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Burn
Medical Questions » Burn
| Name: Burn |
| Also known as: |
| The severity of a burn depends on the area covered by the burn and the depth of the burn. They are categorised as first degree (superficial), second degree (partial thickness) and third degree (full thickness). |
Causes of Burn
A burn may be caused by hot fluids (scald), flame (eg. clothing catching alight), dry heat (eg. touching a stove hot plate) or radiation (eg. sunburn). |
Symptoms of Burn
First degree: red or grey in colour, and are not blistered initially, but can be very painful.
Second degree: blistered initially, then moist and red or white after the blister bursts. Tissue under the burn becomes progressively more swollen for several days. Often not as painful as first degree burns, as the nerve endings have been partially destroyed.
Third degree: sometimes difficult to differentiate from second degree burns unless there is obvious tissue charring or exposed fat, muscle or bone. Appear tough and leathery, and may be almost any colour, but there is usually no pain as the sensory nerve endings have been totally destroyed. |
Tests for Burn
None normally necessary for minor burns, but patients hospitalised with serious burns will have regular blood tests to check for dehydration and body chemistry disorders. |
Treatment for Burn
First aid: no matter how mild or serious, all burns should initially be treated by immersion in cool water, or covering the area with a wet cloth, for at least 30 minutes. Those with severe burns may need mouth-to-mouth resuscitation and external cardiac massage.
First degree: soothing antiseptic creams and moderate to strong pain-killers may be required for the first two or three days.
Second degree: antibiotic cream or other dressings.
Third degree: skin grafts are required for all but small areas.
Extensive second and third degree: life threatening because of the loss of body fluids through the burn area and the absorption of large amounts of toxic waste products into the blood that can cause kidney and liver failure. Once in a hospital burns unit patients can be kept alive on a ventilator and fluids can be replaced through drips into a vein. Antiseptic paints, creams, amniotic sac membrane (recovered from the placenta of mothers who have just delivered a baby) or pig skin may be used to protect wounds after the burnt tissue has been cleaned or cut away (surgical debridement). Pressure may be applied in various ways to reduce scarring. Skin taken from unburnt areas of the body is grafted to areas that have been totally destroyed in a late stage of treatment. Tissue cultures of the patient' s own skin cells, or those of a donor, are used in severe cases to replace missing skin. Rehabilitation takes months or years, and may involve plastic surgery to correct contractures (tight scars) or improve appearance. Physiotherapists, occupational therapists, and even speech pathologists (for inhaled hot gas burns) will all play a part.
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Complications of Burn of its treatment
First degree: do not cause major problems and heal readily without scarring.
Second degree: scarring only results if the burn becomes infected or otherwise further damaged.
Third degree: scarring occurs. Burns may become infected and require antibiotics. Pneumonia, kidney and heart failure are common complications of severe burns. |
Likely Outcome of Burn
First degree: heal rapidly.
Second degree: take between two and four weeks to heal.
Third degree: varies widely depending on the extent, position and severity of the burn, and the availability of a hospital burns unit. Patients under 2 years and over 60 have a higher death rate. Burns to the face, hands, feet and groin are more difficult to treat, and have a poorer outcome. Any victim with more than 20% of the body surface burnt is considered to be critically injured, and it is rare for patients to survive a burn of more than 70% of the body surface. |
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