Burn and post-burn scars
In a period of intense climate changes, with an increased risk of fire, we must all be aware of measures to deal with and protect against the complications of the burn.
BURNS: WHAT WE NEED TO KNOW TO REDUCE ITS COMPLICATIONS
By burn we define any damage to body tissues caused by the action of heat, chemicals, electricity, radiation or friction. A burn is the most serious injury to the human body. A burn of 40% of the total body surface corresponds to amputation of both thighs.
Burns are divided into the following categories, depending on their cause:
Thermal burns: Caused by contact with hot/cold surfaces, liquids or vapours.
Chemical burns: Caused by contact with caustic substances, such as acids or alkalis.
Electrical burns: Caused by exposure to electric current.
Radiation burns: Caused by exposure to radiation, such as sunlight and radiation therapy.
Abrasion Burns: Caused by the skin rubbing against a rough surface.
Depending on the extent and depth of the damage, burns are categorized into:
Superficial: They affect only the outer layer of the skin (epidermis) and cause redness and pain. They usually heal without scarring.
Partial thickness: They affect both the epidermis and the dermis (the second layer of the skin). They cause blisters, severe pain and swelling.
Full thickness: They affect all layers of the skin and possibly the underlying tissues. The skin is hard, white, black or absent, and pain is absent due to the destruction of nerve endings.
The treatment of burns depends on their severity, extent and the cause that caused them. As a general rule, a burn should be immediately assessed by a doctor. Thermal burns to the head, joints, perineum, hand and foot require hospitalization in a unit. The same applies to inhalation burns, since inhaled smoke causes damage to the entire respiratory system, to chemical burns, which need special neutralization and take time to show their final depth, and finally to electrical burns, which are so more serious the greater the voltage of the current and the time it acts.
In the event that we need to provide assistance to a burn victim, we think of the following: call for help (166) and take protective measures to help without putting ourselves in danger. The following apply as general principles:
Superficial burns:
Cooling: Place the affected area under cool (not ice) running water for 10-20 minutes.
Cleaning: Clean the area with mild soap and water.
Hydration: We apply a mild moisturizing or antimicrobial cream.
Pain management: We administer analgesics and NSAIDs such as paracetamol or ibuprofen.
Covering: Cover the area with a clean and dry bandage.
Diet: rich in albumen, lots of fluids
Partial thickness burns:
Cooling: Place the area under cool water for 10-20 minutes.
Cleaning: Clean the area gently with soap and water.
We don't break the blisters: The blisters help protect against infection.
Application of cream or ointment: We use an antibiotic cream or ointment.
Bandage: Cover the burn with a clean and dry bandage.
Pain management: We administer analgesics and NSAIDs such as paracetamol or ibuprofen.
Diet: rich in albumen, lots of fluids
Full thickness burns:
We do not remove clothes that are stuck to the skin.
Do not immerse the burn in water.
Cover: Cover the area with a clean, dry bandage or cloth.
Get medical help right away: Full thickness burns need immediate medical attention.
Elevation: If possible, elevate the affected area above the level of the heart.
Diet: rich in albumen, lots of fluids
The treatment of burns requiring hospitalization continues in special burn centers or, in their absence, in clinics cooperating with plastic surgeons. Taking into account the patient's history, a clinical examination is performed and the depth and extent of the burn is determined. Laboratory and imaging tests follow, and a plan is drawn up for the patient's treatment, which briefly includes the following:
Burn cleaning: The doctor will clean the burn surfaces and assess the deepest points and true extent of the burn to determine the best treatment.
Intravenous fluids and antibiotics: we give fluids and antibiotics to prevent hypoglycemia and treat infections.
Tetanus vaccine or anti-tetanus serum: Depending on vaccination history, a booster dose may be needed.
Surgical treatment: In severe cases, skin grafts or other surgical procedures may be needed.
Physiotherapy and use of special splints: To restore mobility and prevent sprains.
Correct and timely management of burns, by appropriate medical teams, is critical to prevent complications and improve the healing process. Adherence to doctors' instructions for changes and suppression of inflammation initially accelerates healing, while initiation of treatment of post-burn scars, which usually progress to keloid, with silicone patches, moisturisers and sun protection, are key to the best possible outcome of the burn. Equally important as the previous ones is the psychological support of himself and his family, who should be shielded with patience and endurance until the completion of his treatments.
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