Burn

A burn is damage to the skin caused by heat, cold, electricity, chemicals, friction, or radiation. This can be a result of different external factors which can lead to injuries that are both minor else life-threatening.

• Thermal Burn – This is a kind of burn resulting from making a contact with cold (such as the ice) or heated objects (such as hot liquids like water, milk and fry oil, especially for the children) or fire (especially for the adults).
• Chemical Burn – It is a result of making contact with corrosive substances such as strong acid or base (like chemical weapons, or urticant).
• Electrical Burn – Basically, this type of burn is an outcome of contact sources of electricity, such as lightning, stun guns and household current. When the body comes into contact with the electricity, it travels through the body damaging the organs and tissues. This damage could be mild or severe. The most frequent cause of electrical burn in the children is the contact with household current.
• Radiation Burn – This takes place when a contact is made with any of those various effects of radiation. The most common types of radiation burns are sunburn (caused by UV radiation) or high exposure to X-ray for radiotherapy.

The burns have different severity, in accordance with the anatomical part involved and with the extension. It is possible to use two different classifications for the burns.

The first is used especially at the Emergency Department and the name is “Wallace Rule of Nines”. It allows assessing the total body surface area (TBSA) involved in burn patients. The second classification depends on how deep the burn is which can be understood by severity or simply the degree

• First-Degree (Superficial) Burn: It involves the outer layer of skin (epidermis). The patient complains pain and the skin is red without any blisters. The mild sunburn is a classic example of it.
• Second-Degree (Partial Thickness) Burn: This affects a part of the lower layer of skin (epidermis and dermis). The patient complains pain and the skin is swollen, red and blistered.
• Third-Degree (Full Thickness) Burn: Includes all innermost layers of the skin (epidermis and dermis), which can even destroy it. It may go into the underlying layer of skin and subcutaneous tissue. The tissue involved in the burn could be white colored or it could be blackened and charred.
• Fourth-Degree Burn: This involves the deepest tissues (such as muscles and bones). Here, the nerve endings are destroyed and the patient doesn’t complain of any pain.

Proper treatment of the burn should be performed, keeping in mind the complications involved and undertaking steps to avoid the same. A few risks associated include infection, blood loss, sepsis, tetanus, retractive scar and so on.

The burn treatment depends on the extension and how deep the burn is. Sometimes the use of advanced dressing could be enough; whereas in a few cases it is necessary to perform surgical procedures using dermal substitutes (bioactive tissue matrix allograft composed of dehydrated human amnion/chorion membrane (dHACM), hyaluronic acid ester matrix, naturally-occurring urinary bladder matrix (UBM), a porous matrix of fibers of cross-linked bovine tendon collagen and so on). Also, if required dermal/epidermal skin graft must also be performed.

Rest, the worst clinical cases will need hospitalization to have intensive care treatment.