Degree Burns And Burn Treatment

What is a burn ?

A burn is an injury that is generally caused by combustion of the skin by the influence of heat, for a certain period of time and above a certain critical temperature. Above this temperature (± 42 ° C) occurs after some time, damage to the skin on.


Burns can result from contact of the skin with hot gases, liquids or other materials. Extreme cold, such as touch of liquid nitrogen, has the same effect on the skin as heat and are also sometimes called frostbite. Also highly corrosive chemicals can fire cause blisters when they come into contact with the skin.

Further radiation (such as the Sun or in radiotherapy), electricity and friction (for example, after falling barns on the road surface) also cause burns. Burns by hot water and steam deserve separate mention: because water has a very large heat content are often more severe than, for example, hot water burns Burns by hot cooking oil, which, although hotter but its heat on contact with the skin much faster.

 A burn is an injury that is generally caused by combustion of the skin by the influence o Degree Burns and Burn Treatment

Degree burns

Burns are, depending on the depth, divided into several gradations. The depth, and thus the degree of a burn depends on the temperature, the time that the skin is exposed to that temperature, and the cause. Hot water burns and blowtorch burns usually have second degree burns, flame burns are usually third degree.
  • First degree burns. In a first burning, the skin becomes red and painful, but no blisters occur. The pain and discoloration are generally resolved within 24 hours. The skin tissue is not destroyed, and even when there are large areas of the body are affected, there is no danger. Often there are signs of inflammation seen in first-degree burns.
-Loss of function

Also general symptoms such as; fever, no appetite, may be feeling sick with a first burn.
A first degree burn is common: most burns covered by the sun below.
  • Second degree burns (further divided into superficial and deep burns). In a second-degree burn occurs blistering; Moisture forms between the epidermis and the dermis. This blistering is usually quite painful. When large areas are burned, the pain is often extreme. It is important that, although a part of the skin is destroyed, there are still parts of the epidermis remained intact. As a result, there can be, after detachment of the wound crusts of itself new skin to grow over the wound. The cure takes, depending on the depth of the burn, a few days up to four or five weeks. The hair roots and sweat glands are located deep in the skin. As long as there remains only a part of it preserved is healing possible. However, the risk of wound infection is lurking. If this happens, the originally intact skin can still nevertheless be destroyed, so that formation of new skin is prevented. If this happens, the prospects are very unfavorable.
  • Third degree burns. With a third degree burn is destroyed, the entire skin. The wound area no longer responds to sensory stimuli and even to pain. In the beginning, the burned skin area white to gray-white, later brown, parchment-like color. After detachment of the formed scab is a pale red or light red colored layer wound appeared. This release of the wound crust in a large wound surface takes a lot of time to complete. Often, third-degree burns on more than three centimeters, to shorten the healing, closed with pieces of skin are removed elsewhere in the body (skin graft).
  • Fourth degree burns. Sometimes the carbonization term is used. Here, the combustion is so deep that even structures under the skin, such as bone and muscle tissue are destroyed. The appearance of the skin is usually charred, cooked (bleach) or raw. Lost tissue can not be recovered, though it may sometimes be transplanted tissue from elsewhere via a surgical procedure.
Not only the degree of the burn is of importance but also the size of the surface and the place. If all the elements epidermal (skin cells) have disappeared in the wound healing should occur by encroachment from the edge; however, there are still in the wound skin cells alive (for example, in hair follicles) then forms in healing islands where the wound center will also be close and healing much easier. Deep burns often give large scars left untreated usually cause severe contractures. People with burns over 25% of body surface area and third-degree burns greater than 10% of the body surface area should be included in a burns unit.

Burns treatment

In the treatment of burns are the following important topics:
  • first aid
  • action and combat shock
  • wound management and wound healing
  • occurrence of complications
First aid
When the victim on fire assistance in the first place should consist of putting out the fire with water. Preferably water should be used, but also a fire extinguisher can be very useful, provided that care is taken to ensure that they do not face spray the victim. The fire can be extinguished by the victim tightly wrap a blanket or jacket. It should be ensured here that first the top at the neck is closed, because otherwise the whole works as a chimney. Is there nothing at hand then we must summon the victim, "lie and roll!" It should be as compelling as possible to be taken since there is otherwise large that one does not penetrate to the victim because of his panic.

The victim's clothes should never be opened or torn, because then the risk of being drawn large areas of skin.

The first thing one should do when treating a burn is cooling. A well-known slogan is first water, the rest comes later. This is done with lukewarm water, so that the victim does not become hypothermic. Cool at least 10 minutes, fifteen minutes is better. Cooling after the first minute has not so much effect on the temperature of the tissue more - which is long since then cooled down to temperatures that are well below the harmful - but has a very marked effect on the felt by the patient, usually very severe pain. Stops one with cooling and thereby heats the tissue back on by blood flow then takes the pain increased again. Is there nothing else, use ditch water if necessary.

The burnt surface of the skin does not need to fire ointment, vaseline, butter or something like that are smeared, but it is loosely capped, preferably with metal line connection. This context contains a aluminum layer, so that it can not stick to the wound. If this is not available, one can use a clean napkin or a towel or dishcloth. Is a large surface area of ​​the burned skin then this can be covered with a clean cloth or cloth ironed.

Follow-up treatment
The further treatment is left to the doctor. Sometimes these exist (with second or third degree burns) from prescribing a cream containing silver sulfadiazine, partly to prevent skin infections. When intact blisters or 1st degree burns this means is pointless; it makes the wound more difficult assessable.

It may even be necessary to elsewhere removed from the patient by means of skin graft with skin off by too "planing" and to make a mesh bag so as to cover the thus burned areas and thereby possible to accelerate the healing process.

In all open burn wound infection can also occur, especially in poor care, but any longer existing burn in a short time colonized by bacteria. In case of burns are especially infections with Pseudomonas aeruginosa greatly feared, as these bacteria are often resistant to many antibiotics. In addition, often also the body's own bacteria involved in an infection. In developing countries also is the tetanus bacteria lurking.

When a burn more than 20% of the body surface area is affected, the chance of shock is especially large. The risk of shock is not only immediately after the combustion, but shock may take several hours or even days after the combustion still occur. As previously noted the occurrence of blisters is associated with fluid accumulation between the epidermis and dermis. This fluid consists of blood fluid (plasma) and is thus withdrawn from the circulating fluid in the bloodstream.

Shock may therefore in the first instance be combated by administration of moisture. Here one must go very cautiously because the victims often unconscious. In the hospital, one can provide for fluid administration by means of a drip.

In a patient with burns metabolism is often increased. The patient evaporates namely, a lot of moisture, because the protective function of the skin has disappeared. For the evaporation of moisture requires energy. Because the patient in addition to moisture, the body loses too much heat will do everything to keep warm. A patient with severe burns will thus have an increased respiration, because the body needs a lot of energy and heat. To make this process run smoothly is needed oxygen. A patient will therefore often have extra oxygen, usually with the aid of a non-rebreathing mask; thus all available oxygen is used.

Wound management and wound healing
An open wound is an ideal food source for bacteria that sooner or later penetrate each burn. Infection of the wound may result in bacteria through the circulatory system to reach the organs of the body. This is one of the most dangerous complications that threaten a patient with burns. This danger continues to exist, in general, until the wound closes spontaneously, or is closed by pieces of healthy skin. Therefore, the treatment of burns is aimed at closing the wound surface and the halting or inhibiting infections. An agent that can effectively help in the healing of burns caused by contact with aggressive chemicals is Diphoterine.

First- and second degree burns can heal spontaneously, ie without skin grafting. Third degree burns may receive a skin coating only again by ingrowth from the edges, which is a very slow process. Therefore, it is certainly the case of larger third degree burns usually chosen for skin grafting. Only my own skin of the patient can grow without being divested. However, this also means that the wound surface will be temporarily increased, as will be made elsewhere in the body wound with the removal of the pieces of skin in front of the transplant. These are generally removed by a device that makes so that any cuts in the piece of skin can be greatly stretched in a sort of check pattern, so that the donor site can remain much smaller than the through-covered defect.

In addition to the aforementioned shock is there some other complications that threaten the life of a patient with burns. Due to the poor blood supply to a number of organs during the shock period may include the kidneys be seriously damaged.

Through the application of heat or inhalation of toxic fumes respiratory organs can be severely damaged. Burning of the face keeps usually done in that the respiratory system. In the course can then inflammation of the trachea, windpipe branches or lung tissue occur.

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