description: '**Concept**\r\nA burn wound is a wound caused by skin being exposed to heat for a certain time above a certain critical temperature. Heat above this critical temperature (+/- 40°C) will cause damage to the skin. There are different types of burn wounds, which are categorized according to the depth of the burn wound. \r\nThe depth of the burn wound depends on: \r\n\r\n* the temperature of the impacting heat;\r\n* the duration of the impact of heat on the skin;\r\n* the source of the burn (e.g. fire, fluid).\r\n\r\n\r\n\r\n**Purpose**\r\nThe description of the burn wound is of importance for starting or continuing the best possible wound treatment and to be able to properly monitor the wound healing process.\r\n**Evidence Base**\r\nDifferent degrees are used to evaluate the depth of the burn wound: \r\n\r\nFirst-degree burn (no wound): \r\n\r\n* redness\r\n* good capillary refill\r\n* supple\r\n* painful\r\nSuperficial second-degree burn wound (partial thickness of the skin): \r\n\r\n* intact / broken blisters\r\n* pink, shiny, uniform\r\n* good capillary refill\r\n* supple\r\n* painful\r\nDeep second-degree burn wound:\r\n\r\n* intact / broken blisters\r\n* pink, matte, not homogenous, damp\r\n* slow capillary refill\r\n* slightly more firm\r\n* painful\r\nThird-degree burn wound \r\n\r\n* intact / broken blisters, epidermis stuck to burned dermis\r\n* white, brown, yellow, red (when kept in hot water for a prolonged period of time)\r\n* no capillary refill, non-removable redness\r\n* firm\r\n* less painful than the size of the wound makes it appear\r\n(Source: Brandwondenprotocol 2010, Rode Kruis Brandwondencentrum Beverwijk [2010 Burn wound protocol, Beverwijk Red Cross Burn Wound Center])\r\n\r\n**Example Instances**\r\n\r\n**Instructions**\r\n\r\n**Issues**\r\nDamages to the skin as a result of exposure to intense heat and cold can lead to similar wounds. Nevertheless, we have decided not to expand the information model to become a generic thermal wound information model. The reason for this was the lack of a guideline for treating freeze wounds and insufficient agreement in the field on the applicability of the burn wound classification for freeze wounds. Freeze wounds also rarely occur in the Netherlands, due to the climate.' package_name: healthdata.be.r4.cbb derivation: specialization name: HdBeBurnwound abstract: true type: https://fhir.healthdata.be/StructureDefinition/LogicalModel/burn_wound elements: date_of_onset: short: DateOfOnset _definition: extension: - url: http://hl7.org/fhir/StructureDefinition/translation extension: - {url: lang, valueCode: nl-NL} - {url: content, valueMarkdown: Datum waarop de brandwond is ontstaan.} type: dateTime _short: extension: - url: http://hl7.org/fhir/StructureDefinition/translation extension: - {url: lang, valueCode: nl-NL} - {url: content, valueMarkdown: OntstaansDatum} base: {max: '1', min: 0, path: burn_wound.date_of_onset} index: 0 extent: short: Extent _definition: extension: - url: http://hl7.org/fhir/StructureDefinition/translation extension: - {url: lang, valueCode: nl-NL} - url: content valueMarkdown: "De uitgebreidheid van een brandwond wordt weergegeven in een percentage van het ‘Totaal Verbrande Lichaamsoppervlak’ (TVLO). Voor volwassenen is het TVLO te berekenen aan de hand van de ‘regel van negen’, waarbij de lichaamsdelen worden uitgedrukt in het percentage 9 en veelvouden hiervan. Deze ’regel van negen’ is voor kinderen niet bruikbaar omdat de lichaamsverhoudingen van een kind en een volwassene verschillen. Voor kinderen zijn per leeftijdsgroep aparte tabellen ontwikkeld om de uitgebreidheid van een brandwond vast te stellen. Een andere mogelijkheid is de uitgebreidheid te meten met het handoppervlak van de patiënt. De oppervlakte van een hand van de patiënt (met aaneengesloten vingers) komt overeen met ± 1% van het lichaamsoppervlak. \r\n(Bron: Brandwonden genezen. Hoe verder?)" type: Quantity _short: extension: - url: http://hl7.org/fhir/StructureDefinition/translation extension: - {url: lang, valueCode: nl-NL} - {url: content, valueMarkdown: Uitgebreidheid} base: {max: '1', min: 0, path: burn_wound.extent} index: 1 anatomical_location: short: AnatomicalLocation _definition: extension: - url: http://hl7.org/fhir/StructureDefinition/translation extension: - {url: lang, valueCode: nl-NL} - {url: content, valueMarkdown: Locatie op het lichaam waar de brandwond zich bevindt.} type: AnatomicalLocation _short: extension: - url: http://hl7.org/fhir/StructureDefinition/translation extension: - {url: lang, valueCode: nl-NL} - {url: content, valueMarkdown: AnatomischeLocatie} index: 2 laterality: short: Laterality _definition: extension: - url: http://hl7.org/fhir/StructureDefinition/translation extension: - {url: lang, valueCode: nl-NL} - {url: content, valueMarkdown: 'Lateraliteit verbijzondert de anatomische locatie door, indien van toepassing, de zijdigheid vast te leggen, bijvoorbeeld links.'} type: CodeableConcept _short: extension: - url: http://hl7.org/fhir/StructureDefinition/translation extension: - {url: lang, valueCode: nl-NL} - {url: content, valueMarkdown: Lateraliteit} binding: {strength: required, valueSet: 'https://fhir.healthdata.be/ValueSet/BrandwondLateraliteit'} base: {max: '1', min: 0, path: burn_wound.laterality} index: 3 depth: short: Depth _definition: extension: - url: http://hl7.org/fhir/StructureDefinition/translation extension: - {url: lang, valueCode: nl-NL} - {url: content, valueMarkdown: 'Beschrijving van de ernst van de brandwond, oplopend van graad 1 tot en met 3.'} type: CodeableConcept _short: extension: - url: http://hl7.org/fhir/StructureDefinition/translation extension: - {url: lang, valueCode: nl-NL} - {url: content, valueMarkdown: Dieptegraad} binding: {strength: required, valueSet: 'https://fhir.healthdata.be/ValueSet/Dieptegraad'} base: {max: '1', min: 1, path: burn_wound.depth} index: 4 comment: short: Comment _definition: extension: - url: http://hl7.org/fhir/StructureDefinition/translation extension: - {url: lang, valueCode: nl-NL} - {url: content, valueMarkdown: Toelichting over de brandwond.} type: string _short: extension: - url: http://hl7.org/fhir/StructureDefinition/translation extension: - {url: lang, valueCode: nl-NL} - {url: content, valueMarkdown: Toelichting} base: {max: '1', min: 0, path: burn_wound.comment} index: 5 date_of_last_dressing_change: short: DateOfLastDressingChange _definition: extension: - url: http://hl7.org/fhir/StructureDefinition/translation extension: - {url: lang, valueCode: nl-NL} - {url: content, valueMarkdown: De datum waarop de laatste verbandwissel heeft plaatsgevonden.} type: dateTime _short: extension: - url: http://hl7.org/fhir/StructureDefinition/translation extension: - {url: lang, valueCode: nl-NL} - {url: content, valueMarkdown: DatumLaatsteVerbandwissel} base: {max: '1', min: 0, path: burn_wound.date_of_last_dressing_change} index: 6 wound_image: short: WoundImage _definition: extension: - url: http://hl7.org/fhir/StructureDefinition/translation extension: - {url: lang, valueCode: nl-NL} - {url: content, valueMarkdown: Een foto van de wond als visuele informatie.} type: base64Binary _short: extension: - url: http://hl7.org/fhir/StructureDefinition/translation extension: - {url: lang, valueCode: nl-NL} - {url: content, valueMarkdown: Wondfoto} array: true base: {max: '*', min: 0, path: burn_wound.wound_image} index: 7 package_version: 0.4.1-alpha class: logical kind: logical url: https://fhir.healthdata.be/StructureDefinition/LogicalModel/HdBe-Burnwound base: http://hl7.org/fhir/StructureDefinition/Element version: null required: [depth]