Focus: Restore function, minimize deformity, improve psychosocial well-being
| ♿ Focus Area | 📝 Interventions |
|---|---|
| Mobility & Function | – Encourage physical therapy – Teach ROM exercises – Use splints as ordered |
| Skin Care | – Apply moisturizers on healed skin – Avoid sun exposure for 6–12 months – Use compression garments to prevent hypertrophic scars |
| Psychological Support | – Address body image issues – Refer to counseling or support groups – Involve family in care |
| Patient Education | – Teach wound care at home – Explain signs of infection – Emphasize nutrition and hydration |
| Vocational Rehab | – Refer to occupational therapy – Help patient return to work/school if possible |
| 🩺 Nursing Focus | ✅ Key Actions |
|---|---|
| Airway & Breathing | O₂ therapy, suctioning, position HOB up |
| Fluid Balance | IV fluids, hourly I&O, urine output monitoring |
| Pain Relief | IV opioids, distraction, calm environment |
| Wound Management | Debridement assistance, sterile dressing |
| Infection Control | Isolation, hand hygiene, monitor WBC |
| Nutrition | High protein/calorie intake, supplements |
| Psychosocial Support | Emotional care, body image, education |
| Rehabilitation | PT/OT referral, scar management |
👩⚕️ Nurses work with:
Burns trigger a hypermetabolic and catabolic response → the body requires 2–3 times more energy and protein to heal.
➤ Support wound healing
➤ Prevent infection
➤ Preserve lean body mass
➤ Enhance immune function
➤ Reduce length of hospital stay
| 🔍 Need | 🔢 Guideline |
|---|---|
| Total Calories | 25–30 kcal/kg/day + burn factor |
| In major burns | 4000–6000 kcal/day may be required |
| Formula Used | Curreri formula, Harris-Benedict equation |
| 💪 Purpose | 🧫 Needs |
|---|---|
| Wound healing, immune boost | 1.5–2.5 g/kg/day |
| Prevent muscle loss | High Biological Value Proteins |
| Sources | Eggs, milk, chicken, fish, pulses |
➤ Maintain hydration
➤ Replace ongoing losses (urine, evaporation)
➤ Use oral or IV fluids based on Parkland formula initially
| 🍊 Vitamin/Mineral | 💡 Function |
|---|---|
| Vitamin C | Collagen synthesis, immunity |
| Vitamin A | Skin integrity, epithelial repair |
| Zinc | Wound healing, immunity |
| Selenium | Antioxidant defense |
| Iron | Prevent anemia due to blood loss |
| Calcium, Magnesium | For neuromuscular balance, healing |
| 🚪 Route | 📝 Indications |
|---|---|
| Oral (PO) | If patient is conscious and alert |
| Enteral (NG/PEG) | If oral intake inadequate or patient unconscious |
| Parenteral Nutrition | If GI tract is non-functional or severely impaired |
| 🧠 System | ❗ Common Complications |
|---|---|
| Cardiovascular | Burn shock, hypotension, arrhythmias (esp. in electrical burns) |
| Respiratory | Inhalation injury, ARDS, pneumonia |
| Renal | Acute kidney injury, myoglobinuria |
| GI | Paralytic ileus, stress ulcers |
| Metabolic | Hyperglycemia, hypermetabolic state |
| Psychological | PTSD, anxiety, depression |
| Nutritional | Weight loss, hypoalbuminemia, vitamin/mineral deficiencies |
✔ Early airway management is life-saving
✔ First 24–48 hrs = fluid resuscitation crucial
✔ Depth + %TBSA burned = determines severity & treatment
✔ Infection control is critical throughout
✔ Maintain asepsis in wound care
✔ Monitor for signs of burn shock & infection
✔ Hourly urine output = key resuscitation marker
✔ Start early nutrition – it accelerates healing
✔ High protein = muscle + tissue regeneration
✔ Supplement vitamins (A, C, Zinc) for immune boost
✔ Enteral nutrition preferred when possible
✔ Monitor weight, labs (albumin, electrolytes)
✔ Support body image & emotional recovery
✔ Include family in care and education
✔ Encourage participation in rehabilitation activities.
After major burns, especially deep partial-thickness and full-thickness burns, patients are often left with functional limitations, contractures, and visible disfigurement.
➡ Reconstructive and cosmetic surgeries aim to:
Reconstructive surgery refers to procedures aimed at restoring anatomical structure and physical function following burn injuries.
✔ Burn contractures limiting joint movement
✔ Hypertrophic or keloid scars
✔ Non-healing burn wounds
✔ Facial deformities (eyelids, lips, nose)
✔ Scalp, hands, perineum involvement
✔ Breathing or eating difficulty due to tissue distortion
| 🔨 Procedure | 📝 Purpose |
|---|---|
| Contracture Release | Surgical release of tight scars limiting movement |
| Skin Grafting | Cover open wounds or scars using own skin |
| Tissue Expansion | Stretch healthy skin for reconstruction |
| Flap Surgery | Transfer of healthy tissue with its blood supply |
| Z-Plasty/Local Flaps | Rearrange scar tissue for improved mobility/cosmesis |
| Free Flap Transfer | For large defects using distant tissue |
Cosmetic surgery in burn patients focuses on improving physical appearance and restoring self-esteem without necessarily restoring function.
| 💉 Procedure | 🎯 Purpose |
|---|---|
| Scar Revision Surgery | Improve color, shape, and contour of scar |
| Laser Therapy | Reduce redness, thickness, and pigmentation |
| Dermabrasion | Smoothen raised scars (especially facial burns) |
| Chemical Peeling | Reduce discoloration, improve texture |
| Botox & Fillers | Minimize scar depression and asymmetry |
| Tattoo Camouflage | Color match scars in visible areas (optional) |
✅ Psychological counseling
✅ Patient education on expectations and risks
✅ Nutritional support for tissue healing
✅ Pain and infection control
✅ Informed consent and documentation
| 🩺 Focus Area | 🧾 Nursing Actions |
|---|---|
| Wound Care | Sterile dressing, monitor for infection |
| Pain Management | Administer analgesics regularly |
| Mobility Support | Assist with physiotherapy, prevent re-contracture |
| Emotional Support | Encourage expression, build body confidence |
| Education | Scar care, follow-up, pressure garments, sun protection |
| Nutrition | High protein, vitamins A/C/Zinc for healing |
✔ Restores lost or damaged tissue function
✔ Reduces deformities and disabilities
✔ Improves patient’s body image & confidence
✔ Minimizes social stigma
✔ Supports return to normal activities and work
🔹 Reconstruction = Function focused
🔹 Cosmetic = Appearance focused
🔹 Healing burns is not just physical—psychological recovery is vital
🔹 Teamwork between surgeons, nurses, psychologists, physiotherapists is essential
🔹 Timely surgery improves outcomes; delay can cause contractures and deeper scarring
🔹 Congenital deformities are structural or functional abnormalities that are present at birth due to genetic, environmental, or unknown factors.
🔹 These deformities can affect the:
➡ Cosmetic surgery is often used to correct or improve the aesthetic appearance and functional outcome of these deformities.
🔹 Cosmetic Surgery is a branch of plastic surgery focused on enhancing appearance, reshaping normal structures, and improving aesthetic appeal or self-esteem — not necessarily to treat disease.
✔ Refine features to achieve a more aesthetically pleasing look
✔ Common areas: face, breasts, abdomen, nose, lips, and skin
✔ Helps individuals feel more confident in social and professional settings
✔ Corrects physical features that may cause personal dissatisfaction
✔ Improve appearance and proportion in patients with:
✔ Cosmetic procedures may follow:
✔ To maintain a youthful appearance, cosmetic surgery can reduce:
🧴 Includes:
✔ Targeted fat removal or reshaping body contours
✔ Procedures include:
✔ Supports transgender individuals in aligning physical features with gender identity
✔ Includes:
✔ Helps women restore pre-pregnancy body shape
✔ Combines:
| 🎯 Purpose | 💡 Examples |
|---|---|
| Aesthetic enhancement | Rhinoplasty, lip fillers, jaw reshaping |
| Age-related appearance improvement | Facelift, Botox, eyelid surgery |
| Congenital deformity correction | Cleft lip repair, ear reshaping |
| Post-trauma or illness reconstruction | Breast reconstruction, scar revision |
| Post-pregnancy body reshaping | Tummy tuck, breast lift |
| Transgender identity affirmation | Facial contouring, breast and genital surgeries |
| Improve confidence & body image | General appearance-enhancing surgeries |
| 🌱 Cause | 🔍 Examples/Explanation |
|---|---|
| Genetic mutations | Down syndrome, cleft lip/palate, Marfan syndrome |
| Chromosomal disorders | Trisomy 13, 18, 21 |
| Teratogens | Alcohol (Fetal Alcohol Syndrome), drugs, infections |
| Nutritional deficiencies | Folic acid deficiency → Neural tube defects |
| Unknown factors | Idiopathic cases with no clear cause |
| 🎯 Goal | 📝 How It Helps |
|---|---|
| ✅ Improve appearance | Reshapes or rebuilds the deformed area |
| ✅ Enhance function | Improves speech, feeding, hearing, mobility |
| ✅ Reduce social stigma | Minimizes bullying, increases confidence |
| ✅ Promote psychological healing | Supports self-image and emotional development |
| 🩺 Focus | ✅ Nursing Actions |
|---|---|
| Wound Care | Sterile dressing, assess for infection |
| Pain Relief | Administer analgesics as prescribed |
| Feeding Support | Use special bottles post cleft lip surgery |
| Monitor Vitals | Especially for airway post facial surgery |
| Psychosocial | Emotional support, encourage positive body image |
| Parent Teaching | Home care, scar management, follow-up appointments |
✔ Congenital deformities may be functional or cosmetic
✔ Cosmetic surgery = enhances appearance, sometimes also function
✔ Multidisciplinary approach is crucial (surgeons, nurses, therapists, counselors)
✔ Early intervention = better long-term outcomes
✔ Psychological and family support is vital for coping and adaptation
🔹 Gender Reassignment Surgery (GRS) refers to a series of medical and surgical procedures that help an individual transition from their assigned sex at birth to their identified gender.
🔹 Also called:
➡ It is a part of the broader process called gender transition, which may also include hormonal therapy, psychological support, and legal/social changes.
| 💉 Procedure | 🔍 Purpose |
|---|---|
| Orchiectomy | Removal of testicles |
| Penectomy | Removal of penis |
| Vaginoplasty | Construction of a neo-vagina using penile tissue or colon segment |
| Clitoroplasty | Creation of a sensitive clitoris |
| Labiaplasty | Creation of labia majora and minora |
| Breast Augmentation | Enhances breast size if hormone therapy is inadequate |
| Facial Feminization Surgery (FFS) | Refines features (jaw, brow, nose) |
| 💉 Procedure | 🔍 Purpose |
|---|---|
| Mastectomy (Top Surgery) | Removal of breast tissue, chest reshaping |
| Hysterectomy | Removal of uterus |
| Oophorectomy | Removal of ovaries |
| Metoidioplasty | Creation of small penis using hormonally enlarged clitoris |
| Phalloplasty | Construction of full-size penis using tissue grafts |
| Urethroplasty | Extension of urethra for urination through penis |
| Scrotoplasty | Creation of scrotum using labial tissue + testicular implants |
✔ Persistent, well-documented gender dysphoria
✔ Capacity to consent and understand risks
✔ Age ≥18 years (some exceptions for top surgery)
✔ Completed at least 12 months of hormone therapy (except in certain cases)
✔ Lived in the desired gender role for ≥1 year (Real-life experience)
✔ Support from a qualified mental health professional
| 🩺 Focus | ✅ Care Provided |
|---|---|
| Pain control | Administer analgesics, monitor for pain levels |
| Wound care | Keep surgical site clean and dry, monitor for infection |
| Urinary care | Catheter care if urethral surgery performed |
| Drain management | Record and monitor drainage amounts |
| Ambulation | Encourage early mobility |
| Nutrition | High protein diet to promote healing |
| 🚨 Risk | 📌 Description |
|---|---|
| Infection | Common in genital surgeries |
| Fistula or stricture | Urethral complications in FTM surgeries |
| Graft necrosis | In phalloplasty or vaginoplasty |
| Psychological distress | Post-op regret, body image issues (rare but important) |
| Blood clots | DVT, especially in major surgeries |
| 💬 Aspect | 🧾 Nursing Role |
|---|---|
| Emotional Support | Provide safe space to discuss identity and fears |
| Use of Pronouns | Use patient’s chosen name and pronouns respectfully |
| Body Image Counseling | Support during physical transformation |
| Education | Self-care, hygiene, scar management, follow-up |
| Support Groups | Referral to LGBTQ+ mental health or peer networks |
✔ Gender reassignment surgery is a medically recognized treatment for gender dysphoria
✔ It includes genital and non-genital surgeries for functional and aesthetic transformation
✔ Requires a multidisciplinary approach: surgeons, nurses, psychologists, endocrinologists
✔ Informed consent and psychosocial preparation are crucial
✔ Nursing care must be respectful, inclusive, and affirming at all stages
Both reconstructive and cosmetic surgeries involve surgical interventions to restore or enhance the human body. Due to the invasive nature and deep psychological impact, these surgeries are governed by important legal and ethical principles to protect patients’ rights, dignity, safety, and well-being.
✅ Patients must be provided with:
🛑 Consent from parents/guardians is required for minors.
✔ Surgeons may be held legally liable for:
👩⚖️ Patient can sue under medical negligence laws in civil court.
✔ Legally required to maintain:
📁 Proper documentation protects both patient and provider.
🚫 Surgeons must avoid:
➡ Governed under Consumer Protection Act (CPA) and Medical Council Regulations in India.
✅ Surgery should not be performed on minors or mentally incompetent individuals unless:
✔ Patient has the right to choose or refuse treatment
✔ Cosmetic decisions must be voluntary and free from coercion
✔ Surgeon must respect personal values and beliefs
✔ Aim to benefit the patient – physically, emotionally, socially
✔ Avoid harm from unnecessary or excessive procedures
✔ Ensure realistic expectations are set
✅ “Do No Harm” principle:
🧠 Referral to psychiatrist may be ethically appropriate in such cases.
✔ Equal and fair treatment of all patients regardless of gender, socioeconomic status, or background
✔ No discrimination in offering reconstructive or cosmetic services
✔ Patient’s identity, procedure details, and photographs must remain private
✔ Disclosure only with written patient permission
📸 Especially important in cosmetic surgery cases involving celebrities or public figures.
✔ Understand diverse beliefs, values, and societal norms
✔ Respect modesty, gender roles, and religious customs when planning surgeries
| ⚖️ Legal Aspects | 🧠 Ethical Aspects |
|---|---|
| Informed written consent | Respecting autonomy and decision-making |
| Avoid medical negligence | Beneficence – acting in the patient’s interest |
| Maintain proper documentation | Non-maleficence – do no harm |
| Regulated advertising and publicity | Justice – fairness and equity |
| Age/legal capacity requirement | Confidentiality and privacy |
✅ Cosmetic surgery is elective – legal consent and ethical counseling are critical
✅ Reconstructive surgery may be medically essential (post-trauma, birth defects)
✅ Set realistic expectations and screen for mental health issues
✅ Always follow legal documentation and standard protocols
✅ Nurses play a key role in emotional support, patient education, and privacy
Laser-Assisted Debridement (LAD) is an advanced, technology-driven technique used in burn and chronic wound management to precisely remove necrotic (dead) or devitalized tissue using focused laser energy. It is considered a form of selective surgical debridement where thermal energy is used to vaporize or coagulate tissue. This method is minimally invasive, highly controlled, and can be a valuable tool in complex or cosmetically sensitive areas where traditional surgical debridement might pose aesthetic or functional risks.
LAD utilizes focused beams of coherent light (typically from CO₂ or Er:YAG lasers) that are directed at necrotic tissue. The laser energy penetrates tissue at precise depths and wavelengths, leading to controlled vaporization, ablation, or coagulation of the affected area. CO₂ lasers work on a photothermal basis, where water in the tissue absorbs the laser energy, causing the cells to disintegrate. This allows LAD to remove only the targeted damaged tissue while sparing surrounding healthy structures. Additionally, laser energy promotes microcirculation, stimulates cell proliferation, and may have an antimicrobial effect, further supporting wound healing.
LAD is especially useful in patients with partial-thickness or full-thickness burns, infected wounds, chronic ulcers, diabetic foot wounds, or in those who are not good candidates for traditional surgical debridement. It is also used in burn patients where eschar needs to be removed from the face, neck, or perineum — areas where preservation of function and appearance is critical.
The patient is positioned comfortably and local or general anesthesia may be used depending on the wound size and location. Protective goggles are worn by the surgical team. The laser handpiece is aimed at the wound site, and short, focused pulses are delivered to the non-viable tissue. The surgeon controls the depth and area of ablation using pre-calibrated settings. As the laser vaporizes the devitalized tissue, smoke evacuation is performed to reduce aerosolization. Once the wound bed appears clean with viable tissue, the procedure is halted. LAD may be followed by topical antimicrobial dressings, grafting, or biological coverings depending on wound status.
Laser-Assisted Debridement offers several benefits compared to conventional mechanical or surgical debridement. It is more precise, minimizes blood loss, reduces operative trauma, and preserves maximum viable tissue, which is essential in functionally or cosmetically important areas. It is especially valuable in pain-sensitive patients or those with bleeding disorders, as laser energy promotes hemostasis through coagulation. Furthermore, the antimicrobial effect of lasers helps reduce bacterial colonization, which is beneficial in infected or chronic wounds. Additionally, LAD has been shown to stimulate fibroblast activity, promoting granulation and epithelialization.
Despite its advantages, LAD is not suitable for all patients. The procedure requires costly equipment, skilled personnel, and strict safety protocols, which may not be available in all clinical settings. Improper use may cause thermal injury to surrounding healthy tissue. Also, LAD may not be appropriate in deep, heavily infected wounds with exposed bone or tendons. Careful patient selection and clinical judgment are therefore crucial. It should be used as part of a comprehensive wound care plan, often alongside antibiotics, dressings, and nutritional support.
Nurses play an essential role in LAD therapy by assisting in pre-procedure preparation, ensuring laser safety protocols are followed (e.g., eye protection, smoke evacuation), and providing post-procedural wound care. Nurses must monitor the patient’s pain levels, wound appearance, and signs of infection. Patient education on wound hygiene, dressing changes, and follow-up visits is also essential for promoting recovery and preventing complications. Emotional support and patient reassurance are especially important when LAD is used on visible areas like the face.
Laser-Assisted Debridement (LAD) is a modern, precise, and minimally invasive technique that uses focused laser energy to remove necrotic tissue, promote healing, and reduce infection in burn and chronic wounds. It is particularly useful in cosmetically and functionally sensitive areas. LAD offers advantages such as reduced bleeding, preservation of healthy tissue, and antimicrobial benefits, but it also requires expensive equipment and trained personnel. It is a valuable adjunct to conventional burn care, especially in specialized centers, and requires collaborative input from surgeons, nurses, and wound care teams for optimal outcomes.
Vacuum-Assisted Closure (VAC), also known as Negative Pressure Wound Therapy (NPWT) or vacuum dressing, is an advanced wound care technique that uses controlled negative pressure (suction) to promote healing in acute, chronic, or infected wounds.
➡ It involves the application of a sealed dressing connected to a vacuum pump, which draws out exudates, reduces edema, and stimulates tissue granulation.
VAC therapy is indicated for wounds that are:
Vacuum-Assisted Closure (VAC) or Negative Pressure Wound Therapy is an advanced, effective, and widely accepted technique used to manage complex wounds. It works by applying controlled suction to the wound to remove exudates, reduce bacterial contamination, promote granulation, and accelerate healing. While it offers numerous advantages, careful application, regular monitoring, and skilled nursing care are essential to prevent complications and ensure success. VAC therapy represents a significant advancement in wound care, particularly for chronic or difficult-to-heal wounds.
LASER stands for Light Amplification by Stimulated Emission of Radiation.
It is a medical technology that emits a highly focused, coherent, monochromatic beam of light, capable of cutting, vaporizing, or coagulating tissues with precision. Lasers are widely used in surgery, dermatology, ophthalmology, urology, and cosmetic medicine due to their selectivity and minimal invasiveness.
Laser therapy is indicated in:
✔ LASER = Precise, powerful medical tool used in many surgical and cosmetic procedures
✔ Always follow strict laser safety guidelines including eye protection
✔ Nurses are essential for equipment handling, patient preparation, and post-op care
✔ LASER is both diagnostic and therapeutic in modern healthcare
✔ Improper use can result in severe injuries or legal consequences, so training is vital
Liposuction, also known as lipoplasty or suction-assisted lipectomy, is a cosmetic surgical procedure used to remove localized deposits of subcutaneous fat using suction cannulas. It reshapes and contours specific areas of the body by breaking up and aspirating fat through small incisions.
➡ Liposuction is not a weight-loss surgery but a body contouring method used when diet and exercise fail to remove stubborn fat pockets.
✔️ Cosmetic contouring in healthy individuals with localized fat deposits resistant to diet/exercise.
✔️ Common target areas:
🔸 Can also be used in:
✅ Pre-operative:
✅ Intra-operative:
✅ Post-operative:
✔ Liposuction is not a weight-loss tool, but a contouring procedure
✔ Best candidates: healthy individuals with good skin elasticity
✔ Use of compression garments is crucial post-operatively to reduce swelling
✔ Nurses play a central role in patient preparation, monitoring, and post-op teaching
✔ Realistic expectations must be discussed with the patient beforehand
✔ Liposuction can improve appearance and confidence, but it is not a substitute for healthy lifestyle
Skin rejuvenation refers to therapeutic and cosmetic procedures or interventions aimed at restoring youthful appearance, improving skin texture, tone, elasticity, and reducing signs of aging, damage, or stress.
➡ It involves various non-invasive, minimally invasive, and invasive treatments that work by stimulating collagen production, improving hydration, removing damaged layers, and enhancing the overall health of the skin.
Skin rejuvenation can be broadly classified into:
All rejuvenation strategies aim to:
✔ Skin rejuvenation involves multiple disciplines: dermatology, aesthetics, nutrition, and nursing
✔ Key to success = personalized treatment based on skin type, age, and concern
✔ Prevention is better than cure — sunscreen, hydration, and gentle care delay aging
✔ Collagen stimulation is at the core of most medical techniques
✔ Nurses and healthcare providers must ensure safe, evidence-based, and ethical care
Dermal fillers are injectable substances used to restore lost volume, smooth wrinkles, enhance facial contours, and rejuvenate the skin. They are commonly applied in aesthetic dermatology and cosmetic surgery and are typically used in non-surgical facial rejuvenation.
Dermal fillers are used for:
Dermal fillers physically fill the space under the skin where volume is lost or wrinkles have formed.
Some fillers (like HA) also attract and bind water molecules, which further plump the area.
Others (like Sculptra) stimulate the body to produce new collagen, improving skin firmness and elasticity over time.
✔ Dermal fillers restore volume, smooth lines, and enhance facial features
✔ Best suited for healthy individuals with realistic expectations
✔ Use of licensed, FDA-approved products and trained professionals is essential
✔ Pre-injection assessment and sterile technique prevent complications
✔ Patient safety, consent, and education are key responsibilities of the nurse