Almost everyone is injured one or more times from burns in the course of their life. These burns can then lead to small or severe burns. Usually these are minor injuries to the fingers or arms that occur when preparing food in the kitchen or when handling an open fire. Even the smallest burns can be very painful and should be treated.
What is a burn?
Burn wounds can injure and damage the skin, muscles, tendons or organs. Depending on the type of injury, its extent and depth, burn injuries are divided into specific degrees of severity and treated accordingly.
Human breathing is not exclusively through the lungs, but also through what is known as skin breathing. Therefore, extensive burns can be life-threatening and require specialist medical treatment as quickly as possible. A severe burn is always an emergency and can be associated with danger to life and limb. The time factor plays a very important role in the initial treatment of burn victims.
Direct body contact with fire, explosions, abrasions or burning with liquids can cause burns to any part of the human body. This scorches or burns the skin or the affected tissue, in severe cases organs such as the nose, mouth or ears.
According to DigoPaul, burn injuries can also affect the eyes. The treatment of larger burns definitely belongs in the hands of medical professionals. Only they can determine whether a hospital stay is necessary or whether conventional methods such as an ointment are sufficient for treatment.
Symptoms, ailments & signs
Depending on the degree of burn, a burn will manifest itself through different symptoms and signs. A first-degree burn shows a superficial injury to the skin, which can be associated with pain, redness, and itching. Occasionally, moisture will leak from the wound. Usually a blister forms, which heals after a few days. Grade 2a burns experience severe pain associated with redness, itching, and peeling of the skin.
In addition, the wound becomes wet and a blister forms. Occasionally, scars are left behind if not handled properly. Second-degree burns are manifested by open blisters, slightly rough wound edges and a moist wound surface. The wound is usually very sensitive to pain, but usually heals without scars. Third-degree burns leave the skin dry and leathery.
Touching is not painful and usually no more liquid escapes. Externally, a grade 3b burn is evident as a whitish to brownish discoloration of the skin. A fourth degree burn damages the muscles, tendons, bones, and joints. It can movement disorders, paralysis and sensory disturbances come. The skin is charred and discolored black.
Diagnosis & course
A simple burn blister caused by brief contact with a burning lighter, stove or pot can usually be treated by the patient himself.
However, if there is a large burn, the patient is taken to a doctor or hospital as quickly as possible. Many larger cities also have accident clinics and special burn injury centers where the correct diagnoses can be made quickly and safely. The attending physician first diagnoses burns through the visual examination.
Crimson, detached, tattered or even black skin shows him the degree of injury. If there are burns on the face and head, an ophthalmologist is called in immediately. In addition, there is an examination by an ear, nose and throat doctor who diagnoses charring on the ears, nose and in the throat area. If internal injuries are feared, an MRI or magnetic resonance imaging of the body can also be ordered.
A burn wound that is not promptly treated by a medical professional can lead to various complications. Wound infection comes first, because the damaged skin layers are much more susceptible to bacterial attack. In this context, the increased risk of sepsis (blood poisoning) should also be mentioned.
If sepsis spreads through the bloodstream in the body, it can damage the entire organism and, in the worst case, develop into a life-threatening condition. Septic shock and (multiple) organ failure can follow and are almost always fatal.
How massive the scarring is depends on how extensive and deep the burn injury is. If thick and bulging scars develop, pain due to the shortening of the skin, tendons and muscles cannot be ruled out. Very deep burns can even lead to bone and joint problems.
The larger the burn, the more likely a skin graft will be used to cover the area. This prevents further infections and, under certain circumstances, stimulates the formation of new skin cells. Large burn wounds can damage the blood vessels and lead to massive fluid loss.
This creates the risk that not enough blood can be pumped from the heart around the body. There is also the risk of hypothermia because the body temperature drops dangerously.
When should you go to the doctor?
A burn wound is usually associated with considerable pain, so drug and medical treatment is highly advisable. In many cases, a burn wound also forms burn blisters that fill with water. Affected persons should consult a doctor as soon as possible if burn blisters occur. Serious complications or secondary diseases can only be avoided through medical treatment.
Anyone who refrains from such treatment at this point is putting himself at great risk. Burst burn blisters are extremely susceptible to infections, as bacteria and viruses can nestle in them. There is a risk of developing a dangerous inflammation, so that it can even lead to the formation of pus. If there is an inflammation including pus formation, a visit to the doctor is inevitable.
The inflammation present can only be combated effectively and quickly with appropriate treatment. If this is not done, then the pus fluid will increase considerably. In the worst case, there is even a risk of blood poisoning if bacteria and viruses get into the human bloodstream.
The following applies: Burn wounds should always be treated by an appropriate doctor. Serious complications or permanent consequential damage can only be avoided through medical and drug treatment. Therefore, a visit to the doctor should not be postponed in the event of a burn.
Treatment & Therapy
Serious burn injuries urgently need fluids and they are given glucose infusions during the first aid measures. They are wrapped in special burn-injured foils to keep their body temperature stable and to protect the injured skin from bacteria.
Burn injuries cool down easily and the falling body temperature can impair the function of organs or even cause the death of the patient. Blood pressure and heart activity are seamlessly monitored. Burn injuries are often unconscious or even in a coma. Only a doctor can take the necessary measures.
A first-aider who is a layman only has to put them in fire foil and in the stable side position. Conscious burn injured persons are in great pain and are given immediate pain medication by medical staff.
In the clinic, burn injuries have to be cut out of leftover clothing or operated on. Treatment of burn injuries is tedious and can require multiple surgeries. Skin grafts may be performed and muscles and tendons restored to function. If parts of the body are burned too badly, they may also have to be amputated.
Outlook & forecast
The healing process of burn wounds depends heavily on various factors such as the extent and degree of the burn. Healing takes at least a few days, but in severe cases it can take several months. A moderate burn (second-degree burn) heals in about four weeks. After that, however, scars are often left behind.
Minor burns, such as typical sunburns, manifest themselves as reddening and irritation of the skin, which is associated with moderate pain. They can be treated well with home remedies such as creams and bandages and leave at most light scars. Minor burn wounds can be completely healed after just a few days.
More severe burns are manifested by noticeable wounds and severe pain. In addition to bleeding, layers of the skin may become detached. Severe burn wounds absolutely require medical treatment. This may take place in special centers. In some cases a skin graft is necessary, which can lead to noticeable scars and different colors of the skin.
In particularly severe cases, burns can even be fatal – especially if the patient is very old or has previous illnesses, or if a large part of the body surface has been damaged by the burn. The chance of survival of patients with very severe burns can be assessed using the Abbreviated Burn Severity Index (ABSI).
Proper handling of open flames, electrical appliances and hot kitchen utensils helps to avoid burns as much as possible. Young children should never play unsupervised where hot bath water is running, boiling or where lighters and chemicals are located. The housewife only handles hot equipment with caution and suitable gloves.
But also when it comes to occupational health and safety, all the necessary measures to prevent burn accidents must always be observed. Electrical apparatus and machines must be handled and maintained according to regulations. Keep flammable liquids away from open flames.
Which aftercare measures are necessary for a burn wound depends on its extent and depth. In the case of a superficial and small burn wound, aftercare is usually not necessary after it has healed. But it is important to protect the newly formed skin from sunburn. The larger and deeper a burn wound, the more complex the follow-up care must be. After a burn of the second degree, follow-up care is inevitable.
A problem with larger ligament wounds is scarring. Follow-up care is required here so that there are no restrictions on movement. Scar-related distortions are also possible. It can take months or even years for the burn scar to become paler and softer. Cosmetic treatments can help hide the discoloration on the burn.
Psychological follow-up care may also be indicated, as well as pain relievers or the prescription of protective and nourishing creams. Follow-up care can also include adjusting compression garments. Correcting functional impairments is an important topic of follow-up care.
If there is a grade 2 or 3 burn wound, functional impairment of the joints can result from bulge scars. The burned skin contracts over the joint. It restricts its mobility. In addition to surgical solutions from the plastic surgeon, aftercare can also include physiotherapeutic treatments. Scar massages as well as occupational therapy or physiotherapy are also possible in aftercare.
You can do that yourself
Smaller burn wounds should be cooled first. The affected area is best cooled under running, cold water and then wrapped with damp towels. Ice cubes, ice packs and the like should be avoided to prevent hypothermia or tissue damage. Then pain-relieving ointments or branding gel can be applied to the burn wound.
Alternatively, preparations with aloe vera, Bach flowers or Schüßler salts can also be used. Vinegar or apple cider vinegar can be used to protect against infection. Onion, garlic or plantain – placed directly on the burn wound – soothe the itching and reduce the formation of blisters. If a burn blister has already formed, the following applies: do not open it and instead stick a protective plaster over it, which should be replaced daily.
Large burns should be treated immediately by a doctor. Before the doctor’s visit, the wound must be covered loosely and as free of germs as possible. In the event of scalding, the soaked clothing must be removed immediately. Regardless of the degree and extent, a burn should always be examined by a doctor. Scarring can only be reliably avoided through good infection control and follow-up care. In the case of large burn wounds, psychological counseling may be useful.