Burn Treatment
Burns are tissue damage caused by heat, electricity, chemicals, boiling water, flame and similar agents. Burns affect not only the skin but the entire organism as systemic trauma.
Classification by Depth
- First degree burn: The upper skin layer (epidermis) is intact, redness is present. Example: sunburns.
- Second degree burn: The upper skin layer’s integrity is disrupted. If limited to the upper dermis, it is superficial second degree; if lower dermis layers are involved, it is deep second degree.
- Third degree burn: All skin layers (epidermis + dermis) are involved. The skin is hard, depressed, pale and painless.
- Fourth degree burn: All skin layers, subcutaneous fat and deep structures (muscle, tendon, etc.) are involved, with a charred appearance.
Treatment Methods
First degree burns: Moisturizing creams or ointments are sufficient. Pain medication may be given.
Second degree burns: Paraffin-impregnated dressings reduce pain during dressing changes. Blister treatment depends on size. Antibiotic creams are applied for deep burns.
Third and fourth degree burns: Spontaneous separation of the eschar indicates wound infection. Surgical intervention is required for these degree burns.
Chemical Burns
Chemical burns are categorized into acid and alkali groups. Alkali burns particularly cause liquefaction necrosis and can progress to deep tissues. Clothing should be removed quickly and affected areas washed with water.
Electrical Burns
Low-voltage electrical burns are below 1000 volts; high-voltage burns are above 1000 volts. These patients must be closely monitored for kidney damage from muscle breakdown and cardiac arrhythmias.
Burn Sequelae
Burn contractures are the most common burn sequelae. After healing, the burned area is not as elastic and healthy as normal skin. Over time, the burned area may show severe contraction. The tension resulting from this contraction is called a contracture.
When contractures occur at joint areas, they affect underlying tissues and cause joint movement restriction. Facial contracture lines cause significant deformities and functional loss as they create traction on eyelids, lips, ears and other structures.
Burn or other contractures can be surgically corrected without delay. If delayed, the full benefit of treatment may not be achieved.