Base knowledge, skills, the skills necessary for studying of the theme (interdisciplinary integration).

Names of the previous disciplines	The received skills
1. Topographical anatomy.	To define localization of damage and possible complications.
2. Histology.	To know a histologic structure of tissues of maxillofacial area. To define localization of thermal trauma according to layers of a skin.
3. Internal illnesses.	To make the examination of the patient.
4. General surgery and field surgery.	Definition of concept "burn" and "frostbite", clinical attributes of these damages and methods of their diagnostics volume. To define a character of trauma, to examine the wounded, to define the plan of medical aid and a plan of evacuation of the wounded.
5. Special military preparation.	To know principles of the organization of medical aid by the wounded at stages of medical evacuation. A primary medical card of the wounded.
6. Medicine of accidents.	To know the organization of medical aid by the maxillofacial wounded in structure of a civil defence. To organize the first medical, pre-medical and first medical assistance by the wounded at stages of medical evacuation

TASKs FOR INDividual WORK DURING PREPARATION TO Lesson.

4.1. List of basic terms, parameters, characteristic, which a student must master at preparation to lesson:

The term	Definition
1. A burn.	Thermal trauma.
2. A frostbite.	A trauma of low temperature.
3. Burns illness.	Pathological process as a result of a thermal trauma.

4.2. Theoretical questions to the lesson: 1. Aetiology of burns. 2. Aetiology of frost bites. 3. Pathological changes in tissues at burns and frost bites. 4. Classifications of burns. 5. Clinical features of thermal burns of maxillofacial area. 6. Clinical features of chemical burns of maxillofacial area. 7. Methods of definition of depths of burns.8. Methods of definition of the area of burns. 9. Features of granting of medical aid by the maxillofacial wounded with thermal burns. 10. Features of granting of medical aid by the maxillofacial wounded with chemical burns. 11. A pathogenesis of a symptom mutual aggravation at burns and frost bites in maxillofacial area. 12. Principles of surgical tactic of burns wounds of maxillofacial area.

4.3. Practical works (task): 1. Practical training to rendering first aid for the victims with burns of the face. 2. Practical training to make the plan of examination and treatment for victims with burns and frostbite.

5. TABLE OF CONTENTS OF THEME:

Burns are the damage to tissues caused by their exposure to thermal, chemical, electrical or radiation energy.

Classification

A) Causes:

1. thermal;

2. chemical;

3. electrical;

4. radiation.

B) Dept of damage:

degree 1 – damage of the epidermis only.

degree 2 –damage of the epithelium up to the basal layer

degree 3 – damage of the dermis.

3a –epithelial necrosis with partial involvement of the basal layer, hair follicles, sweat and sebaceous glands are intact.

3 b – complete necroses of the dermis, basal layer and part of the subcutaneous layer.

degree 4 – complete necrosis of the skin and underlying tissues.

The severity of burns depends on the area and depth of damage.

Assessment of the area of burns facilitates the adequacy of the therapy. The methods currently used to calculate the area involved:

1. A “rule of nine”

According to this rule, the body surface regions are divided into areas that are multiples of 9%. Each of the following body regions comprises 9% of total surface burn area:

- head and neck – 9%,

- upper limb – 9%, anterior part of the trunk – 18%,

- back – 18%,

- lower limb – 18% (thigh – 9%, leg and foot – 9%);

- external genitals – 1%.

2. A “rule of palm”

If the damaged areas are not so extensive and scattered on different parts of the body, the rule of palm is applied to determine the areas of deep burns on the basis of superficial ones. The size of an adult palm is about 1% of the body surface area.

Special tables with graduations made according to the body surface areas (cm²) can also be used:

- the face 500cm² or 3,1%;

- scalp-the hairy part of the head – 480 cm* or 3,0%;

- chest and abdomen – 2990 cm² or 18,0%;

- the hand – 360 cm² or 2,25%;

- the back – 2560 cm² or 16,0%.