Burns or burns are a type of injury to skin or other tissues due to heat, electricity, chemicals, friction, or radiation. Burns are not merely a burning sensation, burns may be serious skin damage that causes the surrounding cells to be affected or die.
Consequences of burns: Skin is the first layer to protect the body and burns can destroy that protection. All types of burns if not treated properly can cause serious complications. The most common complications of burns are often associated with infection.
How many burns need skin graft?
Classification of severe burns:
Agricultural burns:
Burns I: Acute dermatitis.
Burns II: epidermal burns.
Burns III: Burns of the dermis.
Deep burns:
Burns IV: Burn the entire skin layer.
Burns V: Burns deep under shallow weight layer.
Deep burns instant burns from IV or higher need Skin Surgery.
Causes of Burn's disease
Some possible causes of burns include:
Thermal burns: due to fire, steam, hot objects or hot liquids
cold burns: Due to exposure to wet, wind or cold conditions
Electrical burns: Due to contact with electricity or lightning
Chemical burns: due to contact with chemicals at home or industrial chemicals. This chemical may be in a solid, liquid or gas form. Natural foods like chili contain skin irritation, which can cause burns
radiation burns: caused by sunlight, skin dyeing machine, ultraviolet rays, X -rays or radiation therapy in cancer treatment Fruit burns: Due to contact with any hard surface such as sugar, carpet or gym floors
Agency analysis of burns by age:
Dry heat: Adults meet more children.
Wet heat: Children meet more than adults.
Chemical burns: mainly in adults.
Electric burns: The ratio between children and adults is similar.
Symptoms of Burn's disease
The common symptoms of burns include:
Burns: Skin redness, mild inflammation or swelling, pain, dry skin, peeling when healing burns
Burns II: The appearance of water, then the skin is very red and painful. Some broken water shadows make the wound look very wet. Over time, soft and thick scales (fiber secretion) can grow on wounds
Burns III or higher: Burns are waxed and white, burned black, dark brown, sores and muscle convex, water ball without breaking
Patients should see a doctor if:
Burns on hands, feet, face, sensitive area, large joints or large body area
Deep burns
Burns due to chemicals or electrical
Difficulty breathing or respiratory burns
There are signs of infections such as fluid flowing from wounds, more pain, redness and swelling
burn or have a long -lasting water ball
Large scars
Burns occur in children under 5 years old, older people, people with weak immune systems or chronic health problems (such as cancer, heart disease or diabetes). The periods of burns include:
The first period: The first 2-3 days after burns. The characteristic manifestation is the state of burn shock
The second period (period of poisoning, acute bacterial infection): from 4 to 45-60 after burns. This is a period of healing and recovering from shallow burns but for deep burns this is the period of poisoning and infection.
Third period (erosion period): From 45-60 onwards, patients will go through this period if burns are not treated and nurtured well. There are three levels of burn failure including:
Light: organization of edema, thin weight about 4–9 kg
Medium: Organizing bleeding, thin weight loss about 10–19 kg, muscle atrophy, subcutaneous edema, sores under the spleen
Heavy: Burn wounds without granular tissue, secondary necrosis, thin weight loss about 20–40 kg, muscle atrophy, subcutaneous edema, ulcers under a lot of spleen and bad progress. There are disorders, functional and atrophy of internal organs and endocrine glands, mental disorders. Moderate burning may have death from other complications of burns. Severe burn failure has a mortality rate of about 50 - 60 %.
The fourth period: The recovery period of burns. The burned wound has been covered and healed. The dysfunction of the organs is gradually recovered. Disorders of metabolism and nutrition also return to normal (this period lasts from 1-1.5 months).
People at risk for Burn's disease
Burns can affect all ages.
The factors that increase the risk of burns include:
Use wood stoves, contact with heat or wires
Incense storage of flammable materials and skin eating
Smoking is not careful
Child abuse
Adjust the water heater temperature above 54.4 ° C
Foods and tools for warming foods
Excessive contact with the sun
Prevention of Burn's disease
Methods of preventing severe burning burns include:
cold burns: Leave the burn under the cold water for 10 to 15 minutes until the pain is reduced or use a clean towel to moisturize with cool water. Do not use ice directly on the burn because it can be further harmful
Remove the ring or other tight objects from the burned skin
Do not break small blisters. If the blisters are broken, gently rinse with mild soap and water, use antibiotic to apply antibiotics, apply with a non -stick gauze tape
Using moisturizer, aloe or gel can soothe the burn area and prevent dry skin
Using common painkillers such as ibuprofen, naproxen and acetaminophen
Full tetanus vaccination. Doctors recommend that tetanus injections at least every 10 years
Use sunscreen and moisturizer regularly: whether small or serious burns need to use these products when the wound heals completely.
Diagnostic measures for Burn's disease
Clinical examination:
Assess the depth of the burn, the degree of damage, pain, swelling and signs of infection.
Patients need to go to emergency immediately if burns in important parts of the body, burns due to smoke, electric burns and suspected burns related to body abuse. The doctor will check for other injuries and determine whether burns have affected the body somewhat.
Testing: including X-rays and other diagnostic procedures depending on the cause of burns.
Burn's disease treatments
Principle of treating burns depends on the cause of burns and the severity of the disease:
Most mild burns can be treated at home with non -prescribed drugs or aloe vera and often heal very quickly.
For serious burns, after initial first aid, patients need to continue treating with drugs, wounds, therapeutic and surgery to reduce pain, type Remove dead tissues, prevent infections, reduce scars, restore function and psychotherapy.
For severe burns, drugs and other products that can support the treatment including:
Water therapy: Including techniques such as dew therapy, echocardial stimulating and cleaning the lesions
Interpretation: To avoid dehydration and impairment
Pain relievers and anxiety: like morphine and anti -anxiety drugs because the treatment of burns can cause pain
Cream and ointment: Helps keep wounds moist, pain relief, prevent infections and heal wounds
gauze: Helps create a humid environment, fight infections and help heal burns tetanus vaccine: Tetanintic shot after burns
Physiotherapy and labor therapy: If the area of the burn area is large, especially the burn passes through the joints, physical therapy exercises will help tighten the skin and do it Flexible joints. Other exercises can improve muscle strength and flexibility. If the patient has difficulty with daily activities, the doctor will recommend therapeutic labor.
In addition, for large burns, patients will need other additional procedures after surgery, from breathing support, placing stomach feed to surgery The United States to ensure the healing of wounds, fully restored functions of the affected organs and restructuring the affected area.
First aid in place
quickly eliminates the cause of burns:
seek to put out the fire, take off the burning clothes or be absorbed by boiling water.
If an electric burn must find ways to cut the power, pull the victim out of the dangerous area, perform artificial respiration, massage heart outside the chest
If burns in large fires, must find a way to bring the victim to a ventilation, monitor the victim's respiratory status, suck the viscous phlegm, ensure the circulation gas.
Khi bị bỏng do acid phải cởi bỏ quần áo, giày dép, dùng nhiều nước lạnh dội vào vùng bỏng hoặc ngâm vùng bỏng vào nước để pha loãng nồng độ acid, thời gian trên 15 phút . Can use soap water, 5% lime water to neutralize acid. If alkaline burns neutralize with 6%acetic acid, boric acid 3%, can use cold water, vinegar, sugar water 20%.
For burn lesions:
Soak cold water to relieve pain and prevent shock. The cold soaked must be done early in the first 30 minutes to get results, if after 45 minutes, it does not work.
After soaking the cold, pressed the burning area. The pressed tape works to limit the development of the burn, limiting the escape. Do not apply anything on the burn area (except for chemical burns that need to be treated based on burns).
Pain relief:
immobilization of burns.
The block of Novocaine is 0.25% in the root area of burns.
Using painkillers.
Oresol or a phase solution of 5.5gr of salt + 4gr sodium bicarbonate + 100gr glucose mixed in a liter of water (drink from 1-2 liters for 24 hours). >
warm: People with widespread burns with shocks are often trembling, they need to warm but do not let high temperatures more than 370C will cause further dehydration in the form of evaporation. Do not transport the patient shocking or threatening shock.
Surgery methods for burning burns:
Surgery to eliminate burn necrotic organizations:
Indications: To diagnose depth when unclear or to remove early necrosis in the deep dermis.
Disadvantages: Causes blood loss during surgery, easy to form hematoma in the surgical area.
Cut off the entire burn necrotic layer:
Indications: When necrosis is dry and diagnosed with depth is clear. Do not have early surgery when the burn is acute inflammation. The best time is from day 3 to Saturday after burns.
For electric burns that cause skin necrosis, muscle, tendon, bone, it is necessary to have surgery early when the patient gets out of shock and stability.
for large-scale burns and large depths, premature necrotic removal should be conducted 4-5 days apart and use skin or heterotrophic. Skin itself.
Arrecid canal:
Indications: When the necrotic area is close to the body, it hinders the circulation or makes it difficult for the patient to breathe.
Technical: incisings vertical lines or flag cans.
Surgery to remove bone necrosis:
Indications: fire burns, electric burns
For the skull should drill many holes 15-20mm apart, the diameter of the hole is from 3-8mm, drilling to the bleeding layer of bleeding is okay.
amputated limb burns:
Indications: When the limb burns all layers, especially when the muscle mass of the span is unable to retain.
When anaerobic infection (steam scholarship), amputated limb is conducted when escaping from shock and diagnosis is clear.
Skin transplant surgery to treat burn wounds:
Suitable leather graft:
Mainly the skin of the patient itself or the skin of the twins and eggs. This type of skin permanently lives on the graft.
Disadvantages: The area for the skin leaves bad scars, cannot graft a large area, aesthetic results and poor function.
Skin grafting has a depth: thickness of leather pieces from 0.25-0.6mm. The area of the skin depends on the healthy skin. For cases of deep burns, the skin can be removed many times in the same position.
Advantages in both function and aesthetics, withstands in the overweight and movement areas, should be indicated for skin grafting on the face, neck, hands and joints.
Disadvantages: Skin is grafted difficult to live if not in good motility. Where to get the skin if the wide area must be thin.
Inappropriate leather transplant: Skin grafted can be homosexual or heterotrophic.
Indications: For temporary coating, the particle organization is too large, combined with self -skin grafting.
Disadvantages: The piece that only lives on the background for a while will be eliminated.
Musical leather flap, muscle flap by microscopic surgery.
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