Burns occurs when heat, chemicals, sunlight, electricity or radiation damages skin tissue. Most burns happen accidentally. There are different degrees of burns. 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.
Classification & Symptoms –
Burns are classified as first-, second-, third-degree, or fourth-degree depending on how deeply and severely they penetrate the skin’s surface.
• First-degree (superficial) burns.
First-degree burns affect only the outer layer of skin, the epidermis. The burn site is red, painful, dry, and with no blisters. Mild sunburn is an example. Long-term tissue damage is rare and often consists of an increase or decrease in the skin color.
Healing time is about 3–6 days; the superficial skin layer over the burn may peel off in 1 or 2 days.
• Second-degree (partial thickness) burns.
Second-degree burns involve the epidermis and part of the lower layer of skin, the dermis. The burn site looks red, blistered, and may be swollen and painful.
Healing time varies depending on the severity of the burn. It can take up to 3 weeks or longer.
• Third-degree (full thickness) burns.
Third-degree burns destroy the epidermis and dermis. They may go into the innermost layer of skin, the subcutaneous tissue. The burn site may look white or blackened and charred.
Healing time depends on the severity of the burn. Most need to be treated with skin grafts, in which healthy skin is taken from another part of the body and surgically placed over the burn wound to help the area heal.
• Fourth-degree burns.
Fourth-degree burns go through both layers of the skin and underlying tissue as well as deeper tissue, possibly involving muscle and bone. There is no feeling in the area since the nerve endings are destroyed.
Healing time and process of these burns is almost same as of third degree burns.
Significance of the amount of body surface area burned –
In addition to the depth of the burn, the total surface area of the burn is significant. Burns are measured as a percentage of total body area affected. The “rule of nines” is often used, adjusted for infants and children. This calculation is based upon the fact that the surface area of the following parts of an adult body each correspond to approximately
9% of total (and the total body area of 100% is achieved):
• Head = 9%
• Chest (front) = 9%
• Abdomen (front) = 9%
• Upper/mid/low back and buttocks = 18%
• Each arm = 9%
• Each palm = 1%
• Groin = 1%
• Each leg = 18% total (front = 9%, back = 9%)
As an example, if both legs (18% x 2 = 36%), the groin (1%) and the front chest and abdomen were burned, this would involve 55% of the body.
8Only second- and third-degree burn areas are added together to measure total body burn area. While first-degree burns are painful, the skin integrity is intact and it is able to do its job with fluid and temperature maintenance.
If more than 15%-20% of the body is involved in a burn, significant fluid may be lost. Shock may occur if inadequate fluid is not provided intravenously. As the percentage of burn surface area increases, the risk of death increases as well. Patients with burns involving less than 20% of their body should do well, but those with burns involving greater than 50% have a significant mortality risk, depending upon a variety of factors, including underlying medical conditions and age.
Burns have a variety of causes, including:
• Thermal burns:
These burns raise the temperature of the skin and tissue underneath. Thermal burns happen from steam, hot bath water, tipped-over coffee cups, hot foods, cooking fluids, etc.
• Radiation burns:
These happen from exposure to the sun’s ultraviolet rays (a sunburn because skin isn’t well-protected in the sun) or from radiation such as during an X-ray.
• Chemical burns:
These happen from swallowing strong acids (like drain cleaner or button batteries) or spilling chemicals (like bleach) onto the skin or eyes.
• Electrical burns:
These are from contact with electrical current and can happen from things like biting on electrical cords or sticking fingers or objects in electrical outlets, etc.
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.
Complications of deep or widespread burns can include:
• Bacterial infection, which may lead to a bloodstream infection (sepsis)
• Fluid loss, including low blood volume (hypovolemia)
• Dangerously low body temperature (hypothermia)
• Breathing problems from the intake of hot air or smoke
• Scars or ridged areas caused by an overgrowth of scar tissue (keloids)
• Bone and joint problems, such as when scar tissue causes the shortening and tightening of skin, muscles or tendons (contractures)
Your healthcare provider will examine the burn to determine the degree or severity. This process involves estimating the percentage of the body affected by the burn and its depth. Your provider may classify the burn as:
First- and second-degree burns that cover less than 10% of the body are considered minor and rarely require hospitalization.
Second-degree burns that cover about 10% of the body are classified as moderate. Burns on the hands, feet, face or genitals can range from moderate to severe.
Third-degree burns that cover more than 1% of the body are considered severe.
Burn treatment varies depending on the cause and severity. You need to keep all burns clean and apply proper bandages/dressing depending on the severity of the wounds. Treating the person’s pain is key: inadequate control can interfere with wound care.
Continue to check wounds for signs of infection and other long term issues, such as scarring and tightening of the skin over joints and muscles, which makes them difficult to move.
Treatments by burn type include:
• First-degree burns:
Run cool water over the burn. Don’t apply ice. For sunburns, apply aloe vera gel. For thermal burns, apply antibiotic cream and cover lightly with gauze. You can also take over-the-counter pain medication.
• Second-degree burns:
Treatment for second- and first-degree burns is similar. Your healthcare provider may prescribe a stronger antibiotic cream that contains silver, such as silver sulfadiazine, to kill bacteria. Elevating the burned area can reduce pain and swelling.
• Third-degree & fourth degree burns:
Third-degree & fourth degree burns can be life-threatening and often require skin grafts. Skin grafts replace damaged tissue with healthy skin from another of the uninjured part of the person’s body. The area where the skin graft is taken from generally heals on its own. If the person does not have enough skin available for a graft at the time of injury, a temporary source of graft can come from a deceased donor or a human-made (artificial) source but these will eventually need to be replace by the person’s own skin. Treatment also includes extra fluids (usually given intravenously, with an IV) to keep blood pressure steady and prevent shock and dehydration.
Lifestyle and home remedies –
To treat minor burns, follow these steps:
• Cool the burn.
Hold the burned area under cool (not cold) running water or apply a cool, wet compress until the pain eases. Don’t use ice. Putting ice directly on a burn can cause further damage to the tissue.
• Remove rings or other tight items.
Try to do this quickly and gently, before the burned area swells.
• Don’t break blisters.
Fluid-filled blisters protect against infection. If a blister breaks, clean the area with water (mild soap is optional). Apply an antibiotic ointment. But if a rash appears, stop using the ointment.
• Apply lotion.
Once a burn is completely cooled, apply a lotion, such as one that contains aloe vera or a moisturizer. This helps prevent drying and provides relief.
• Bandage the burn.
Cover the burn with a sterile gauze bandage (not fluffy cotton). Wrap it loosely to avoid putting pressure on burned skin. Bandaging keeps air off the area, reduces pain and protects blistered skin.
• Take a pain reliever.
Over-the-counter medications, such as ibuprofen (Advil, Motrin IB, others), naproxen sodium (Aleve) or acetaminophen (Tylenol, others), can help relieve pain.
• Consider a tetanus shot.
Make sure that your tetanus booster is up to date. Doctors recommend that people get a tetanus shot at least every 10 years.
Whether your burn was minor or serious, use sunscreen and moisturizer regularly once the wound is healed.
Some home remedies to apply on burn wound –
•Wash with Cucumber Water Put the affected area under running tap water for a few minutes and wash with cucumber water or rose water. Both of these have astringent properties and help in preventing infection.
• Apply Cucumber & Carrot or Aloe Vera Paste Grind cucumber and carrot in a blender or mash them finely in a mortar & pestle. Strain the juice out and apply the paste on the affected area. You can also crush Aloe Vera leaves and apply the pulp. If fresh leaves are not easily available, you can use Aloe Vera gel available in stores.
• Jatyadi Oil is a classical Ayurvedic formulation which heals burns and provides pain relief. Use a cotton ball and apply directly on the area.
• Ghee gives a cooling effect on the skin. If possible, take barks of Pipal and Bargad and mash it into a pulp. Add this to cow ghee and apply on the affected area. Applying plain ghee on burn area is also beneficial.
• Mix equal amounts of honey and plain coconut oil. Use this mixture on the burn area for relief. Instead of coconut oil you can use sesame oil as well.
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.
For more informative articles about other health related issues, please visit our website www.santripty.com and also feel free to consult.