Thermal burn - Causes, symptoms and treatment. MF.

Burns are a fairly common form of dermatitis, resulting from the direct action of high temperatures on the skin of a person. High temperatures that cause a burn can result from exposure to liquid, solid, and gaseous substances. Most often this flame, steam, hot bodies and hot liquids. To determine the tactics of managing the victim with burns in the first place, it is necessary to know the factor that caused the defeat.

Symptoms of burn

Symptoms of burns can be redness, bubbles and blisters with serous contents, erosive and ulcerous surfaces, as well as heavier damages in the form of necrosis( destruction, necrosis) of tissues. For proper and timely treatment, burns were divided into superficial and deep. To superficial burns carry burns 1, 2 and 3 and degrees. And to the deep 3b and 4degree.

The most mild burns, lesions of 1 degree, are characterized by the appearance of redness, a slight swelling and pain. Such burns often pass independently, without consequences, after 2-4 days. Recovering can manifest as exfoliation of damaged cells. Such burns most often occur as a result of insignificant effects of steam and liquids.

Symptoms of 1st degree burn

Second degree burns are manifested by the appearance of not only redness, but also bubbles of various sizes with serous contents. Since these lesions do not damage the growth layer, the restoration of the skin is completely possible in 1-2 weeks.

Symptoms of a burn of 2nd degree

The heaviest of superficial ones are burns of 3rd degree. Already all layers of the epidermis are affected, the bottom of the wound is represented by an intact part of the dermis and partially preserved follicles, sebaceous and sweat glands. Clinically, such burns are manifested by bubbles of various sizes with serous-hemorrhagic contents. Such damage is already brown or black. There is a danger of joining a secondary infection, as a result of which the bottom of the wound can go deeper before the defeat of deeper layers.

All deep burns( 3-b and 4-degree) are characterized by total damage to the dermis, and accordingly the death of the underlying tissues.

On the photo of the degree of burn: 3a, 3b, 4

Depending on the factor that caused the damage, burns have corresponding features. Damage from the flame most often causes burns of II degree, but has a significant area of ​​damage. Particles of burned tissues, left in the wound during treatment, subsequently lead to secondary infection of wounds. It must be remembered that with such forms of defeat, the first priority is to stop burning parts of clothing. This can be done by means of water or by covering a burning area with a dense fabric.

Fluids most often cause a small area of ​​damage, but deeper: II-III degree. When exposed to the skin of a red-hot object, a clear boundary of damage and a considerable depth are characteristic.

Treatment of burns

It is not enough to know the factor that caused the defeat and its depth in order to choose the treatment tactics and prognosis. It is also necessary to determine the area of ​​damage. Various methods are used for this. The most common are the "9" and "palm" rules.

When determining the area of ​​the lesion according to the rule "9", the adult body is divided into 11 equal zones, each of which is 9%( 1. head and neck, 2. chest, 3. stomach, 4-5.), 6-7 each arm, 8-9 each hip, 10-11 each shin and foot( together.) Perineum and external genitals - 1% of the body surface.

The rule of "palm" is to calculate the area of ​​the lesion as followsIn this case, it is considered that the human palm is about 1% of the area of ​​his body

Depth and area of ​​damageFirst of all, to determine the tactics of managing a patient with burns, for example, in the presence of superficial burns with an area of ​​more than 30%, the development of the body's reaction is natural, this is the so-called: burn disease, with the development of intoxication, infection and sepsis. These conditions require emergency medical measuresand self-treatment in such cases is not permissible. Since bubbles contain a large amount of serous content, there is a violation of the rheological properties of the blood. To assess the severity of the condition in the hospital, the acid-base equilibrium indexes must be evaluated.

First aid for burns

First aid for burns should primarily consist in stopping the effect of an irritating factor of elevated temperature on the skin. If there is only redness, the skin should be cooled under cold water for 15-20 minutes. Independently, an anti-burn medication from the home medicine kit "Olazol" can be applied. If there are skin lesions in the form of blisters, erosions, etc.it is urgent to seek specialized care. A qualified primary wound treatment should be done, with the application of antibacterial ointments. Bubbles are opened, the wound is disinfected and aseptic dressings are applied. If the wound is heavily contaminated, tetanus antitetanus is administered. Anesthetics are often given. In specialized preparations with extensive and deep lesions, numerous infusion solutions are introduced.

For local treatment, the following groups of drugs should be used: for disinfection and wound treatment, 3% hydrogen peroxide solution, potassium permanganate water solution, nitrofurans( furacillin, furagin), chlorhexidine, polymyxins, antibiotics( levomycetin and erythromycin) and antibacterial drugs(sulfanilamides).

For maximum effective treatment is necessary to comply with the regime, corresponding to the vastness and depth of the lesion. It is often recommended to limit the mobility of the damaged part of the body. In the diet of such a patient must be taken into account the loss of fluid and protein in the lesion.

After recovery, a protective regime of the skin affected by the damaging factor is necessary. It is necessary to protect such skin from excessive exposure to UV radiation, protecting it with special cosmetic products with an SPF factor of more than 50.

Treatment of burns with folk remedies

In the treatment of burns, the use of folk remedies is possible. With a slight effect on the skin, which is manifested by redness, bubbles and blisters, it is possible to use wet-drying dressings with herbal decoctions. The most suitable are: oak bark, chamomile, string, celandine, prepared according to the instructions for external use. In the decoction of herbs at room temperature, a gauze cloth is applied, folded into 6-8 layers and the damaged part of the skin is covered for 15 minutes. The procedure is repeated for one and a half hours, followed by a 3-hour rest from the procedures. Thus, wet-drying dressings during the day are performed 2-3 times, until the signs of acute inflammation disappear. At night, it is necessary to apply an antibacterial cream "Levomikol" under the napkin and a mesh bandage to the wound. It is not recommended to use decoctions of herbs if there are signs of infection of the wound. Signs of infection is the appearance in the blisters of hemorrhagic contents or just pus, as well as redness along the edges of the bladder. It is necessary to consult a specialist for the purpose of appropriate treatment.

The sufferer with burns needs an abundant drink( mineral water, fruit drinks, warm tea) to restore the balance of water in the body. With a large area of ​​damage, chills are possible. In this case, the victim must be protected. Inside will need non-steroidal anti-inflammatory drugs with the purpose of antipyretic and analgesic effect. You can use Analgin, Efferalgan in therapeutic dosages.

With redness of the skin, it is possible to use moisturizing creams from numerous dermatological lines, such as "Urjazh" - "Kzemoz", "Aven" - "Trikzera", up to 5-6 times a day, especially after contact with water. Care for the skin exposed to the irritant should be very gentle. When washing, use should be made of products that do not damage the hydro-lipid mantle of the skin. To do this, special gels and soaps from the "Bioderma" and "Uriyazh" series are purchased in the pharmacy network: "Cu-Zn" or "H2O-Sensei".

Doctor's consultation on the burn:

1. Is it true that the burn doctor should be engaged in a doctor-konbustiolog.
Yes, indeed there is such a specialist who deals only with burns, and all aspects associated with them. In his competence, there is often a combination of a large area and the depth of the lesion, as well as the appearance of the body's reaction to the burn surface. Treatment of superficial burns is successfully conducted by a dermatologist.

2. Is it possible to lubricate a fresh burn with oily ointments or fat-containing products, such as sour cream or vegetable oil?
No. Such behavior will aggravate the severity of the lesion and there will be a need for an additional cleansing of the wound, now from the oil.

3. It is known that during the Middle Ages torture was used with hot iron. Why did the subjects die from such a strong impact?
Yes, the incandescent object caused deep burns, but the area of ​​damage was not large, the systemic reaction of the organism, usually did not develop.

4. Can I apply to a damaged ice surface when burned?
Not possible, becausethis can be caused by frostbite, which will contribute to additional damage to cells and tissues.

5. Is it possible to apply leaves of various plants, such as aloe, calanchoe, golden mustache and others, to the wound from a burn?
No. When processing such a wound, the removal of plant debris will lead to additional traumatization of the wound.

6. Is it true that taking vitamins can speed up the healing of burned skin?
Yes. When healing the burn surface with the formation of scar tissue increases the formation of collagen - the main protein of fibrous tissue. This increases the body's need for vitamin C. The burn causes considerable physical and emotional stress for the body, which increases the body's need for vitamins of the B group.

Dermatologist Tatyana Kuklina