BURNS

DEFINITIONBurn is any damage to the skin and/or other organs in the body induced by excessive heat, chemicals, electricity and radiation.

CLASSIFICATION Causes:

Thermal Fire Heat Steam Cold thermal injury

Electricity Chemicals Radiation

Severity Mild Moderate Severe

Depth 1st degree 2nd degree 3rd degree 4th degree

DEPTH

Partial-thickness burns

First degree

Superficial and deep

partial

Second degree

Full-thickness burns

Third degree

BURNSSuperficial partial-thickness injury

•Thin-walled fluid blisters form

quickly

•Nerves may be exposed to air

when blisters break

•Tactile and pain receptors intact,

thus extreme pain

•Healing within 3-4 weeks,

scarring unusual

BURNS

Deep partial-thickness

injury

•Entire dermis

•Wounds appear waxy

white

•Takes weeks to heal

•Autografts

•Hypertrophic scarring,

poor functional and

cosmetic results

BURNSFull-thickness injury

•Epidermis, dermis, underlying

tissue

•Perhaps muscle and bone, too

(4th degree?)

•Elasticity destroyed – wound

looks dry, leathery

•Oedema – compromised

circulation of circumferential

burns

•Escharotomies – cutting through

burned skin to relieve pressure

•Painless

COMPLICATIONS

Infection: LocalSepticaemia

Dehydration/tissue hypoxiaHypovalaemic shockAcidosis Circulatory failureMulti-organ failure

Electrolyte imbalancesSeizures in childrenCardiac electrical disorders

Myoglobin and Hb induced acute renal failure

COMPLICATIONS Hypothermia Inhalation of smokes and toxic substances:

Suffocation Pulmonary complications:

Aspiration pneumonia Pulmonary oedema Respiratory failure

Neurological disorders Keloids Contracture Psychosocial problems:

Disfiguration and distortion Loss of job Depression Suicidal attempts

HYPERTROPHIC SCARRING

APPLICATION OF CULTURED EPITHELIAL AUTOGRAFTS

FIRST AID FOR BURNS Call 111 immediately Remove the victim safely

Don’t try to be a hero, your safety is also important.

Breathing and airway:Remove constricting objects such as

jewelleries , neck ties, etc.Keep the airway patent

Use cold water repeatedlyConsider hypothermia

Don’t use butter, onion… topical antibiotics

PREVENTION Education Safe handling of corrosive and

flammable substancesKeep them out of reach of childrenNo candles in bedroom

Keep your smoke alarm maintained Keep first aid toolkits Don’t use water to put out fire caused

by boiling oil Always have an exit plan

REFERENCES Porth, C. M. (2007). Essentials of pathophysiology:

Concepts of Altered Health States. Lippincott, Williams & Wilkins.

Springhouse Corporation. (2001). Handbook of pathophysiology. Lippincott, Williams & Wilkins.

Saladin, K. S. (2004). Anatomy & Physiology: The unity of form and function (3rd ed). New York: McGraw-Hill

Tortora, G. J. & Derrickson, B. H. (2006). Principles of anatomy and physiology (11th ed). Hoboken, NJ: John Wiley & Sons.

http://www.staphy.com/Clinical-photos.aspx http://emedicine.medscape.com http://www.patient.co.uk/health/Cellulitis.htm