Symptoms of stomach cancer development. Stomach cancer: symptoms and manifestation of the first signs. Treatment methods for stomach cancer, prognosis. The importance of early diagnosis of gastric cancer

home

Burns are certain types of injuries resulting from external influences. They can be thermal, chemical, radiation, electrical. There are also different degrees of burns depending on the severity of the injury.

Classification of burns

There are two generally accepted classifications. The division is carried out depending on the impact that caused the damage. Burns are also divided into degrees of burns, depending on the severity and depth of damage to the skin and soft tissues.

Thermal

This type is the most common among such injuries. Exposure to heat from solids, liquids or steam accounts for approximately 94% of all such injuries. Most often, people receive such injuries in living conditions

. About half of cases occur as a result of contact with an open flame. Rest

- due to the interaction of body surfaces with hot liquids, steam, and hot solid objects. A 2nd or 3rd degree thermal burn that covers one third of the body area can lead to death.

When thermal burns occur, the severity of the burns depends on several factors. The temperature of exposure matters.

Temperatures above 45 degrees are dangerous. As this indicator increases, the damage worsens. The thermal conductivity of the substance causing the effect also plays an important role. For example, while in a bathhouse, some people like to set the air temperature to 90 degrees or higher, and no injuries occur. Gaseous substances have much lower thermal conductivity than liquids and solids

. Exposure to water at a temperature of 90 degrees will definitely lead to burns. In addition, the duration of exposure to the traumatic factor plays an important role.

Electric

In addition, you can be burned by electricity from a distance, without contact with the source. With such injuries, the severity of the damage depends on the thickness of the skin and its moisture content. Do not touch electrical appliances with wet hands, even if they are working properly.

Electrical injuries are often painless due to the destruction of nerve endings. If clothing catches fire, electrical injury can be combined with thermal burn. Also, people often suffer mechanical injuries as a result of falling after an electric shock.

These include fractures, head injuries, abrasions and scratches. Such lesions are rarely mild.

Chemical

These types of injuries occur as a result of exposure to certain chemical compounds. These include acids, alkalis,...

Most often, such injuries are suffered by workers in laboratories or specific industries, but this can also happen in domestic conditions.

The most severe burns are those caused by exposure to alkali. Such injuries have characteristic features: take a long time to heal, penetrate deeply, sometimes striking internal organs.

Ray

These types of injuries occur under the influence of radiation. Their features and stages depend on the dosage, as well as the type of radiation beam.

This one is the most rare view burns can occur in the event of an accident in a specific industry involving radiation, during radiography and radiotherapy.

Severity of damage. Degrees of burns

There are several degrees of burns depending on the severity of the injury, there are four in total. Classification by degree allows doctors to predict the development of the situation. It also matters what percentage of total area human body is damaged.

The classification is based on determining the required volume of therapeutic measures, as well as the possibility of tissue regeneration without surgical intervention.

First degree

Each of us has received a first-degree burn more than once throughout our lives.

The first degree of thermal burn is characterized by slight redness, an unpleasant burning sensation, and mild swelling. This type of injury goes away in a couple of days. If you burn yourself at home, you can simply apply cool running water to the damaged area of ​​the skin. This will relieve inflammation and pain.

When the 1st degree of thermal burn is observed, the skin damage is minimal, only the upper layers of the epidermis are affected. Even under normal conditions, they constantly die off; this is the most common physiological process.

First-degree burns do not require special treatment; they pass quickly and completely without a trace. In most cases, they have a small affected area.

Widespread superficial damage is extremely rare. If this happens, then most often a 1st degree burn is combined with deeper lesions.

Second degree

With a second degree burn, more significant damage to the skin is observed. The traumatic effect leads to the formation of blisters filled with fluid. Sometimes they appear after some time. Such lesions have a very favorable prognosis and pass without leaving any traces or noticeable scars on the skin.

The second stage is characterized by the destruction of the epidermis and the outermost layer of the dermis. In this case, symptoms such as severe pain, hyperemia, and swelling are noted.

The pain is burning, aggravated by touch, and is quite long-lasting. Redness around the blisters may or may not be present.

Blisters are formed by dead cells of the epidermis, and are filled with the liquid fraction of blood - plasma, penetrating into them from damaged tiny vessels.

These types of injuries do not require medical attention or special therapeutic measures. The regeneration process can take up to two weeks. To speed it up and relieve pain, you can use special pharmaceutical ointments or gels.

Do not treat damaged areas with oil under any circumstances. This method interferes with cellular respiration and significantly slows down healing.

The danger of such damage is that bursting blisters are an open gate for infections. If the affected area is large, it is better to consult a doctor. He will recommend medications to prevent infection.

Differentiation between the second and third degrees is carried out using pain identification. Both of these stages are characterized by the formation of blisters, but in the second there is pain, and in the third there is none, since the nerve endings are damaged.

Third degree

Three degree burns are usually divided into two subtypes. 3A is a violation of the dermis to deep layers, the lowest of which remain intact.

With such a depth of penetration, independent regeneration is still possible, without surgical intervention.

This only applies to fairly minor wounds. They can be delayed due to the growth of epithelium from the marginal zones. Degree 3B is characterized by deep damage, involving all layers of the dermis, reaching the layer of subcutaneous fat.

This layer of skin does not have the structural elements that are necessary for the regeneration of epidermal and dermal cells. Therefore, independent restoration and growth of tissue does not occur with such a degree of burns.

The main signs are the formation of blisters of various sizes filled with bloody contents, as well as the absence of pain when touched. Exudes from the wound a large number of mucous fluid with blood impurities. Around the wound defects there is pronounced swelling, redness, and increased local temperature. The damaged area is inflamed.

With such deep lesions, there is a number of common symptoms. The clinical picture includes an increase in general temperature, a drop in blood pressure, interruptions in heart function, tachycardia, and difficult shallow breathing.

The third stage of a burn requires immediate hospitalization of the victim. Patients need surgical intervention and drug therapy.

The prognosis depends on what percentage of the body area the lesion occupies. How quickly medical care is provided has important prognostic significance.

In addition, the prognosis also depends on general condition the victim. For example, with thermal burns received during a fire, the degree of intoxication plays a role carbon monoxide.

Fourth

The most rare type of injury of this type. This is the most severe type of lesion, characterized by an unfavorable prognosis even with a small wound area.

With damage of such depth, even within a small area, there is a high probability of death or alienation of the injured limb.

The deep layers of the human body are affected: the skin burns, muscle tissue, tendons and even bones are damaged. A 4th degree burn involves the destruction of most of the nerve endings and blood vessels in the affected area.

The fourth degree can occur as a result of prolonged high temperature exposure, damage to acids or alkalis, as well as electricity.

Wounds of such severity are immediately visible and cannot be confused with anything else. 4th degree burn is characterized by charring, that is, a long-term combustion reaction leading to a change chemical structure tissue cells. The burn site becomes dark, sometimes black. The condition of the victims is extremely serious.

As a rule, people are in a state of shock or coma. If the wound defect has a significant area, medical care must be provided urgently, minutes count. But still, the probability of death is very high.

In cases where such injuries occur, determining their severity and classification is necessary only for medical professionals. When you are burned or someone is injured in front of your eyes, it is necessary not to assess the damage, but to provide first aid.

If the victim is in serious condition, timely therapeutic measures can save his life.

Content

A burn is thermal damage to tissue due to exposure to external factors. Depending on the intensity of the injury, there are 4 degrees of injury. Each degree requires different measures medical care.

Damaging factors

According to medical classification burns are classified depending on the damaging factors:

1. Thermal damage. In case of fires, a person's face and upper respiratory tract are mainly affected. If other parts of the body are affected, the consequences are compounded by the need to remove burnt clothing and the associated risk of infection. Damage from boiling water has a small area, but differs in depth. Hot steam causes mostly shallow tissue damage. When an unprotected surface of the body comes into contact with hot objects, serious burns with clear boundaries remain.
2. Chemical exposure. The strength of the attack depends on the concentration of the substance. In most cases, acids cause shallow lesions. When skin comes into contact with acid short time a burn crust appears, preventing further damage. Heavy metal salts are more likely to cause superficial injuries. The most dangerous and deepest lesions are caused by caustic alkalis.
3. Electrical impact. It is characterized by the depth of the lesion, but a small area in the form of an entry and exit point. Electrical injuries are classified into three types: supervoltage, high-voltage, low-voltage.
4. Radiation exposure. Infrared rays damage the skin and eyes (especially the cornea and retina). The extent depends on the duration and intensity of exposure. Ionizing radiation affects the epidermis and shallow organs. Ultraviolet damage to the skin is large in area and shallow in depth, and is mainly common in the summer.

What does the degree of burn mean?

The classification of burn degrees is based on the residual level of the epidermis’ ability to naturally regenerate without medical support. This principle allows us to standardize the scheme and scope of emergency medical measures.

The ability of the skin to recover is determined by the level of preservation of the microcircular bed and the germ part. When they are damaged, self-healing takes for a long time resulting in the appearance of a pronounced cosmetic defect. Urgent surgical measures are required.

Clinical manifestations of burns depending on the degree

Each degree of burn damage manifests itself with its own symptoms. Their description:

1st degree burn

In the first degree, the upper layer of keratinized epithelium is affected. The causes are sun rays, hot liquids, weak acids, alkalis. The burn is manifested by redness of the skin, swelling, pain, and heals after 2-4 days without leaving any traces. It is not accompanied by pronounced structural changes in the skin or microcirculatory disorders.

Touching the affected skin areas increases the burning sensation. Therapeutic measures are minimal.

2nd degree burn

In the second degree, the keratinized epithelium is affected down to the germinal layer, and blisters with serous contents form. In this case, the deeper layers of the skin are affected, and microcirculation in the damaged area and adjacent areas is slightly disrupted. Such burns are more common than others. They are characterized by favorable flow even over large areas.

The lesion heals due to the regeneration of the germ layer in 1-2 weeks. With a second-degree burn, the papillary layer and capillaries are not damaged, but their function is temporarily impaired while pain persists. Patients suffer from burning and swelling. If the affected area is large, there is a risk of infection and dehydration.

The third degree is divided into types A and B (differing in the severity of symptoms). It affects all layers of the epidermis and dermis. The main difference between the third degree and the second is the absence of pain when touching the surface. This indicates damage to the nerves and subcutaneous tissue. Complete independent recovery does not occur; microcirculatory disorders are maximally expressed.

Due to the large volume of damage, decay products of dead tissue are actively absorbed into the blood, causing severe intoxication. There is a high possibility of skin infection and the development of sepsis. Recovery lasts several months and often requires surgery. Rough scars remain afterwards.

Degree 3A

Degree 3A can cause thermal, chemical burns. In this case, the dermis is partially affected; the bottom of the wound is the intact part of the dermis with sebaceous, sweat glands, and hair follicles. Immediately after the burn, the area turns black or brown and looks like a scab. Sometimes large blisters with serous-hemorrhagic contents, prone to fusion, form.

Pain sensitivity is reduced, but due to its preservation, independent restoration of the skin is possible. If infection does not occur and the wound does not deepen again, the affected areas will heal due to granulation and marginal epithelialization.

Degree 3B

A thermal burn of degree 3B leads to total death of the skin, including the layer of subcutaneous fat and adnexal structures. This makes it impossible to recover on its own. The stage is characterized by the formation of thick-walled bloody blisters or dense scabs of dead skin.

The surrounding skin turns red, swells, and the person exhibits symptoms of intoxication and dehydration. Symptoms include rapid breathing, tachycardia, increased body temperature, and a drop in blood pressure. With such burns, the patient is immediately taken to the hospital for surgical and medicinal treatment.

4th degree burn

A 4th degree burn is characterized by the death of underlying tissues, charring of muscles, bones and subcutaneous fat. This is the most severe defeat of all, regardless of the area of ​​damage. If the burn spreads within one segment, it can lead to the death of the patient or loss of a limb.

The causes may be flames, hot objects, acids, alkalis, or electrical injuries. The damage is deep, affecting blood vessels, nerves, and sometimes bones. The changes spread circulatory around the affected areas, which leads to the formation of a dense crust of necrotic tissue. The preserved elements are compressed, and the blood supply is disrupted.

A dense, thick-walled brown or black scab forms in place of the tissue; patients may fall into shock or coma. With large lesions, burn disease develops within a few hours. Recovery of small lesions takes several months, large lesions take years.

How to help a victim with 1st and 2nd degree burns

The first and second degrees are considered superficial, so they can be treated without emergency medical care. The exception is cases of damage to large areas or severe human condition. Algorithm for help or self-help:

1. Cool the skin - place the burned area in cool water for 10-15 minutes. Ice should not be used.
2. Treat the lesion with special means - aerosols based on dexpanthenol.
3. In the absence of special means, the affected area can be lubricated with raw protein, aloe juice, or make a compress from raw potatoes or pumpkin.
4. The application of oils, fatty creams, and sour cream is prohibited.
5. In case of chemical burns, you need to wash off or neutralize the active substance (acid - with soda solution, alkali - with acetic acid solution), in case of electrical injury - interrupt contact with the power source.
6. At severe pain You can take a painkiller tablet - Ketoprofen, Ketorolac, Perfalgan. For extensive lesions, Promedol and Omnopon are prescribed.
7. At the second stage, the doctor peels off the epidermis, drains or removes blisters, and covers the surface with a hygroscopic aseptic dressing to prevent wound infection.

What to do for 3rd and 4th degree burns

The third and fourth degrees are very dangerous, therefore, with burns of this stage, a person is immediately sent to the hospital. Help algorithm:

1. Treat the skin around the scab with hydrogen peroxide, Furacilin solution, Chlorhexidine, and apply a sterile bandage to the wound.
2. Daily treatment of the crust with ointments and antiseptic solutions.
3. Surgical intervention - necrotomy (for deep circular burns on the body), necrectomy (excision, amputation of the scab, indicated for cleansing the wound), dermatoplasty (to compensate for cosmetic defects).
4. Infusion therapy - to replenish the loss of fluid and protein. With it, colloidal and crystalloid solutions are administered parenterally. Antishock treatment includes the administration of glucose, rheological solutions, and cardiovascular drugs.
5. Wound healing - drying the scab, applying protein coagulants. The use of infrared emitters and fans to prevent germs from entering the wound. Antibiotics are used - the bandages are soaked in them.
6. Decompression – can be performed during the shock stage. Reduces the severity of the patient's condition, prevents the development of edema, which leads to ischemia of nerves and muscles.
7. Cell therapy is part of a complex treatment in which allofibroblasts or keratinocytes are introduced onto the affected surface. They accelerate homeostasis and heal damage.

Video

The concept of “degree of burns” is used to classify injuries received by a victim from thermal, chemical, electrical or radiation burns. Depending on how large the area of ​​the affected skin surface is and how deep the burn penetrates into the tissue, it is assigned a degree from first to fourth.

For more effective treatment, you should have an idea of ​​the severity of the burn. We suggest you understand the classification and find out what actions need to be taken in case of symptoms of burns of varying degrees.

1st degree burn

Remember how your shoulders once “burned” on the beach. Or you burned your hand with boiling water in the kitchen. This is a 1st degree burn. When exposed to a damaging factor, superficial damage to the upper layers of the skin (epidermis) occurs. Pain, redness and swelling of the skin, and slight erythema (inflammation of the skin caused by dilation of capillaries) at the burn site are observed.

First aid

A 1st degree burn does not require special treatment. It is enough to cool the burn area under cool water. After 2-4 days, the burn will go away on its own, leaving behind slight itching and peeling of the skin at the site of injury.

2nd degree burn

A 2nd degree burn is characterized by the formation of vesicles (bubbles up to 1.5 cm in diameter). This burn affects the top 2 layers of skin - the epidermis and dermis. Often accompanied by severe pain, which can last up to 2 days.

It should be noted that with a 2nd degree burn, the area of ​​the affected surface should also be taken into account. This circumstance is important because with a large area of ​​burn, even if its degree does not exceed the second, there is a danger of developing burn shock and then burn disease, and these serious complications require hospital treatment. So if you fall asleep on the beach under the scorching sun, and your whole body has acquired a bright crimson color, this can already lead to and serve as a reason for hospitalization.

First aid for 2nd degree burns

Cool the affected area ( cold water or cool, wet compress). We give the victim a painkiller (an analgesic or an analgesic and anti-inflammatory combination drug such as ketanov or ketoralac) and provide plenty of fluids. Under no circumstances do we puncture the resulting blisters, as this risks introducing infection into the wound. If the affected area is more than 10% skin, or an elderly victim with concomitant pathologies, hospitalization and inpatient treatment are required.

3rd degree burn

3rd degree burns are divided into 2 subgroups: A and B. The difference lies in the depth of damage to the skin and is only a few millimeters. But for the victim, this seemingly small difference can be quite noticeable. The thing is that 3rd degree B burns affect the germ layer of the skin down to the subcutaneous fat. Burn shock, complete damage to the epidermis, the appearance of bullae (large blisters with a diameter of more than 2 cm), erosions and ulcers on the skin are observed.

Third-degree burns can occur due to exposure to flames, hot metal surfaces, or when the victim’s clothing ignites. Skin exposure can also cause severe chemical burns. chemical substances high concentration (acid, alkali, etc.).

What to do if you have a 3rd degree burn?

The first step is to distance yourself from the damaging factor, or, if the victim is unconscious, move him away from the source of damage (knock the flames off his clothes, pull him away from open fire). Then you need to call an ambulance. Before the arrival of specialists, the victim must be relieved of painful shock. For this, it is best to use analgesic solutions (morphine, promedone, pantopon). At the same time, (diphenhydramine, suprastin, travelegil) should be administered.

For local treatment of burns, you can use sterile dressings with a 33% solution of medical alcohol.

4th degree burn

Deep 4th degree burns are characterized by complete destruction of the skin, damage to tissue, muscles, tendons and bones. A dense dark brown or dark brown scab forms on damaged surfaces. At the edges of the burn, thrombosed veins and hanging films of thin epidermis remain open.
With a 4th degree burn, the victim experiences severe pain shock: breathing and pulse become more frequent, arterial pressure. The next (torpid) phase of shock is accompanied by lethargy and confusion, nausea and vomiting, and the pressure slowly decreases.

Deep 4th degree burn - what to do?

The sequence of emergency actions for a 4th degree burn is as follows:

Calling an ambulance or transporting the victim to an emergency room as soon as possible;

If possible, relieve pain with analgesics;

Before doctors arrive, it is important to place the victim in a horizontal position, provide him with rest and warm drinks.

Further assistance should be provided in a medical facility.

Dmitry Belov

A 1st degree burn is a skin injury caused by high temperature, chemical reagent, current or radiation. This is the earliest form of damage, in which the upper layer, the epidermis, suffers. Accompanied by slight redness of the skin and slight swelling.

The human body is designed in such a way that dermal cells are constantly renewed. A first stage burn can be treated in 3-5 days. The hyperemia gradually goes away, the swelling subsides, the skin becomes dry, wrinkled, then the outer layer comes off. It takes about a week to regenerate the epidermis.

Signs of the first stage are visible immediately after contact with the traumatic agent. A slight burning sensation and erythema appear at the site of the lesion. A slight swelling will form around the injury.

Such wounds most often occupy small area and heal quickly. Rough scars and cicatrices are not preserved even in delicate areas.

1st degree burns result from:

• temperature exposure - boiling water, hot steam, hot objects;
• use of chemicals - acid, alkali, salt;
• electrical – touching exposed wires, damaged electrical appliances;
• radiation burn – excessive exposure to ultraviolet and radiation rays.

Minor irritation often appears due to prolonged exposure to the sun or injury at home (boiling water, hot appliances, electricity). If the skin is injured over a large area, this can cause poisoning by decay products or dehydration. To avoid complications, you need to pay attention to the following symptoms:

1. Pain and redness of the skin.
2. Dizziness and headache.
3. Nausea, vomiting, chills.
4. Rapid pulse.

First you need to remove the source of injury and cool the wound. You cannot treat burned areas with ice - you can.

It is advisable to treat the wound under medical supervision to avoid infection. If a child is injured, be sure to consult a doctor.

Features of 1st degree burns of various types

In order for the treatment of a first-degree burn to proceed correctly, it is necessary to take into account the conditions under which it occurred.

1. Thermal burn occurs from contact with hot objects, liquid, steam or fire. The stage of damage is determined by temperature (55-60 degrees), exposure time, thermal conductivity, and characteristics of human skin.

• Fire can damage the respiratory tract, face and other places. If there is clothing at the site of the lesion, this makes it more difficult to remove it and free the wound. Burnt clothing sometimes causes infection.
• Hot objects leave a clear mark at high temperatures. Such burns can be superficial or quite deep.
• Boiling water produces a painful reaction and often affects the deep layers of the skin.
• The steam does not usually cause dangerous injuries, but it can damage the nasopharynx.

1. Chemical is characterized by the influence of acid, alkali, and metal salts. The depth of tissue damage depends on the saturation of the substance and the time of its influence. A first-degree chemical burn is also characterized by swelling of the skin.

• Concentrated acids, getting on the tissue, dehydrate it, the protein breaks down, and a dry crust with clear boundaries is formed. Necrotic scab can have different colors and structures. Its features characterize the substance that caused the wound.
• Alkalies penetrate the fabric more slowly, but are stronger than acids. They destroy tissue proteins and saponification of fats occurs. The formed scab looks like a loose structure and does not have clear boundaries. It is important for the doctor to know the nature of the scab in order to determine the cause of the burn and further treatment.

1. A radiation burn is formed under the influence of sunlight (UV rays), ionizing (alpha, beta and neural rays), beta and x-rays, radiation pulse.

Most often we encounter sun injuries that occur as a result of prolonged exposure to the sun or. The skin turns red imperceptibly, swelling and pain may appear. Sometimes bubbles filled with liquid appear. The bubble may burst and the liquid may leak out. The dermis loses moisture, acquires a parchment texture, and the painful area begins to peel off. Dark-skinned people are less susceptible to sunburn. It is not advisable for fair-haired people with delicate skin to sunbathe for a long time.

1. Electrical burns occur when contacting exposed wires, damaged electrical appliances, touching the metal surface of a switched-on appliance with a wet hand, or being struck by lightning. In addition to skin damage, there is a malfunction in the cardiovascular, respiratory and other systems of the body.

The conditional percentage proportions of skin damage by burns apply:

• head – 9% of the total body;
• right, left hand – 9% each;
• thoracic region – 18%;
• right, left leg – 18%;
• back – 18%.

The percentage helps assess a person’s condition in order to make a conclusion about the possibility of salvation.

How to distinguish stage 1 burn from other degrees

All burns are conventionally classified into 4 degrees. The most common injury in everyday life is damage of stage I severity.

First-degree burns are characterized by redness of the skin, mild swelling and a burning sensation that lasts for several hours. When you touch the affected area, the pain intensifies.

A second degree burn is a deeper injury. The dermis contains capillaries and nerve endings - their functionality is temporarily impaired. The second degree is characterized by bubbles with liquid (plasma) of different diameters and occupied area. The skin around them may remain unchanged or swelling may appear. The burning pain lasts for several hours after the injury. The bubble may burst, leaving behind a red spot.

A third degree burn is characterized by damage to the skin down to the fiber. The cover cannot recover on its own - there is a risk of burn disease. The reason for this is the large size of the damage. The wound and dead tissue produce decay products that enter the blood, causing intoxication. Externally, the 3rd degree has a step-by-step manifestation:

• the formation of blisters filled with liquid;
• wound with mucous-bloody discharge;
• swelling and hyperemia of the skin around the wound;
• possible tachycardia, intermittent breathing, low blood pressure;
• increase in body temperature.

A fourth degree burn is the main dangerous look skin damage. A thick brown or black scab appears at the site of injury. The victim may go into shock or coma. Emergency medical care can save a person's life.

First aid

The algorithm of actions depends on the stage and type of skin damage. When providing first aid for 1st degree burns, you first need to eliminate the cause and then treat.

1. Thermal.

Under the influence of high temperature (boiling water, oil, steam), you need to release the affected area and rinse cold water. The most traumatic areas are the face and eyes. In this case, it is better to immediately seek help from a medical center. For acute pain, an anesthetic is administered intramuscularly, 1-2 ml of morphine solution 1%, 1 ml of promedol 2%.

1. Chemical:

• Carefully release the damaged area and rinse for 10 - 20 minutes with running water.
• A chemical burn from hydrochloric acid is treated with soda or soap solution. Do not wet the affected area, as hydrochloric acid generates heat. Alkaline substances are neutralized with diluted boric, acetic or citric acid.
• The burned area should be dried and then applied with ointment and a sterile bandage.

1. Solar:

• Pour cold water over the affected area.
• Lubricate the sore spot with Panthenol, Spasatel or other anti-inflammatory ointments.
• If degree I damage occupies a large area, it would be better to go to the doctor and listen to professional answers and recommendations.

1. Electric:

• First you need to de-energize the object.
• If this does not work, you need to remove the person from the current using an insulated object.
• Call an ambulance.
• Provide resuscitation measures.

Treatment at home

A characteristic feature of stage I disease is minor skin damage. If the injury occurred at home, you will have to provide assistance yourself. When exposed to heat, the wound on the leg, hand and other parts of the body is first washed with cold water, and then one of the following is applied folk remedies as first aid:

• Sea buckthorn oil is an excellent medicine for treating thermal, chemical and radiation burns. Its value is manifested in its good healing characteristics.
• Soak a gauze pad with sterile sea buckthorn oil, apply to the wound and secure with a bandage. The pain goes away, and the wound heals within a week.
• From sunburn sour cream helps a lot. First you need to take a cool shower and then spread the product onto the burned areas.
• Fresh potatoes provide a good soothing effect after sun damage. It is grated on a fine grater, sour cream or kefir is added and applied to the sore spot. This compress helps restore epidermal cells.
• The product can be used for slight redness of the skin and for severe burns with blisters.

In the first stages, antiseptic ointments and creams (Panthenol, Bepanten) are used. Before using them, you must familiarize yourself with the contraindications indicated in the instructions.

Each of us has suffered burns in our lives. The area of ​​burns varies, but the sensations are always the same: as if a hot coal is being applied to the affected area. And no amount of water, ice or cold compress can overcome this feeling.

And from a medical point of view, a burn is tissue damage caused by high temperature or highly active chemicals, such as acids, alkalis, and heavy metal salts. The severity of the condition is determined by the depth of damage and the area of ​​damaged tissue. There are special forms of burns received from radiation or electric shock.

Classification

The classification of burns is based on the depth and type of damage, but there is a division according to clinical manifestations, medical tactics or type of injury.

Burns are classified according to depth:

1. The first degree is characterized by damage to only the top layer of skin. Externally, this manifests itself as redness, slight swelling and pain. Symptoms disappear after three to four days, and the affected area of ​​the epithelium is replaced by a new one.
2. Damage to the epidermis down to the basal layer indicates a 2nd degree burn. Bubbles with cloudy contents appear on the surface of the skin. Healing lasts up to two weeks.
3. When thermal damage occurs, not only the epidermis, but also the dermis.
   - Grade A: the dermis at the bottom of the wound is partially intact, but immediately after the injury it looks like a black scab, sometimes blisters appear that can merge with each other. No pain is felt at the burn site due to damage to the receptors. Independent regeneration is possible only if there is no secondary infection.
   - Grade B: complete destruction of the epidermis, dermis and hypodermis.
4. The fourth degree is charring of the skin, fat layer, muscles and even bones.

Classification of burns by type of damage:

1. Impact high temperatures:
   - Fire - the affected area is large, but the depth is relatively small. Primary treatment is complicated by the fact that it is difficult to clean the wound from foreign bodies (threads from clothing, pieces of melted buttons or zippers).
   - Liquid - the burn is small but deep (up to the third A-degree).
   - Hot steam - a significant extent of the burn, but the depth rarely reaches the second degree. Often affects the respiratory tract.
   - Hot objects - the wound follows the outline of the object and can have significant depth.
2. Chemical substances:
   - Acids cause coagulative necrosis, and a scab of coagulated proteins appears at the site of the lesion. This prevents the substance from penetrating into the underlying tissue. The stronger the acid, the closer to the surface of the skin the affected area is located.
   - Alkalies form liquefaction necrosis, it softens the tissues and the caustic substance penetrates deeply, a 2nd degree burn is possible.
   - Salts of heavy metals resemble acid burns in appearance. They are only 1st degree.
3. Electrical burns occur after contact with technical or atmospheric electricity and, as a rule, occur only at the point of entry and exit of the discharge.
4. Radiation burns can occur after exposure to ionizing or light radiation. They are shallow, and their impact is associated with damage to organs and systems, and not directly to soft tissues.
5. Combined burns involve multiple damaging factors, such as gas and flame.
6. Combined injuries can be those where, in addition to a burn, there are also other types of injuries, such as fractures.

Forecast

Anyone who has ever received burns (the area of ​​the burns was larger than a five-ruble coin) knows that the prognosis of the development of the disease is an important detail in making a diagnosis. Often, trauma patients are victims of accidents, natural disasters, or work-related emergencies. Therefore, people are brought to the emergency room in whole groups. And that’s when the ability to predict changes in the patient’s future condition will come in handy during triage. The heaviest and complex cases should be considered by doctors first, because sometimes hours and minutes count. Typically, the prognosis is based on the area of ​​the damaged surface and the depth of the lesion, as well as associated injuries.

In order to accurately determine the forecast, conditional indices are used (for example, the Frank index). To do this, for each percentage of the affected area, from one to four points are assigned. This depends on the degree and location of the burn, as well as on the area of ​​the burn on the upper respiratory tract. If there is no breathing problem, then the burn to the head and neck receives 15 points, and if there is, then all 30. And then all the scores are calculated. There is a scale:

Less than 30 points - the prognosis is favorable;
- from thirty to sixty - conditionally favorable;
- up to ninety - doubtful;
- more than ninety - unfavorable.

Damage area

In medicine, there are several ways to calculate the area of ​​the affected surface. Determining the area and degree of the burn is possible if we take it as a rule that the surface different parts The body occupies nine percent of the total skin area, according to this, the head along with the neck, chest, abdomen, each arm, thighs, legs and feet each occupy 9%, and the back surface of the body is twice as much (18%). Only one percent each suffered injuries to the perineum and genitals, but these injuries are considered quite severe.

There are other rules for determining the area of ​​burns, for example using the palm of your hand. It is known that the area of ​​the human palm occupies from one to one and a half percent of the entire surface of the body. This allows us to conditionally determine the size of the damaged area and assume the severity of the condition. The percentage of burns on the body is a relative value. They depend on the subjective assessment of the doctor.

Clinic

There are several symptoms that burns can cause. The area of ​​burns in this case does not play a special role, since they are extensive but shallow. Over time, the forms of clinical manifestations may change into each other during the healing process:

1. Erythema, or redness, is accompanied by redness of the skin. Occurs with any degree of burns.
2. A vesicle is a bubble filled with cloudy liquid. It may be mixed with blood. Appears due to detachment of the top layer of skin.
3. A bulla is several vesicles that have merged into one bubble more than one and a half centimeters in diameter.
4. Erosion is a burn surface on which there is no epidermis. It bleeds or secretes ichor. Occurs during the removal of blisters or bullae, necrotic tissue.
5. An ulcer is a deeper erosion affecting the dermis, hypodermis and muscles. The value depends on the area of ​​previous necrosis.
6. Coagulative necrosis is dry, dead tissue that is black or dark brown in color. Easily removed surgically.
7. Liquation necrosis is wet rotting tissue that can spread both deep into the body and to the sides, capturing healthy tissue.

Burn disease

This is a systemic response of the body to a burn injury. This condition can occur both with superficial injuries, if the body is burned 30% or more, and with deep burns, occupying no more than ten percent. The weaker a person’s health, the stronger this manifestation. Pathophysiologists distinguish four stages in the development of burn disease:

1. Burn shock. It lasts the first two days, for severe damage - three days. It occurs due to improper redistribution of fluid in the shock organs (heart, lungs, brain, kidneys).
2. Acute burn toxemia develops before infection occurs and lasts from a week to nine days. Pathophysiologically similar to long-term crush syndrome, that is, tissue breakdown products enter the systemic bloodstream and poison the body.
3. Burn septicotoxemia appears after infection. It can last up to several months until all bacteria are eliminated from the wound surface.
4. Recovery begins after the burn wounds are covered with granulation tissue or epithelium.

Endogenous intoxication, infection and sepsis

A body burn is accompanied by body poisoning with protein denaturation products. The liver and kidneys are almost unable to cope with the increased load when the pressure in the systemic circulation decreases. In addition, after an injury, a person’s immune system is in a state of high alert, but prolonged poisoning of the body disrupts the defense mechanisms, and secondary immunodeficiency is formed. This leads to the fact that the wound surface is colonized by putrefactive microflora.

Triage of burn victims

Local treatment

There are two known methods of treating burns - closed and open. They can be used either separately or together. To prevent the wound from becoming infected, it is actively dried so that dry necrosis appears. This is what the open method is based on. Substances, such as alcohol solutions of halogens, which can coagulate proteins, are applied to the wound surface. In addition, physical therapy techniques such as infrared radiation may be used.

Closed treatment involves the presence of dressings to prevent the entry of bacteria, and drainages ensure the outflow of fluid. Under the bandage, medications are applied that promote wound granulation, improve fluid outflow and have antiseptic properties. Most often, this method uses broad-spectrum antibiotics, which have a complex effect.