Thermal burn is one of the most common damages. It can be obtained by contact with fire, steam, water. With a dangerous degree of injury, high-quality first aid plays a significant role, since in the future even human life can depend on it. How to treat a thermal burn, and what features does it have? It would be superfluous to find out how to provide first aid for thermal burns.
Features of the ailment
Both men and women are more likely to get injured, although weaker sex is more at risk. This risk is usually associated with food preparation on unsafe kitchen stoves or open fire. Men, more often than women, can get eye burns. Thermal burn is not the last place in the list of traumatizing children.
- The likelihood of complications in children is very high with 5% of the body affected, as in older patients.
- In adults, complications can be discussed provided that about 20% of the body is affected, but if the burns are deep, 10% is enough to cause internal organs dysfunction.
- In pregnancy, such a lesion can be dangerous for the child himself, so even a small degree of burn is best treated under the supervision of a doctor.
Thermal burn( photo)
Thermal burn is divided into the following degrees:
- I degree. Surface lesions are not dangerous. As a rule, already on day 3, the affected epidermis is sloughed and the healthy layer is restored.
- II degree. Defeat affects partially the dermis, so the recovery process stretches to 12-14 days. Blood circulation is maintained at a normal level, and after epithelialization, sensitivity is also returned. Purulent lesion develops extremely rarely. Thanks to this, even independent healing is possible.
- IIIa stage extends to more extensive areas, accompanied by exudation, necrosis of tissue, the appearance of a large number of blisters. The dead epidermis thus becomes grayish or brown in color.
- IIIb stage is characterized by the appearance of a scab, and after it appears suppuration. With competent therapy, along with the release of pus, rejection of dead particles occurs. Then the degree completes the granulation and scarring. Epithelialization is also possible, but healthy tissue grows at the edges of the wound no more than 2 cm.
- IV degree is the most dangerous. The scab is black, sometimes reaching to charring. Under the influence of compression of the limb, the course of necrosis is often aggravated. Pain with this form of injury is not present.
What this thermal burn will tell this video:
Reasons for occurrence of
- The cause of a thermal burn is often an open flame, which occurs in 85% of cases.
- About 7% of injuries are caused by liquid or steam.
- Another 6% are burns caused by electricity.
- The remaining percentages of injuries occur when exposed to light, hot objects, rays, etc.
Symptoms of thermal burns
Manifestations are entirely dependent on the stage of burns.
- When I degree of the disease there are such symptoms as:
- peeling( in the last stages).
- At the II degree of , bubbles develop, which inside have a yellowish liquid. There are no additional changes on the skin, although scars are sometimes formed, whereas after the first degree of lesion, they hardly ever occur. Pain syndrome is very pronounced.
- Stage III of burn disease is characterized by the development of necrosis of different severity, which can be wet or dry. The affected tissue itself can have a yellow hue, blisters more obvious. Scars form extensive, obvious, but with a small localization of the injury, epithelialization may occur.
- Some still allocate IV stage , while others are more accustomed to allocate IIIb stage. Symptoms are very obvious. In addition to severe pain, there is extensive necrosis, often deep, affecting even bones, muscles, tendons. Skin is both brown and black due to charring.
The burn itself is quite bright, so its diagnosis is not difficult. Much more important is differential diagnosis between forms of injury, since it is of fundamental importance in the selection of treatment.
The depth of the burn is determined by the scab, in which thrombosed vessels can be seen. Diagnostics is assisted by infrared thermography. In the study, the deepest lesion is highlighted by cold colors. It is only possible to reveal the depth only 7 days after the injury.
The lesion area is measured, as this is also important for the installation of the stage and subsequent therapy. Here the doctor must make calculations, taking as a basis the individual data of the victim.
For treatment of thermal burns in stationary and home conditions read below.
A number of physiotherapeutic measures are used for better healing:
- baths with detergents,
- laser irradiation.
Treatment is also carried out on special anti-burn beds. It is very important in the therapy of such lesions often to change dressings in order to ensure proper antiseptic effect on the affected area.
- Cryotherapy with liquid nitrogen is suitable at the first stage of the injury. Timely cooling allows to prevent a lot of complications, will make the site of necrosis less extensive and deep, and also as a whole will reduce the intoxication of the organism.
- Use a wide range of anti-inflammatory drugs and ointments that promote skin regeneration. In winter, it is better to hide even small burns after bandages, lubricating them with creams or ointment Vishnevsky, Propolis or Furacilin ointment. With the 2 form of the disease, it is also good to use anti-inflammatory sprays that create a film surface on the skin that protects against bacteria.
- At 3 degrees of burn, physiotherapy is also used. So, UV-irradiation and CC-irradiation help to improve regeneration, and if suppuration occurs, they contribute to a better separation of pus.
Next we'll talk about the treatment of thermal burns 1, 2, 3, 4 degrees.
The video below examines the first pre-medical and medical care for a victim with a thermal or chemical skin burn:
Primary treatment of burns is always performed with medication.
- If the surface is very dirty, additional cleaning and opening up of large bubbles may be required. In primary care, the main task is to prevent the development of shock, so together with the cooling of the damaged area, an anesthetic injection is made. The application of a sterile dressing is mandatory, otherwise there is a risk of infection.
- The injection against tetanus is mandatory for burns. Further treatment depends on the degree of damage. At the first form there is enough regular disinfection, for a while you can apply glucocorticosteroids in the form of a spray to improve healing.
- Second-degree burns do not always need to be bandaged. So, if the purulent contents do not separate, in general, the recovery is normal, then the permanent wearing of a sterile dressing is not necessary. In other cases, they are applied to prevent the occurrence of a secondary infection and, as a consequence, dangerous complications. If the healing proceeds slowly, a course of injections of anabolic steroids or glucocorticosteroids is carried out.
- At 2 degrees of injury, full recovery may occur after 12 days. Of these, for 6-8 days, the superimposed primary bandage is not removed. Before this period, it is replaced only in case of development of suppuration. With this outcome, the treatment period is prolonged.
- 3 the degree of burns is characterized by necrosis of the dermis, so at these stages festering develops much more often. Therapy should be aimed not only at preventing infection, but also at preventing the deepening of trauma. A large role is played by frequent dressings, while antibiotics or antiseptic agents are applied to the bandages themselves. As soon as the exudate begins to separate in a smaller volume, the dressings should be soaked with ointments. The following are the best:
- Synthomycin ointment.
- Furacilin ointment.
- Propolis ointment.
- Dioxydin Ointment.
All these medicines kill the pathogenic microflora, which contribute to healing, anesthetize and soften the skin. Of the medicines used:
- cardiac glycosides.
Anesthesia is carried out with solutions of analgin, droperidol and promedol, and in severe pain syndrome, the use of morphine is indicated. Drug therapy may include a variety of techniques, but each of them is selected by the doctor individually. So, some patients may require a blood transfusion, for others it will be more important to conduct hemodialysis, lymphosorption or hemosorption.
This treatment method is used only in extreme cases, taking into account the depth, degree of burn, age of the patient. A number of individual data is also important for the selection of the type of surgical intervention.
- If the lesion is deep, it is most rational to excise the areas with necrotic tissue, and then put the stitches.
- Replace this approach with sometimes combined or primary free plastics. Usually this happens when you can not connect the edges of wounds. Excision is advisable to be carried out a few days after the injury. Early surgery is also necessary for osteonecrosis to prevent sequestration.
- Necrectomy done on the 4th-10th day after the lesion remains one of the best methods of surgical intervention for burns. By this time, the condition stabilizes even patients with extensive lesions, and in the place of deep trauma there is a clear boundary.
- Emergency necrectomy is performed in cases where there is a threat of disturbed blood flow in deep tissues or a sudden stop of breathing. The doctor may perform a partial intervention to eliminate risks or perform a full-fledged operation if the patient takes it well.
Skin plastic in the early stages of a burn helps to prevent several dangerous consequences:
- tissue infection;
- prevention of intoxication;
- cessation of burn progression;
- improved healing.
Not always early skin plasty can give such a vast effect, so often such an intervention is planned at a later date. Such an operation is called secondary cutaneous plasty and is used in cases where the burn occupies not less than 10% of the body surface. At the outset, often perform necrectomy, and sometimes preoperative preparation is to remove the scab of the burn. For a week, lactic acid, benzoic ointment or salicylic ointment( 40%) is used for this. With the help of procedures with these funds, the preoperative period is significantly reduced.
Vast nekrektomiyu can combine with dermal plasty, but such intervention necessarily turns into a patient aggravation of the condition, significant blood loss, especially if not all tissues have taken root. That is why this combination of two types of operations is used very rarely.
Skin plastic with dermatome is good because it can be done in one step. Multiple-step intervention of this type is performed only when the patient is weakened or a large number of tissues are affected. In such cases, repeated plastic surgery is performed at intervals of up to 7 days. For one procedure, close up to 10% of the body with transplants.
This technique is the introduction into the body of various solutions for replenishment of lost fluid. With its timely application and competent approach, therapy significantly improves the prognosis and effectiveness of surgical intervention.
Intensive infusion-transfusion therapy is performed when 10% of the dermis is affected. The program of infusions is made by a doctor. So, it often requires replenishment of the volume of erythrocytes and proteins, electrolytes. Introduce vitamins C and Group B together with glucose to restore the water balance, and a number of other medical formulations that depend on the nature of the burn injury.
About treatment in the home of a thermal burn will tell this video:
Preventive measures are aimed to prevent the development of complications.
- A whole complex of measures is aimed only at preventing the development of renal, cardiac, and hepatic insufficiency.
- In addition, preventive maintenance of suppuration of wounds is carried out. For this purpose, they are not only constantly irrigated with antiseptic compounds, but also physiotherapy.
To frequent complications of burns it is customary to refer:
- Sepsis .Characteristic for people who have 20% of deep burns. Under the influence of moist necrosis and a decrease in natural immunity, there is a risk of even early sepsis, which is characterized by a very severe course. The condition is accompanied by paresis of the gastrointestinal tract, deficiency of kidney function, toxic hepatitis. The risk of death is very high on condition of the development of pulmonary edema, pulmonary and cardiac failure.
- Pneumonia .It often happens with extensive and profound lesions. This complication also poses a serious threat to life, as it accompanies almost every case of the second and third periods of burn disease.
- Toxic hepatitis .Any form of hepatitis has a bad effect on the condition of the burned, but it is the toxic form that is dangerous.
- Burning depletion of is manifested if the treatment measures for a couple of months do not give proper results, and the degree of tissue healing remains low enough. Dystrophic changes occur in almost all systems and organs, in the wounds the healing processes cease, the immunity and exchange processes deteriorate strongly. Burns exhaustion is accompanied by a number of symptoms, signaling the violation of internal organs, severe weight loss, osteoporosis, the formation of bedsores.
- Vascular thrombosis.
- The development of a number of infectious complications( gangrene, phlebothrombosis, abscess, endomyocarditis, pyelonephritis, meningoencephalitis, etc.).
After a burn injury for several more years, violations of the activity of the most important organs can persist. The average period of such phenomena is 2-4 years. In addition, in later stages, complications such as eczema, scars, nephritis, dermatitis, trophic ulcer, skin cancer can appear. Some processes become chronic( eg, pyelonephritis, hepatitis).All complications always depend on the extent of the lesion.
Sometimes the consequences of burns are so serious that they lead to serious violations in the work of internal organs and even threaten life. In some cases, the burn passes almost without a trace. Affects the prognosis not only the extent of the lesion and its stage, but also the quality of the treatment.
- The age of the victim is very important. For example, in elderly patients the prognosis is somewhat worse in this respect, which is also related to worsening of healing processes occurring at this age.
- The third and second degree burns are considered life threatening if the surface of the body is affected by two thirds.
- To no less critical conditions include situations where at least 10% of the skin of the perineum, face, genitals, and 15% of the lesions of the limbs are affected.
The prognosis will depend on the breadth and depth of penetration into the burn tissue. A lot of contribute to the selection of a suitable course of therapy and take into account the further forecast of specialized techniques( for example, "Index Franc", "Rule of the hundreds").They have developed suitable classification of lesions and possible consequences.