Burn

The burn is damage of fabrics as a result of influence of excessively high temperature, electric current, radiation or the chemical agent. These injuring factors have a similar clinical picture as cause a protein denaturation. In addition to local, the burn causes the general damage to an organism, due to release and hit in blood of products of necrotic disintegration from the destroyed fabric. The general damage to an organism caused by a burn is called a burn disease. At defeat of more than 30% of a surface of skin, the amount of toxics causing damage to life-supporting systems of an organism incompatible with life comes to blood.

Defeat of fabrics at a burn has three zones:

• necrosis zone, or a scab in the center of a burn where influence of a traumatic factor was the strongest;
• paranecrosis zone, or intermediate zone. Here normal blood circulation, and in the subsequent stops if it is not recovered, this zone can also become a necrosis zone, that is the burn wound can increase after the termination of influence of the injuring factor due to death of fabrics in a paranecrosis zone;
• hyperemia zone, on the periphery of a burn. This zone borders on the healthy fabric which is not involved in pathological process. Here fabrics are edematous and congestive.

Degrees of burns

Degrees of burns differ depending on defeat depth. Allocate four degrees of burns:

• First-degree burns, or epidermal burns. This degree of a burn assumes destruction only of a blanket of skin, epidermis. Clinically it is shown by a hyperemia (reddening) of skin, hypostasis and formation of bubbles. The bubbles of the small sizes filled with liquid light serous contents. In spite of the fact that pain can be considerable, such burns independently heal, skin is recovered completely, without formation of cicatricial fabric. The period of full healing makes one and a half-two weeks.
• Second-degree burns, or superficial thermal burns. In this case not only epidermis, but also deeper layers of skin is affected, however the zone of defeat is in derma limits. At the same time in a necrosis zone serous bubbles, however more dense, intense and extensive are also formed. The paranecrosis zone in this case is already outside a derma, in a hypodermic fatty tissue therefore at death of fabrics in this zone, the necrosis extends out of derma limits, and becomes a third-degree burn;
• Third-degree burns, or deep thermal burns. At this degree of a burn not only skin at all depth, but also its appendages, to a hypodermic fatty tissue is surprised. Bubbles of this degree of a burn are not inherent as integrity of a derma is broken, in a zone of a necrosis the scab is formed. Depth of a burn can reach a superficial muscular fascia;
• Fourth-degree burns. It is the strongest degree of a burn at which direct influence of the damaging agent affects deep body tissues: sinews, vessels, nerves, muscles, bones, joints, and sometimes and internals. At burns of the third and fourth degrees inevitably there is a burn disease, and healing of fabrics happens to formation of hems.

Feature of burns is that burn degree, especially it concerns deep or extensive damages, it is possible to establish only 48 hours later after an injury as even after removal of the damaging agent destruction of fabrics can continue.

Corrosive burn

The corrosive burn is caused by influence of the chemical agent who reacts with body tissues, causing their destruction. The corrosive burn has some features distinguishing it from temperature or electric.

So, the damage rate of fabrics directly depends on concentration of chemical, degree of its activity, and also the nature of the caused reaction in fabrics. The general rule is that, as a rule, defeat of fabrics at a corrosive burn is deeper, than it seems at first sight. Each active agent at hit on skin or mucous membranes, causes reaction specific, inherent to it. And still clinical defeats at a corrosive burn can be united in two groups: acid burn and alkali burn.

The corrosive burn acid causes bystry coagulation of protein in a necrosis zone, at the same time Sukhoi a scab is formed dense, so-called. Defeat at the same time is accurately delimited from surrounding fabrics at the expense of koagulirovanny fabrics.

The corrosive burn alkali causes a kollikvatsionny necrosis. The nature of defeat at the same time such is that the dense scab is not formed, and occurs a softening, "fluidifying" of fabrics thanks to what the zone of a necrosis has no clear boundary, and the damaged fabrics "float", and the defeat zone at the same time increases. The corrosive burn alkali has less favorable current and the forecast, than a corrosive burn acid.

First aid at burns

The burn is always formed as a result of accident therefore each person has to know the principles of first-aid treatment at a burn. The help at burns has to be competent as human life sometimes depends on it.

The main thing that needs to be made, it to eliminate influence of the injuring agent. If on the person the clothes burn, it is necessary to extinguish it. At the same time burning it is impossible to run that often happens in panic as from it fire inflames only stronger, and extends up, towards the head and airways. The person needs to be laid, and to extinguish clothes, having thrown with dense fabric (a blanket, a coat, etc.) – it will block access of oxygen and the flame will go out.

First aid at a corrosive burn consists in decrease in concentration of the substance causing a burn by means of plentiful washing by water.

Further actions of the help at burns have to be directed to maintenance of life activity waiting for arrival of ambulance. It is necessary to monitor breath of the victim, and if necessary to make artificial ventilation of the lungs.

Treatment of burns

Treatment of burns can be conservative and surgical. Tactics is defined by depth and the area of defeat.

Treatment of first-degree burns consists in the local therapy of a burn including antiinflammatory and wound healing actions. The anesthetizing drugs in the form of tablets or injections are appointed.

Treatment of second-degree burns consists in prevention of shock, the biological bandage under which apply drugs on an ointment basis is locally applied. Also treatment of a burn can be carried out by an open method.

Treatment of burns of the third and fourth degrees surgical, and operation on removal of nekrotizirovanny fabrics has to be performed as it is possible earlier to reduce hit of toxins in blood. Treatment of burns of the fourth, and sometimes and the third degree, assumes change of fabrics, for the purpose of closing of extensive fabric defect.

At any extent of defeat treatment of burns has to be urgent as without rendering the qualified help destruction of fabrics can continue also after injuring, and the continuing intake of decomposition products in blood considerably worsens a condition of the patient.