Thermal burns 1, 2, 3 and 4 degrees, what to do?
Content:
- What is thermal burn?
- Thermal burns
- First aid for thermal burns
- Thermal burn treatment
- Thermal burn prognosis
What is thermal burn?
A thermal burn is a burn that is caused by contact with a liquid, solid or gaseous heat source. Such a source of heat can be hot bodies, flames, steam, hot liquids. The first place in statistics is occupied by flame burns (about 84% of all thermal burns), followed by burns with liquid substances and electric burns (about 7% for each type). In 2% of victims, burns were provoked by the influence of other factors.
Several layers of skin at once can damage a thermal burn: epidermis (outer layer), dermis, subcutaneous tissues. There are four degrees of thermal burns, depending on the number of damaged layers. Often, a burn includes all of these degrees at the same time. Many doctors, describing burns, classify them according to the depth of damage: superficial, partial, complete.
The severity of the burn depends on the area of the affected tissue. It is expressed as a percentage relative to the area of the entire surface of the skin. When roughly estimating the burn, the so-called “palm rule” is used: the area of the human palm is equal to one percent of the body area.
Thermal burns
It is customary to distinguish four degrees of burns, depending on the depth and severity of the lesion. Burns of the 1st and 2nd degree are considered to be superficial, 3rd and 4th - deep.
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Thermal burn of the 1st degree. The affected area swells, turns red. A person is worried about pain, burning, especially acutely felt when touched. The temperature of the skin in the affected area rises. The listed symptoms last 2, sometimes 3 days, gradually disappearing. The place of the burn disturbs the victim for some time, the epidermis begins to peel off on it. Gradually (after 3-5 days), the injured area looks practically healthy.
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Thermal burn of the II degree. Such a burn appears as a result of prolonged or sudden exposure to high temperatures. There is also redness and swelling of the tissues, but bubbles are also formed. They are filled with tissue fluid sweating from dilated skin vessels. Later, the contents of the blisters, due to protein coagulation, turn from a transparent mass into a jelly-like mass containing leukocytes. The tissue fluid and the skin of the blisters themselves protect the tissues under the lesion from injury and infection, for this reason, the blisters cannot be opened.
Patients with a 2nd degree burn usually suffer from severe pain. But after a few days, tissue irritation and circulatory disorders begin to decrease, the liquid is gradually absorbed. At the bottom of the bubbles, epidermal cells are actively dividing, and a week later a new stratum corneum begins to appear.
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Thermal burn of the III degree. It occurs with prolonged exposure to high temperatures. It is characterized by skin necrosis - tissue necrosis that can be dry or moist. When exposed to steam or boiling water, wet necrosis usually occurs. The skin becomes swollen, pasty, acquires a yellowish tint, and may become covered with blisters.
This inflammation is similar to the melting of dead tissue. When the necrosis is dry, the skin, respectively, is also dry, dense, dark brown or black. The edges of the dead tissue area are clearly visible. Healing of burns of this degree takes place by scarring. However, when at least small areas of the epithelial growth layer are preserved, epithelialization is not excluded.
- Thermal burn of IV degree. This is, without exaggeration, the worst degree of burns. These burns often cover a large area. All layers of the skin and even tissues outside of it die: subcutaneous fat, tendons, muscles, bones. Several large blisters often merge into one huge; the color of the skin becomes dark red, reaching black. Such injuries threaten not only health, but also human life.
Burns of III and IV degrees, of course, are more dangerous, but superficial burns can also be fatal if they cover more than a third of the body surface.
First aid for thermal burns
First aid includes the following steps:
- The first thing to do as quickly as possible is to extinguish the flame (if any) on the victim's clothing and skin. It is necessary to throw off burning clothes from a person or throw a cloth over his body in order to stop the access of air to the fire. A burning area of clothing can be thrown with earth, sand, snow, and doused with water.
- Try to calm down the victim and the people around him.
- Carefully remove the smoldering remains of things that did not get into the wound from the injured person. Never rip off clothing stuck to the burn. Also, you can not touch the burnt body with your hands.
- If it is a sunburn, you need to transfer the affected person to the shade.
- If you do not have information about what happened, quickly clarify the circumstances of the accident ("the child knocked over a bowl of hot broth", "clothes caught fire from the fire," etc.).
- Hold the affected part of the body for 10-20 minutes under a stream of cold running water (you can lower it into a container with cool clean water). This must be done so that the heated wound does not deepen and expand. In addition, it activates blood circulation in the wound. However, ice cannot be used to cool the burned area in order to avoid the likelihood of another injury - frostbite. In extreme cases (if there is no water nearby), cooling the wound with urine is allowed, however, in practice, there is almost never a reason to use this method.
- Apply any available anti-burn agent to the affected surface, apply a sterile (if possible) dry dressing on top. You can not use cotton, only gauze, bandage - fabric materials. It happens that there is no anti-burn agent or sterile bandages at hand, then any dry, clean bandage should be applied to the wound. You can not apply any folk remedies to the burn: vegetable oil, vodka solutions, kefir, sour cream, etc. You can also not apply Kalanchoe or aloe leaves and other "miracle remedies" to the burned skin. In case of a burn of the 1st degree (if there is no extensive damage to the skin or blisters), the bandage can not be applied at all, only an anti-burn spray can be applied.
- If there are extensive burns to the extremities, it is necessary to carefully fix them with a splint (any available means), lifting the burned arms (legs).
- If a large area of the body is burned and there are signs of burn shock (a person is weak, pale, he has increased anxiety, there is tachycardia and a drop in pressure, cold sweat appears, breathing and heart rhythm are disturbed), you should give him as much liquid as possible for drinking - juice, compote or plain clean water. Due to the intake of fluid into the body, intoxication caused by the penetration of decay products of burnt tissues into the blood will decrease.
- If the victim complains of pain, then in order to avoid pain shock, you should give him any available anesthetic (spazmalgon, analgin, etc.).
- In the absence of cardiac and (or) respiratory activity in a person, cardiopulmonary resuscitation (artificial respiration, indirect heart massage) should be performed.
- In case of severe burns, call an ambulance for hospitalization of the victim, or independently deliver him to a specialized medical institution. It is preferable to use the services of an ambulance, since not everyone can say with certainty in which hospital or in which department burns are treated. It's good when it's a specialized clinic or at least a specialized department.
Related article: Providing first aid for burns, both medical and pre-medical
Thermal burn treatment
Treatment of thermal burns involves the use of various means.
It can be creams and ointments, gels and sprays, or special dressings impregnated with a medicinal composition:
- Often, antibacterial and wound-healing ointment Levomekol is used to treat burns. The use of this tool allows you to achieve an analgesic effect. Levomekol can be applied from the first day after getting a burn.
- Povidone-Iodine ointment is aimed at accelerating tissue regeneration, and also prevents infection from penetrating deep into the wound. This is possible thanks to the iodine, which is part of the ointment, which acts as an antibacterial component.
- If a person prefers to use products based on natural ingredients, then you should opt for the Rescuer balm. It contains no synthetic antibiotics or hormones. Applying the balm to the burn will allow damaged tissue to heal as soon as possible.
- To prevent the wound from becoming infected, and also to heal faster, you can combine several drugs at once. So, in the complex, Levomekol ointment and Panthenol ointment (or PanthenolSpray) are often used.
- In addition to ointments, a cream can be applied to the burn. Creams are recommended to start using during the recovery of damaged tissues. They prevent scarring and scar formation. So, when getting sunburn, it is good to use Panthenol cream-foam. If you compare it to an ointment, the effects will be similar, but the light texture of the foam penetrates the tissues faster.
- A burn is always painful. Often, even the application of medicines is accompanied by painful sensations. In this case, experts recommend using sprays. The method of their application is reduced to non-contact spraying on the affected surface, which provides minimal discomfort during treatment.
- Also on sale you can find anti-burn dressings that are impregnated with medicinal solutions. They can relieve pain, speed up healing, and disinfect affected tissues.
- For the treatment of thermal burns, gels are often used, for example, Appolo and Burns net. They are suitable for primary wound care, as they have an antiseptic effect. Also, these gels provide an opportunity to relieve pain and speed up healing. Therefore, they can be used at any stage of treatment. Studies show that the use of gels allows you to quickly cleanse the wound from dead tissue and prevent inflammation, which is the best prevention of further scar and scar formation.
Related Articles: Home Remedies for Burns, Remedies for Sunburn
If you are severely burned, what should you do?
Of course, you need to see a doctor or, in extreme cases, call an ambulance. In a specialized clinic (specialized department), under anesthesia, the primary gentle treatment of wounds and skin surrounding them is carried out with gauze napkins dipped in warm soapy water or 0.5% solution of ammonia. After that, the burn surface is gently washed with warm water or alcohol (40-70 degrees), dried and irrigated with antiseptic solutions.
Very dirty areas of the burn are cleaned with 3% hydrogen peroxide solution. From superficial burns with tweezers or scissors, particles of the epidermis are removed. Small blisters are not opened, but large detached blisters are incised at the base and then emptied by lightly pressing on them with a gauze pad. For burns with resins, bitumen, refined gasoline is used.
With an open method of treatment, a thin layer of a special ointment or other synthetic (biological) coating is applied to the surface of the wound. With a closed method of treatment, a bandage is applied to the burn with a special ointment (syntomycin, streptomycin) or an emulsion (for example, sulfidine). Vishnevsky's anti-burn oil-balsamic emulsion is also effective. Such dressings do not interfere with the healing of the burn, do not cause pain when changing, and provide high-quality protection of the wound from infection. The bandage is carefully bandaged, lightly pressing on the fabric. It should not move; with a successful course of the disease, the bandage is not removed until 7-9 days. This period is enough for the burn surface to epithelize.
If the limbs are burned, immobilization is required, i.e. temporary immobilization. Any position is chosen that is convenient for the victim. In order to avoid the negative consequences of immobilization, immobilization must be suspended every 2-3 days in order to make movements in the joints.
There is no single correct opinion about what to do with burn blisters. Some doctors quickly remove them, explaining that their internal contents are not sterile, other doctors release liquid from the blisters, but they do not remove the blisters themselves.
To restore the body of an injured person who has received a grade IV burn, prompt competent treatment and skin grafting are required.
Thermal burn prognosis
Pathophysiological changes that inevitably develop in the body affected by the burn, provoke violations of the vital systems of the body and even threaten human life. The prognosis largely depends on the area of the lesion, the degree of damage and the age of the victim. Mortality from burns is high in the elderly over 60 years old and children under 3 years old. However, even for patients of this age, burns cannot be considered a sentence.
The critical condition is considered to be 100% - a total burn of the I degree, and burns of the II-III degree with damage to more than a third of the body surface. Burns of III and IY degree are life-threatening, where the genitals, face, perineum (if they hit 10% of the body surface), and burns of the trunk and limbs, if the affected area is more than 15%. For more accurate forecasts of burns, special methods have been developed - the "Rule of a Hundred", "Frank Index", which take into account the depth, the extent of the affected area and the age of the victim.
You need to know: if the thermal effect on the skin lasts longer than 1 minute and exceeds 45 ° C, this inevitably leads to overheating of cells and their death due to inactivation of enzymes, protein denaturation, paralysis of tissue respiration and other metabolic disorders. After the termination of thermal exposure, hyperthermia in the tissues does not stop, but continues and even intensifies!
The author of the article: Volkov Dmitry Sergeevich | c. m. n. surgeon, phlebologist
Education: Moscow State University of Medicine and Dentistry (1996). In 2003 he received a diploma from the Educational and Scientific Medical Center of the Presidential Administration of the Russian Federation.
