Burns - Definition
Burns can range from minor problems to life-threatening medical emergencies. Electricity and chemicals are known as the primary causes of burns. In children, scalding hot liquids are the most common cause of burns.
Minor scalds and sunburns usually do not need to be treated by a physician and can be cared for at home, but causes of burns that are deep or widespread need immediate medical treatment. Severe burns often require treatment at a specialized burn treatment center. Sometimes skin grafts may be needed to cover large burn areas.
In most cases, the initial treatment of a burn includes flooding the area with cool water. Applying ice is not recommended because the damaged tissue can be further injured by extremely cold temperature.
When severely burned tissue heals, scar tissue forms and the nerves may be affected, leading to innervation. This may cause abnormal sensations in the affected area, such as numbness or tingling.
There are many sorts of burns.
- Heat burns: (thermal burns) are caused by flame, steam, hot items, or hot fluids. Since burns from hot fluids are the most widely recognized burns to kids and more established grown-ups.
- Cold temperature burns: are caused by skin exposure to wet, blustery, or icy conditions.
- Electrical burns: are caused by contact with electrical sources or by lightning.
- Chemical burns: are caused by contact with household or mechanical chemicals in a solid, liquid, or gas form.
- Radiation burns: are caused by the sun, tanning corners, sunlamps, X-beams, or radiation treatment for disease treatment.
- Rubbing or friction burns: are caused by contact with any hard surface, for example, streets ("street rash"), rugs, or exercise center floor surfaces. They are normally both a scrape (abrasion) and a heat burn.
Causes of Burns
Some of the common causes of burns include:
- Radiation or radiation therapy
- The sun or ultraviolet light in a tanning bed or sunlamp
- Chemicals, like lye, gasoline or strong acids
- Hot metal or other objects like glass
- Hot steam or liquids
Burns that are deep or extensive can lead to complications. Some of these complications may include:
- Infection: The skin is the body's first line of defense. Burns remove that protection, leaving the skin vulnerable to infection and an increased risk of systemic infection. Sepsis is a life-threatening infection that affects the entire body. It progresses quickly and can cause organ failure and death.
- Low blood volume (hypovolemia): When deep causes of burns occur, blood vessels are damaged and the body's fluids are lost. When too much fluid is lost, a condition known as hypovolemia occurs. Without enough fluids and blood, the heart cannot pump effectively.
- Low body temperature (hypothermia): One function of the skin is to help control the temperature of the body. If a large section of the skin is burned, body heat is lost and the body cools faster than it can warm. A dangerous condition known as hypothermia results if the body temperature falls too low.
- Breathing problems: If causes of burns were fire, smoke may have been inhaled and airways may have been burned as well as the skin and outer tissues. The breathing in of smoke causes lung damage and can lead to respiratory failure.
- Scars: Keloids are areas of excessive scarring caused by an overgrowth of tissue. Burns often cause scars and result in the formation of keloids.
- Bone and joint problems: Scar tissue can be very tight and stiff and if it forms over joints, it can make it difficult to move the bones. Eventually, the tendons or muscles shorten and this can cause a permanent shortening, known as contractures. Contractures lead to loss of mobility and function.
Signs and Symptoms of Burns
Taking in hot air or gasses can harm your lungs (internal breath wounds). Taking in dangerous gasses, for example, carbon monoxide can be very harmful. Burns harm the skin layers and can likewise harm different parts of the body, for example, muscles, veins, nerves, lungs, and eyes. Signs and symptoms of burns are characterized as first, second, third, or fourth-degree, contingent upon the number of layers of skin and tissue are burnt and affected. The more severe the burn and the bigger the burnt region, the more critical the burn is.
A single burn can result in varying depths of injury because the skin is not uniformly affected. Determining the degree of injury distinguishes a minor burn from a more serious burn injury. There are four burn classifications:
- First-degree burn: These signs and symptoms of burns are minor and only the very outer surface of the skin, the epidermis, is affected. The skin is reddened and painful in a first-degree burn and these usually heal without extensive treatment in a few days to one week. An example of a first-degree burn is a sunburn that doesn't blister.
- Second-degree burn: When the dermis, which is the second layer of skin, is affected as well as the top layer, a second-degree burn has occurred. These are red and painful. They are also swollen and appear moist or wet due to blisters. These signs and symptoms of burns may cause scarring of the skin.
- Third-degree burn: If a burn reaches the layer of fat below the dermis layer of the skin, it is a third-degree burn. Skin that sustains a burn of this depth may be numb because the nerves can be destroyed. The tissue in third-degree signs and symptoms of burns often looks like white wax or it may appear tan or leathery.
- Fourth-degree burn: These are the most severe signs and symptoms of burns and they involve all layers of the skin as well as the muscles and bone. The skin is charred or blackened. If damage to the nerves is significant, there may be no pain.
When to see a doctor
Minor, first-degree and some second-degree signs and symptoms of burns may be safe to be cared for at home, but you should see your doctor if:
- You have a burn of any degree that doesn't heal for several weeks
- You have increased redness, drainage, swelling or pain in a burn
- Symptoms that are new or unexplained develop
Get emergency medical care right away for:
- Electrical or chemical burns
- Third- or fourth-degree burns
- Burns that cover the feet or hands, face, buttocks, groin or any major joint
- Burns that involve the airway or if there is any trouble breathing
When you are seen by a doctor for a burn, you will be examined to see what percentage of your body has been involved. In general, an area approximately the size of the palm of your hand is equal to 1% of your total body surface area, or TBSA.
Your doctor will also examine you to see if you have other injuries associated with your burn and to determine if any other part of your body has been affected. Depending on how severe the burn is, and the circumstances that caused the burn, the doctor may recommend other diagnostic tests such as X-rays or laboratory tests.
Your specialist will analyze your burnt skin and figure out what level of your total body surface territory is included during a physical exam. When the physical examination is done, a region of skin generally equivalent to the measure of your palm breaks even with 1 percent of your total body surface range. For individuals, ages 10 to 40, the American Burn Association characterizes an extreme burn as one that includes 25% of the individual's body surface territory or any burn including the eyes, ears, confront, hands, feet or crotch.
You'll additionally be analyzed for different wounds and to decide if the burn has influenced whatever is left of your body. You may require lab tests, X-rays or other symptomatic systems.
Burns are arranged in view of the profundity and degree of skin harm, level of torment, and swelling:
- Partial Thickness Burns: First–degree burns influence just the external skin layer (epidermis) and are described by redness or staining, swelling, and pain. Overexposure to the sun is a typical reason. Wounds recuperate in three to six days.
- Second– degree burns: influence the epidermis and different bits of the lower skin layer (dermis), causing a red appearance and rankles. The liquid is lost through the harmed skin, and the signs and symptoms of burns are agonizing and delicate. These wounds expect one to three weeks or more to recuperate. Scarring is exceptional, yet there can be long-term skin shading changes, albeit most shading changes blur after some time.
- Full Thickness Burns: Burns that infiltrate past the epidermis and dermis may affect fat (third-degree burn), and muscle, ligament, and bone (fourth–degree burn). Signs and symptoms of burns may have a scorched appearance and contain white, dark-colored, or dark patches.
Treatment for Burns
First-degree and second-degree burns that are not extensive can usually be treated at home with over-the-counter (OTC) products like aloe. It usually takes no more than a few days to a few weeks for minor burns to heal.
If you have burns on your feet, hands, face or in your groin area, if an extensive area of your body has been burned, if the burns are deeper than second-degree, or are very painful, you need emergency treatment for burns.
Depending on how severe burns are, treatment for burns may include:
- A tetanus shot: To prevent tetanus, your physician may recommend you receive a tetanus shot
- Intravenous (IV) fluids: To prevent dehydration and keep your body organs functioning, you may be given fluids slowly and continually through a vein (intravenously)
- Antibiotics: If an infection develops, antibiotic therapy may be needed
- Medicated ointments: These may be applied to help burns heal, to relieve pain and to help prevent infection
- Pain medication: Burns can be extremely painful. Sometimes narcotics are required, especially while the burns are being treated. Anti-anxiety drugs are also sometimes helpful
Physical therapy is often needed, especially if the burn is extensive and involves a joint. Exercise can help stretch the tissues and the skin so the joints don't stiffen and cause permanent immobility. Exercise can also help preserve the strength of the muscles and improve coordination.
Surgical and other procedures
Some patients who have severe burns require other procedures or treatment for burns. These may involve:
- Help with breathing: If burns involve the neck or face, the throat may swell, making breathing difficult. In that case, a tube may be inserted into the trachea (windpipe) to keep the lungs supplied with oxygen and serve as a treatment for burns.
- Tube feeding: When burns occur, the body needs extra energy to heal. To make sure these energy requirements are met, a feeding tube may be inserted into the stomach through the nose or directly through the wall of the abdomen to administer nutrition in the form of tube feedings. This is the usual treatment for burns.
- Decompression: Thick burned tissue called eschar sometimes forms completely around the diameter of the chest, making it hard to breathe, or around an extremity, impairing the blood flow. The eschar may need to be cut in several areas as a treatment for burns to relieve pressure and restore circulation.
- Skin grafts: Very thin sections of healthy tissue from other places on your body are sometimes removed and used to replace tissue that has been damaged by burns. The tissue of cadavers or pigs can sometimes also be used as temporary skin grafts and serve as the treatment for burns.
- Reconstruction: Some surgeons specialize in improving the look of skin that has been damaged by burns. Reconstructive surgery can also help improve the mobility of joints that have been affected by scar tissue.
To reduce the risk of burns around the house:
- Change the batteries in your smoke detectors twice a year and check them monthly
- Keep matches, lighters, and chemicals away from children to prevent burns
- Never leave your stove or oven unattended when cooking or baking
- Keep hot liquids away from children and pets to prevent burns
- Turn the handles of pots and pans toward the back of the stove or cooktop
- Never use the stove when you're wearing loose-fitting clothing
- Never leave space heaters unattended, and keep them away from drapes, linens, and furniture
- Keep your water heater temperature between 120 F and 130 F to prevent scalding burns
- Use oven mitts that cover your wrists and your hands
The first aid treatment for burns and second-degree burns that are small involves taking the following steps:
- Cool the burn: Flood or submerge the area of the burn with cool clean water for 20-30 minutes. Do not apply ice or ice water. Applying ice to a burn can cause further injury.
- Clean the burn: Using a very mild soap and clean cool water, gently sponge the area. Very gently remove any debris that may be present in the burn. If there are blisters present, do not "pop" them.
- Apply a lotion or moisturizer: You can try aloe gel or an anesthetic cream to prevent dryness of the burn area. Avoid putting anything that is oily on a burn.
- Cover the burn: Without using any pressure, loosely apply a sterile gauze bandage to the burn.
- Take pain relievers: Control discomfort with over-the-counter pain relievers like include ibuprofen, acetaminophen or naproxen.
Dealing with a severe burn can be very stressful, especially if the burn is very extensive or is obvious and can be easily seen by others. The possibility of scarring, surgery and impaired mobility add to the stress.
A support group made up of other people who have suffered serious burns and know what you're going through may be very helpful. Consider finding a group where you can share your struggles and concerns and can meet people who are facing similar challenges. Ask your healthcare provider for information about burn support groups in your area or look online.