Burns

What are Burn wounds ?

The term “ Burn wounds” refers to wounds, that are primarily caused by:

  • Heat (thermal burns)
    • hot liquids (scalds)
    • hot solids (contact burns)
    • flames (flame burns)
  • Radiation
  • Radioactivity
  • Electricity
  • Friction
  • contact with chemicals
burn wounds

What Forms of Burn wounds are there?

Burn injuries can affect any tissue.

Most burn injuries occur in the skin area. Depending on the amount of energy released and local factors (blood circulation in the skin, thickness of the skin, …) the skin is damaged to varying degrees of depth:

First-degree (superficial) burns

First-degree burns affect only the outer layer of skin, the epidermis. The burn site is red, painful, dry, and has 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.

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.

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.

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.

The deeper the burn injury, the less pain

What are the consequences of Burn wounds?

Burns can be minor medical problems or life-threatening emergencies depending on 

  • degree of burn injury
  • body surface involved

 

When burn wounds are not well identified, their treatment by an inexperienced treatment team results in:

  • Prolonged treatment duration with significant impairment of the patient
  • Poor treatment outcome
  • Increased complication rate, including permanent damage

How can you treat a Burn wound ?

The classic treatment sequence for burn injuries is:

  • First Aid for Burns (Emergency Treatment)
  • Specific burn Treatment
  • Specific Burn Rehabilitation (Scar Management)

First Aid for Burns (Emergency treatment)

Cooling:

  • Burn should be cooled with cool or lukewarm running water for 20 minutes.  Never use ice, iced water, coffee, or any creams or greasy substances like butter on a burn
  • The sooner a burn is cooled the less the impact of the injury. 
  • Cooling the burn will reduce pain and swelling

Covering:

After the burn has been cooled, cover it with cling film or a clean plastic bag. This helps prevent infection by keeping the area clean. Never use any creams as they may impair the diagnosis

Transfer to spezialized doctor:

Diagnosis and treatment of burn problem wounds is carried out by a multidisciplinary treatment team, which guarantees that the respective discipline with the specific expertise takes over the treatment. This team is lead by a doctor trained in burn wound treatment (Plastic surgeon).

Specific Burn Treatment

Depending on the depth of the burn, conservative (non-surgical) or surgical treatment methods are used.

Closed blisters should always be left in place and not opened, as these provide the best sterile dressing

Specific Burn Rehabilitation (Scar Management)

Higher degree burn injuries (> IIa) always lead to extensive scar areas. Early and consistent scar suppression therapy must always be started immediately after complete wound closure in order to effectively avoid additional secondary damage (contractures).