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Burns

Introduction

Burns are injuries to skin or deeper layers that result from exposure to either:

  • heat ( thermal ) from fire, liquids or steam
  • chemicals
  • electricity and lighting
  • radiation
  • friction

Symptoms

Symptoms depend on the site, type, degree and severity of burn. Common symptoms are pain and redness. Swelling and blistering will form in more severe cases followed by tissue damage of the affected area.

How do we determine the severity of burn ?

Severity of burns is assessed according depth of the skin affected and also estimated percentage of body surface involved. The depth of injury are estimated according to the followings:

  • first degree :  involve only  superficial  skin layer ( epidermis )
  • second degree : involve superficial ( epidermis ) and lower layer of the skin ( dermis )
  • third degree : involve first skin thickness including the nerve causing numbness of the area
  • fourth degree involve whole skin thickness as well as the muscle and bone. Nerve damage causing total loss of sensation.

The estimated body surface of burns is estimated by palm size that account for 1% of affected area. The higher the percentage, the higher the severity. Involvement of face, hands, feet and groin are considered as severe case.

What are the complications of burns ?

In first degree burns, the superficial skin may heal without any complication. In deeper layer burns, the immediate complication can be fluid loss from an exposed skin that could lead into hypotension, hypothermia and shock. In severe burns, respiratory distress cause by burns of respiratory tract , wound infections, nerve and muscle damage are a known complications. Later complications could result in scarring and permanent deformity of the affected area, and also psychological trauma.

What should we do to this patients ?

Do

  • Cool and clean the affected areas with running water to clean the area and reduce pain. This could help to prevent infection and limit  tissue damage.
  • Take patient to nearest clinic or hospital
  • Give analgesic or antibiotic cream
  • Alway keep the affected area clean to prevent infection and facilitate healing
  • Rehabilitation and exercise program later  to prevent deformity

Don’t

  • Cover the area with  dirty cloth
  • Use ice water to clean the areas as it can cause additional damage to the burned tissue
  • Apply any substance without professional consultation

Severe burns

  • Severe burns  and burn involving face, hands, feet and groin require immediate medical attention and preferably hospital admission
  • This patient needs special treatment in burn unit in the hospital
  • Skin graft surgery may be indicated later.

Prevention

To reduce your risk of common household burns:

  • Never leave items cooking on the stove unattended.
  • Turn pot handles toward the rear of the stove.
  • Use sturdy oven mitts that cover hands and wrists.
  • Never cook while wearing loosefitting clothes that could catch fire over the stove.
  • Keep space heaters away from combustible materials.
  • Avoid smoking in the house  especially in bed.
  • Keep chemicals, lighters and matches out of the reach of children

 

Last Reviewed : 30 October 2013
Writer/Translator : Dr. Muhaini bt. Othman
Accreditor : Datuk Dr. Christopher Lee Kwok Chong