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Burns can result from exposure to heat, chemicals, sunlight, electricity, or radiation, and can happen accidentally. When the skin is damaged by burns, it is crucial to seek treatment to prevent infection and scarring. Third-degree burns are the most serious type of burns and can be life-threatening.
The severity of a burn is determined by the depth of the burn and the amount of injured skin. There are several degrees of burns. First-degree burns are mild, mostly sunburns in which on the skin’s surface layer is affected. Second-degree burns affect the top and lower dermis. Third-degree burns are the most severe, which may injure nerve endings.
How burns are treated depends on how severe the damage is and where it is located. If the burn is small, like a sunburn or a small scald, it can typically be treated at home. However, if the burn is deep or covers a large area of the body, it requires immediate medical attention. In some cases, people may need to go to a specialized burn center and receive follow-up care that lasts several months.
Symptoms
The severity of burn symptoms varies according to the depth of the skin damage. Symptoms are frequently severe in the first few hours or days following a burn. For serious burns, it can take a day or two to appear.
- First-degree burn: A first-degree burn affects only the top layer of skin, causing redness and pain but no blistering.
- Second-degree burn: Second-degree burns are more severe and affect both the outer layer and the second layer of skin. They may cause blistering, swelling, and red or splotchy skin. Severe second-degree burns can result in scarring.
- Third-degree burn: Third-degree burns are the most severe and affect all three layers of the skin, including the fat layer underneath. The skin may appear black, brown, or white and have a leathery texture. Third-degree burns can destroy nerves, resulting in numbness.
If you have burns that cover sensitive areas of the body, such as the hands, feet, face, groin, buttocks, or major joints, or if you have burns that penetrate all layers of the skin or go deeper into the tissues, seek immediate medical attention. You should also seek emergency assistance if the burns cause the skin to look leathery, appear charred, or have patches of black, brown, or white. Burns caused by chemicals or electricity and difficulty breathing or burns to the airway also require immediate attention. While waiting for emergency help, provide first-aid measures.
If you encounter any of the following symptoms, it’s recommended to contact your doctor:
- Indications of infection, like discharge from the wound, intensified pain, redness, and inflammation.
- A burn or blister that is large in size or doesn’t recover within two weeks.
- Recently experienced and inexplicable symptoms.
- Noticeable scarring.
Causes
Burns can occur due to various reasons, including exposure to fire, hot liquids or steam, hot metal or glass, electrical currents, radiation like X-rays, sunlight or ultraviolet radiation from sources like tanning beds, chemicals such as strong acids, lye, paint thinner or gasoline, and in some cases, as a result of abuse.
Diagnosis
When seeking medical help for a burn, the doctor will examine the burned area to determine its severity. The evaluation process involves estimating the percentage of the body affected and the depth of the burn. The doctor may classify the burn as minor, moderate, or severe.
Minor burns are classified as first or second-degree burns that cover less than 10% of the body and do not typically require hospitalization. Moderate burns are second-degree burns that cover around 10% of the body, and burns on sensitive areas such as the hands, feet, face, or genitals can range from moderate to severe. Severe burns are classified as third-degree burns that cover more than 1% of the body.
During the medical assessment, the healthcare provider may also look for other injuries and recommend diagnostic tests like X-rays, laboratory analyses, or other procedures to assist in diagnosing and treating the burn.
Treatment
The treatment for burns is determined by the cause and the degree of the burn. Depending on the severity of the wounds, one must keep all burns clean and apply appropriate dressing. Some burns may be treated at home, but some may require hospitalization.
With adequate first aid and injury assessment, the treatment for severe burns may include medications, wound dressings, therapy, and surgery. Severe burns may necessitate care at specialized burn clinics. Patients may also require emotional support as well as months of follow-up care, such as physical therapy.
The majority of mild burns may be treated at home and often heal in a few of weeks. Generally, it is best to continue to inspect wounds for symptoms of infection and other long-term concerns, such as scarring and skin tightening over joints and muscles, making them difficult to move.
- Medical treatment: First-degree burns are often treated by running a cool water over the burn. Aloe vera gels may be used for sunburns. Using antibiotic cream and wrapping the burn with gauze may be done for thermal burns.
Several methods and medications may be advised to promote recovery from burn. These include:- Water-based treatments. To cleanse and activate wound tissue, procedures such as ultrasonic mist therapy may be performed.
- Fluids to prevent dehydration. Extra fluids are also given intravenously or through an IV to maintain blood pressure stable and prevent shock and dehydration.
- Pain and anxiety medications. Morphine and anti-anxiety drugs may be required, particularly during change of dressing which can be excruciatingly painful. Over-the-counter medication may be prescribed to manage pain.
- Burn creams and ointments. To destroy bacteria and prepare the wound for closure, the doctor may prescribe a stronger antibiotic cream containing silver, such as bacitracin and silver sulfadiazine.
- Dressings. The type of wound dressing to be used is determined by the severity of the wound. In most cases, if transferred to a burn center, it will be covered in dry gauze. Dressings help in preparing the wound for healing.
- Drugs that fight infection. Antibiotics administered intravenously may be required in cases of infection.
- Tetanus shot. Following a burn incident, tetanus vaccination may be advised.
- Physical and occupational therapy: In case the burnt area is extensive, particularly if it affects any joints, it might be necessary to undergo physical therapy exercises. Such exercises can assist in stretching the skin, which aids in maintaining joint flexibility. Additionally, certain exercises can enhance muscle strength and coordination. Occupational therapy can also be beneficial if an individual experiences difficulty while performing their regular daily activities.
- Surgical and other procedures: Deep third-degree burns that involve a big area of skin are extremely dangerous and can be fatal. One or more of the following methods may be necessary:
- Breathing assistance: A tube down the trachea or windpipe may be placed to retain oxygen in the lungs. This is done in cases where in the throat swells shut after the neck or face is burned.
- Feeding tube: A feeding tube may be inserted in the nose and into the stomach to aid patients’ nutritional needs. This is commonly used on individuals who have suffered serious burns or are malnourished.
- Easing blood flow around the wound: An eschar or burn scab that wraps entirely around the chest can make breathing difficult. It can also tighten and shut off blood supply. To ease the pressure, the doctor may need to cut the eschar.
- Skin grafts: Skin grafts substitute damaged tissue with healthy skin from another area of the person’s body that has not been affected. The area from which the skin graft is taken usually heals on its own. If the individual does not have enough skin available for a transplant at the time of damage, a temporary supply of graft can come from a deceased donor or a human-made (artificial) source, but these will need to be replaced by the person’s own skin eventually.
- Plastic surgery: Reconstructive surgery can improve the mobility of joints that have been scarred, as well as enhance the appearance of burn scars.
