Burns

What is it?

A burn is the death of the skin and possibly other layers of tissue beneath

Image result for burns patientit as a result of the application of dry heat (or cold). A scald is similar to a burn, but is rather caused by moist heat such as a hot liquid. Other agents that can cause burns include flame, hot solids, exploding gases, flammable liquids, electricity and irradiation.

Burns occur most commonly in children who sustain their injuries at home. Adults usually sustain burns at work or as a result of road traffic accidents.

What happens in burns?

When the skin cells die from the effect of the heat, the dead cells release some substances. These substances act on the tiny blood vessels (capillaries) around the skin making them lose the fluids they contain. Over time, the volume of fluid in the body reduces so much that there is not enough to keep the body organs functioning. The heart is not able to pump effectively, and the kidneys are no longer able to produce enough urine. The lungs get congested quickly and infection develops there, gets into the blood and spreads to other parts of the body, further damaging other organs.

What are the symptoms?

The symptoms of burns depend on the severity. There are a number of methods for assessing how serious a burn is, and your doctor chooses the one most suitable. A simple method of classifying burns is by using the thickness of skin involved.

In a first degree burn, the outermost layer of the skin (the epidermis) looks red and painful, and no blisters are formed (blisters are pockets of skin filled with a clear fluid). It’ll also heal rapidly within a week without a scar forming.

A second degree burn is more painful, and the affected area is mottled and red, with blister formation. It also takes a longer time to heal – about two to three weeks, sometimes with a scar.

In a third degree burn, the affected area is insensitive, so no pain is felt there. This is because the nerves, including the ones that carry pain, have been damaged as well. It is charred and parchment-like. It usually heals after a long time with a lot of scar formation.

What should you do?

First aid for burns

Stop the burning process and keep the person away from the burning area.

Cool the area with tap water by continuous irrigation for about 20 minutes (not cold water as it can lower the body temperature dangerously).

Raising a burnt arm or leg will help prevent swelling.

Take off any jewellery or watches near the burnt area. They could get too tight if the area swells up. And take off any clothing on the burnt area after you have cooled it down. But don’t pull off clothing that is stuck to the skin.

If you need to see a doctor, cover your burn before you go. The local pharmacist should be able to help you do this with the proper materials. Don’t cover your burn with anything sticky (such as sticking plaster) or fluffy (such as cotton wool). Don’t put grease or any cream or ointment on the burn.

Minor burns can be very sore. Simple painkillers like paracetamol or ibuprofen can help ease the pain.

Don’t burst any blisters yourself to avoid infecting the burn or cause more damage.

If your burn is small, with only one or two small blisters, you may be able to treat it at home. But if the blistered area is large, or if the burn goes right around a finger, you should see a doctor immediately. It is always good however to report to a doctor no matter how trivial you may feel the burn is from the outside. He should be able to do a more thorough assessment to be sure you are fine.

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What will happen to me?

The outcome of a burn injury is mostly dependent on the severity and the quality of care given to it. If strict measures are not taken for cleanliness, the exposed burn area may become infected. This may overwhelm the body and the risk of mortality rises.

In severe burns, ugly scars may form as healing takes place, and this usually causes functional and cosmetic problems for the individual. It is necessary to involve the plastic surgeons to manage these cases appropriately.