What are burns? Burns is one of the most common household injuries, especially among children. The term “burn” means more than the burning sensation associated with this injury. Burns are characterized by severe skin damage that causes the affected skin cells to die.
Most people can recover from burns without serious health consequences, depending on the cause and degree of injury. More serious burns require immediate emergency medical care to prevent complications and death.
BURN LEVELS Burn levels There are three primary types of burns: first-, second-, and third-degree. Each degree is based on the severity of damage to the skin, with first-degree being the most minor and third-degree being the most severe. Damage includes:
first-degree burns: red, blistered skin second-degree burns: blisters and some thickening of the skin third-degree burns: widespread thickness with a white, leathery appearance There are also fourth-degree burns. This type of burn includes all of the symptoms of a third-degree burn and also extends beyond the skin into tendons and bones.
Burns have a variety of causes, including:
scalding from hot, boiling liquids chemical burns electrical burns fires, including flames from matches, candles, and lighters excessive sun exposure The type of burn is not based on the cause of it. Scalding, for example, can cause all three burns, depending on how hot the liquid is and how long it stays in contact with the skin.
Chemical and electrical burns warrant immediate medical attention because they can affect the inside of the body, even if skin damage is minor.
Compared with first- and second-degree burns, third-degree burns carry the most risk for complications, such as infections, blood loss, and shock, which is often what could lead to death. At the same time, all burns carry the risk of infections because bacteria can enter broken skin.
Tetanus is another possible complication with burns of all levels. Like sepsis, tetanus is a bacterial infection. It affects the nervous system, eventually leading to problems with muscle contractions. As a rule of thumb, every member of your household should receive updated tetanus shots every 10 years to prevent this type of infection.
Severe burns also carry the risk of hypothermia and hypovolemia. Dangerously low body temperatures characterize hypothermia. While this may seem like an unexpected complication of a burn, the condition is actually prompted by excessive loss of body heat from an injury. Hypovolemia, or low blood volume, occurs when your body loses too much blood from a burn.
Preventing all degrees of burns The obvious best way to fight burns is to prevent them from happening. Certain jobs put you at a greater risk for burns, but the fact is that most burns happen at home. Infants and young children are the most vulnerable to burns. Preventive measures you can take at home include:
Keep children out of the kitchen while cooking. Turn pot handles toward the back of the stove. Place a fire extinguisher in or near the kitchen. Test smoke detectors once a month. Replace smoke detectors every 10 years. Keep water heater temperature under 120 degrees Fahrenheit. Measure bath water temperature before use. Lock up matches and lighters. Install electrical outlet covers. Check and discard electrical cords with exposed wires. Keep chemicals out of reach, and wear gloves during chemical use. Wear sunscreen every day, and avoid peak sunlight. Ensure all smoking products are stubbed out completely. Clean out dryer lint traps regularly. It’s also important to have a fire escape plan and to practice it with your family once a month. In the event of a fire, make sure to crawl underneath smoke. This will minimize the risk of passing out and becoming trapped in a fire.
When properly and quickly treated, the outlook for first- and second-degree burns is good. These burns rarely scar but can result in a change in pigment of the skin that was burned. The key is to minimize further damage and infection. Extensive damage from severe second-degree and third-degree burns can lead to problems in deep skin tissues, bones, and organs. Patients may require:
surgery physical therapy rehabilitation lifelong assisted care It’s important to gain adequate physical treatment for burns, but don’t forget to find help for your emotional needs. There are support groups available for people who have experienced severe burns, as well as certified counselors. Go online or talk to your doctor to find support groups in your area. You can also use other resources such as Burn Survivor Assistance and the Children’s Burn Foundation.
Topical therapy is typically applied to prevent infection and to treat infection when adequate surgical management is not possible.
Chlorhexidine gluconate (Hibiclens, Hibistat, Tegaderm CHG Dressing)
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Effective, safe, and reliable topical wash. Polybiguanide with bactericidal activity; usually supplied as a gluconate salt. At physiologic pH, the salt dissociates to a cation that binds to negatively charged bacterial cell walls and extramicrobial complex, causing bacteriostatic and bactericidal effects. Active against gram-positive and gram-negative organisms, facultative anaerobes, aerobes, and yeast.
Commercially available central venous catheters impregnated with chlorhexidine and silver sulfadiazine are available.
Silver sulfadiazine (Silvadene, SSD, Thermazene)
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Silver sulfadiazine is useful in the prevention of infections from second- or third-degree burns. It has bactericidal activity against many gram-positive and gram-negative bacteria, including yeast. It has poor eschar penetration.
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Silver nitrate coagulates cellular protein and removes granulation tissue. It exhibits activity against gram-positive bacteria, gram-negative bacteria, and candidal species. The major drawbacks are that it has poor penetration of eschar, requires the use of occlusive dressings, and turns black upon contact with tissues.
Ketoprofen is in a group of drugs called nonsteroidal anti-inflammatory drugs (NSAIDs). it works by reducing hormones that cause inflammation and pain in the body, and is often used to treat pain or inflammation.
Misoprostol is a synthetic prostaglandin that is used for pain and various inflammatory conditions.
Phenytoin. An oral anticonvulsant with a noted side effect of tissue hyperplasia which may be beneficial to tissue growth