発音注意
n.

熱湯傷、やけど、熱傷

ex.

ブドウ球菌性熱傷様皮膚症候群 staphylococcal scalded-skin syndrome

関: burn, thermal burn

WordNet

a burn cause by hot liquid or steam
burn with a hot liquid or steam; "She scalded her hands when she turned on the faucet and hot water came out"
heat to the boiling point; "scald the milk"
treat with boiling water; "scald tomatoes so that they can be peeled"
the act of burning with steam or hot water
milk heated almost to boiling
the act of arranging in a graduated series (同)grading
act of measuring or arranging or adjusting according to a scale
ascent by or as if by a ladder

PrepTutorEJDIC

〈熱湯・湯気(ゆげ)が〉…‘を'やげどさせる / ‘を'煮沸[消毒]する / 〈ミルクなど〉‘を'沸点近くまで煮たたせる(熱する) / (熱湯・湯気での)やけど
やけどするほど熱い / (批評などが)てきびしい

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2017/06/15 16:13:41」(JST)

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1. 熱傷の局所治療：外用抗菌薬と被覆材 local treatment of burns topical antimicrobial agents and dressings
2. 熱傷の世界的疫学 epidemiology of burn injuries globally
3. 軽症熱傷の治療 treatment of minor thermal burns
4. 小児における中等度および重度熱傷の救急治療 emergency care of moderate and severe thermal burns in children
5. 熱傷の分類 classification of burns

English Journal

Outpatient treated burns in infants younger than 1 year in Helsinki during 2005-2009.

Laitakari E1, Koljonen V2, Pyörälä S3, Rintala R3.Author information 1Department of Pediatric Surgery, Hospital for Children and Adolescents, Helsinki University Hospital, Helsinki, Finland. Electronic address: elina.laitakari@fimnet.fi.2Department of Plastic Surgery, Helsinki University Hospital, Helsinki, Finland; Institute of Clinical Medicine, Helsinki University, Helsinki, Finland.3Department of Pediatric Surgery, Hospital for Children and Adolescents, Helsinki University Hospital, Helsinki, Finland.AbstractIn general, voluminous data exists concerning burns in children, but the data focusing specially on children less than 1 year of age is sporadic. We therefore focused on examining the special features of burns in children less than 1 year of age. A retrospective study of all outpatient treated burn patients <1 year old at the Hospital for Children and Adolescents, Helsinki, Finland, from January 2005 to December 2009 was performed. During the 5-year period we identified 106 outpatient treated infants with burns, representing 15% of all pediatric burns during the study period. The majority was male and aged 9-12 months. Most of the burns occurred at home, and in most cases a caregiver was present in the injury room. Scalds were the most common type of injury followed by contact burns. The most common source of scald was from cups containing hot drink, and the most common source of contact burn was hot stoves or oven doors. Special attention needs to be targeted toward the prevention of burns in children less than 1 year of age. The majority of the injuries could have been prevented with more vigilance.
Burns : journal of the International Society for Burn Injuries.Burns.2014 May;40(3):489-94. doi: 10.1016/j.burns.2013.08.007. Epub 2013 Sep 1.
In general, voluminous data exists concerning burns in children, but the data focusing specially on children less than 1 year of age is sporadic. We therefore focused on examining the special features of burns in children less than 1 year of age. A retrospective study of all outpatient treated burn
PMID 24001919

Patterns of burns and scalds in children.

Kemp AM1, Jones S, Lawson Z, Maguire SA.Author information 1Early Years Research Programme, Institute of Primary Care and Public Health, Cardiff University, , Heath Park, Cardiff, UK.AbstractOBJECTIVE: To describe the characteristics of childhood burns and scalds, mechanisms and agents to inform prevention.
Archives of disease in childhood.Arch Dis Child.2014 Apr;99(4):316-21. doi: 10.1136/archdischild-2013-304991. Epub 2014 Feb 3.
OBJECTIVE: To describe the characteristics of childhood burns and scalds, mechanisms and agents to inform prevention.METHODS: Prospective multicentred cross-sectional study of children (<16 years) with unintentional burns/scalds from five Emergency Departments (ED), a burns assessment unit and th
PMID 24492796

Mouse Mast Cell Proteases 4 and 5 Mediate Epidermal Injury through Disruption of Tight Junctions.

Bankova LG1, Lezcano C, Pejler G, Stevens RL, Murphy GF, Austen KF, Gurish MF.Author information 1Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115;AbstractWe previously established a mast cell (MC)-dependent thermal injury model in mice with ulceration and scar formation that depended on nonredundant functions of mouse MC protease (mMCP)4 and mMCP5. We hypothesized that MC activation is an early event and now find by histology that exocytosis of granule contents occurred by 2 min after thermal injury in wild-type (WT) C57BL/6 mice and in the mMCP4- or mMCP5-deficient mice. The degranulation was equivalent for MCs in the dermis and hypodermis of all three strains, but only the WT mice showed an appreciable increase in epidermal thickness. There was no loss of total MCs, partially degranulated plus intact, during the 4 h of observation. By electron microscopy, MCs in all strains showed early zonal degranulation at 30 s with marked progression in magnitude by 120 s and no mitochondrial injury or cellular necrosis. Concomitantly there was an increase in intercellular spaces indicative of tight junction (TJ) disruption in WT mice but not in the mMCP4- or mMCP5-deficient strains. The desmosomes were intact in all strains. Immunodetection of the TJ protein claudin 4 in WT and mMCP5-deficient mice indicated a significant reduction after scald injury whereas mMCP4(-/-) mice showed no significant changes. Taken together, these findings reveal that a second-degree burn injury can initiate an immediate novel zonal degranulation of MCs throughout all skin layers and a disruption of the epidermal TJs dependent on the nonredundant presence of mMCP4 and mMCP5.
Journal of immunology (Baltimore, Md. : 1950).J Immunol.2014 Mar 15;192(6):2812-20. doi: 10.4049/jimmunol.1301794. Epub 2014 Feb 12.
We previously established a mast cell (MC)-dependent thermal injury model in mice with ulceration and scar formation that depended on nonredundant functions of mouse MC protease (mMCP)4 and mMCP5. We hypothesized that MC activation is an early event and now find by histology that exocytosis of granu
PMID 24523504

Assessment and management of scalds and burns in children.

Hollywood E1, O'Neill T.Author information 1Trinity College Dublin, Ireland.AbstractIn childhood, burn or scald injuries are comparatively common, and the greatest risk is to infants and toddlers. The extent and severity of injuries can vary greatly, which can significantly affect recovery and outcome. To provide high quality nursing care to the child who has sustained a burn injury and the family, the children's nurse should understand the pathophysiology of the trauma and the associated physical and psychological suffering. Evidence-based nursing management of these aspects is an essential component of recovery. Children's nurses working in hospitals, schools or in the community can engage with parents, families, school staff and children to provide information, advice, and health and safety promotion for burn prevention.
Nursing children and young people.Nurs Child Young People.2014 Mar 11;26(2):28-33. doi: 10.7748/ncyp2014.03.26.2.28.e396.
In childhood, burn or scald injuries are comparatively common, and the greatest risk is to infants and toddlers. The extent and severity of injuries can vary greatly, which can significantly affect recovery and outcome. To provide high quality nursing care to the child who has sustained a burn injur
PMID 24617891

Japanese Journal

1A2-K03 事故データベースを用いたリスク予見支援のための状況構造の要約可視化手法の開発(デジタルヒューマン)

ロボティクス・メカトロニクス講演会講演概要集 2013, "1A2-K03(1)"-"1A2-K03(3)", 2013-05-22
NAID 110009962923

オオムギ・イネにおける耐病性,多収性育種の基礎研究および災害復興支援の研究による北陸地域への貢献(北陸作物・育種学会賞(功労賞))

北陸作物学会報 (48), 1-3, 2013-03-31
NAID 110009985430

Secondary Abdominal Compartment Syndrome Associated with Massive Fluid Resuscitation in Extensive Burn Patients : Report of Two Cases and a Revision of the Institutional Fluid Resuscitation Protocol

日本外科系連合学会誌 37(6), 1086-1090, 2012-12-30
NAID 10031152858

Interferon-gamma inhibits healing post scald burn injury

Wound repair and regeneration 20(4), 580-591, 2012-07-01
NAID 10031181845

「熱傷」

　　[★]

英: burn, burn injury, thermal injury, scald
同: やけど、火傷？
関: 5の法則、9の法則、皮膚。ショック

概念

高温による生体の組織損傷

分類

損傷深度により分類する
第1度：表皮内　(表皮熱傷：紅斑、2-3日で治癒)
第2度：真皮内　(真皮浅層熱傷：疼痛、水疱形成、水疱底赤色、1-2週間で治癒。真皮深層熱傷：知覚鈍麻、水疱形成△、水疱底白色、3-4週間で治癒。)
第3度：皮膚全層(皮下熱傷：壊死。白～褐色。知覚無し。一ヶ月以上)
第4度：炭化

重症度

burn index = II度熱傷面積　＋　0.5 x III度熱傷面積

10-15%を超えた場合、重症熱傷として全身管理が必要になる。

Artの基準

病態

創傷からの体液の漏出
創傷の易感染性

検査

ヘモグロビン尿：血管内溶血による　←　なぜ？

合併症

カーリング潰瘍、播種性血管内凝固、熱傷部位の感染

(遠隔期に熱傷瘢痕から)有棘細胞癌

治療

1. 気道管理：

気道熱傷の場合には気管挿管。
気管支痙攣がある場合には気管拡張薬が有用。副腎皮質コルチコイドは感染リスクを上げるために使用すべきでない。(参考1)

2. 補液：初期治療として必須。

初期治療における輸液量の決定法：Evans法、Brook法、Baxter法など

Parklandの公式(=Baxter法)

4ml x 熱傷面積 (%) x 体重 (kg) = 補液量 (ml/day)

最初の8時間で1/2を、次の16時間で1/2を輸液する

3. 冷却
4. 疼痛管理

参考

1. [charged] Emergency care of moderate and severe thermal burns in adults - uptodate [1]

治療

初期治療には輸液が大切。だけど、入れ過ぎも問題だからちゃんと計算して輸液しろ。なにが問題って、血圧上昇、腹部、四肢、眼窩のcompartment syndromeが起こる。
最初は晶質液をいれる。高Cl性アシドーシスのリスクがあるから乳酸リンゲルがよい。
治療の初期段階で膠質液や高張生食を使うかどうかについては議論中。膠質液(アルブミン、デキストラン)は非常に高いし、生命予後を改善しないから推奨されない。

2. 「血液製剤の使用指針」（改定版）平成17年９月

http://www.mhlw.go.jp/new-info/kobetu/iyaku/kenketsugo/5tekisei3b.html

http://www.mhlw.go.jp/new-info/kobetu/iyaku/kenketsugo/5tekisei3b01.html

血漿の不適切な使用の一つに「DICを伴わない熱傷の治療」がある。DICに至るような熱傷ならば使って良いと考えられる。

「ブドウ球菌性熱傷様皮膚症候群」

　　[★]

scald
英: staphylococcal scalded-skin syndrome, staphylococcal scalded skin syndrome, SSSS(4S)
同: リッター病 Ritter disease Ritter's disease、ブドウ球菌性皮膚剥脱症候群、新生児剥脱性皮膚炎 dermatitis exfoliativa neonatorum DEN
関: 黄色ブドウ球菌 Staphylococcus aureus

病原体

Staphylococcus aureus

疫学

6歳までの乳幼児に多い。

病因

Staphylococcus aureusが分泌する表皮剥脱性毒素(exfoliative toxin, ET)による。
ETが結構によって全身皮膚に到達し、デスモグレイン1を切断し、表皮上層で、落葉状天疱瘡と類似した棘融解と浅い水疱を生じる。弛緩性水疱

症状

皮膚病変は紅斑、弛緩性水疱、落屑の順に出現する。

身体所見

ニコルスキー現象陽性

国試

101A006

「staphylococcal scalded skin syndrome」

　　[★] ブドウ球菌性熱傷様皮膚症候群 SSSS

「staphylococcal scalded-skin syndrome」

　　[★] ブドウ球菌性熱傷様皮膚症候群

「scaling」

　　[★]

n.

スケーリング

縮尺や変換係数を定めること、歯石とプラークを除去すること

リンク元	「熱傷」「ブドウ球菌性熱傷様皮膚症候群」
拡張検索	「staphylococcal scalded skin syndrome」「staphylococcal scalded-skin syndrome」
関連記事	「scaling」

匿名

検索

案内

案内

scald

WordNet

PrepTutorEJDIC

Wikipedia preview

wiki en

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