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Treatment of all types of burns. What does it look like and what to do in case of a chemical burn of the skin? Applying aseptic dressing

A burn is an acute injury to the skin due to exposure to heat, a chemical, ionizing radiation, or electric current.

In everyday life, you can most often encounter a burn with boiling water, steam, boiling oil, a heated curling iron or utensils. If we talk about the external environment, then the most common burns in this case are sunburn, as well as those that occur upon contact with plants that contain stinging poison, such as nettles or hogweed.

Burns are accompanied by quite severe pain and sometimes can even lead to painful shock. In addition, injuries of this kind take a very long time to heal, especially with improper first aid.

With this in mind, we want to tell you what to do in case of burns at home, what first aid should be and what should not be done in any case. But first, let's take a look at what burns can be and how to determine their severity.

Depending on the factor that caused the tissue damage, burns are divided into three types, namely:

  • thermal;
  • chemical;
  • electrical.

The most common type of burns is boiling water burns.

There are also four degrees of burn severity, and in order to determine it, it is necessary to carefully examine the skin, assess the localization, size of the lesion and depth.

For first degree burn characterized by hyperemia, swelling of the skin and single small blisters with fluid in the burn area. Such burns heal without a trace and do not require hospital treatment.

Second degree the burn is characterized by more pronounced damage to the skin: large blisters with fluid, pain and itching in the affected area. In most cases, treatment is carried out at home, but in case of a serious general condition and childhood, hospitalization in a surgical or burn department is indicated.

At third degree burns damage not only the skin, but also muscle fibers with the ligamentous apparatus. The burn surface is covered with a scab, bubbles with liquid. Also, this degree is characterized by severe pain syndrome and tissue edema. In this case, there is a high risk of purulent inflammation.

For the treatment of third-degree burns, patients must be placed in a burn center, where conservative therapy is carried out, and, if necessary, surgical treatment. The recovery period can take up to two months.

Fourth degree- the most severe and is characterized by the formation of a black scab, carbonization of tissues. Injuries of this kind are very rare in everyday life.

Unfortunately, a burn threatens not only a local inflammatory reaction, skin damage or pain, but also intoxication of the body, which develops due to the decay of the affected tissues. Accordingly, the larger the area of ​​the lesion, the stronger the intoxication of the body. Therefore, in addition to the severity of the burn, the area of ​​the burn surface must be determined.

What to do at home with burns?

The algorithm of action for thermal, chemical and electrical burns is significantly different, therefore first aid directly depends on the nature of the factor that caused the injury.

We propose to analyze the algorithms of actions for the most common types of burns.

1. Stop the action of the aggressive factor.

2. Remove clothing if it can be done without damaging your skin.

3. Remove finger jewelry, watches, bracelets, earrings, etc.

4. Cool the burn surface with cold water - 12-18 ° С for 15-20 minutes:

  • what to do in case of a finger burn? The finger is placed under running cold water or in a container with cool water;
  • what to do if you burn your hand? Hand burns are cooled under running water from a tap or immersed in a bucket of cold water;
  • what to do in case of a burn of the face? In this case, the face should be washed with cold water until the feeling of heat passes. If the tongue burns with boiling water, rinse the mouth with cold water for 10-15 minutes;
  • what to do in case of a burn of the lower limb? A burn of a leg with boiling water is also cooled under running water or in a container with cold water, you can also take a cool bath.

5. Apply an anti-burn agent (Panthenol, Olazol, Bepanten and others).

6. Apply a sterile dressing.

7. For severe pain, take a pain reliever or use a local spray with a local anesthetic.

8. To reduce the risk of infection, especially with burns of 2-3 degrees, it is recommended to apply a bandage with Dimexidum or Furacilin solution.

In case of severe burns, when the bladder bursts and an open wound has formed, it is not recommended to use water for cooling, as this threatens to become infected. In this case, you need to apply a sterile bandage, apply ice to the bandage and call an ambulance.

With 1-2 degrees of severity, burns are treated at home under the supervision of a surgeon. Burns of 3-4 degrees are treated exclusively in stationary conditions.

For a second degree burn, treatment consists in applying dressings to the burn surface 2-4 times a day using ointments that contain antimicrobial components (Levomekol, Levosin, Streptomycin). Before applying the bandage, the burn is washed with one of the local antiseptics (Chlorhexidine, Dimexide).

The burn surface on the face, neck or groin area is not covered with a bandage, they can be lubricated with an anti-burn agent, which will also protect the wound from the penetration of pathogenic microbes.

If we talk about what to do after a burn with boiling water, then traditional treatment can be supplemented with folk remedies.

  • sea ​​buckthorn oil: applied to the burn surface 2-3 times a day;
  • aloe juice: the cut leaf of the plant is placed on the wound for 30-40 minutes;
  • raw potatoes: Raw potato puree is mixed in equal proportions with liquid honey and used in the form of compresses.

Burning a child with boiling water: what to do?

Regardless of the severity, localization and area of ​​the burn, the child must definitely call an ambulance, since it is impossible to predict the reaction of the child's body to this kind of trauma. In addition, the younger the child, the more severe the consequences of the burn can be.

First aid for a child with a burn is as follows.

What to do in case of oil burn?

The density of oil is much higher than that of water. Therefore, when hot oil gets on the skin, its temperature is kept for a long time, which contributes to the spread of damage to the deep layers of tissues.

For thermal burns with vegetable oil (sunflower, olive, etc.) you should adhere to this algorithm of actions.

  1. Rinse the burn immediately under running cold water for 15-20 minutes or immerse the burned part of the body in a container of cold water.
  2. Take an anesthetic drug (Ibuprofen, Paracetamol, Analgin).
  3. In case of a 3-4 degree burn, seek medical help by calling an ambulance.

Sunburns are just as rare as boiling water or oil burns, because in the pursuit of a beautiful tan, we often overdo it or neglect sun protection.

After a sunburn, the skin has bright hyperemia, local hyperthermia, soreness and itching. In severe cases, blisters, fever, chills, and symptoms of dehydration appear. In addition to the above, children with sunburns become lethargic, moody, irritable.

The first aid algorithm is as follows.

  1. Stop exposing your skin to direct sunlight. If there is a burn to the face or other part of the body, then you need to hide under a canopy, trees or in a cool room.
  2. In cases of chills, fever, general weakness, dizziness, nausea or vomiting, you should immediately call an ambulance, as this can be a sign of sunstroke, and not just a burn.
  3. If the general condition is not disturbed, you can take a cool shower or immerse the burned part of the body in a container of cold water. If this is not possible, then you can moisten pieces of cloth or a towel with cool water and apply to the skin for 10-15 minutes.
  4. Apply an anti-burn agent (Panthenol, Pantestin, Bepanten, Pantoderm and others) to the affected skin.
  5. Drink plenty of fluids, preferably clean, room temperature water without sugar or gas.
  6. With severe painful sensations, you can take an anesthetic drug (Ibuprofen, Paracetamol, Analgin);
  7. To reduce itching, edema and inflammatory reaction, antihistamines are indicated (Tavegil, Tsetrilev, Suprastin).
  8. During the recovery period, zinc ointment, titin lotion, Actovegin ointment, sea buckthorn oil, aloe juice and other traditional and non-traditional remedies can be used to accelerate the healing of burns.
  9. Avoid direct sunlight for the next two weeks and cover the affected skin with natural clothing.
  10. Use sun protection.

A tanning burn is not as common as a sunburn, but such an injury is also possible. A burn after a tanning bed is treated according to the principles described above.

Iron burns always leave behind pigmentation, which disappears after a few years.

What to do with a chemical burn?

Chemical damage to tissues includes burns:

  • Dimexide;
  • iodine;
  • hydrogen peroxide;
  • Finalgon;
  • vinegar;
  • ammonia;
  • from mustard plaster and others;

The first aid for a chemical burn of the skin depends on the nature of the aggressive factor.

First of all, you need to stop the effect of the factor on the skin. After which the chemical must be neutralized. For example, with acid burns, the skin is abundantly washed with a solution of baking soda, and with alkali burns, with solutions of citric, boric or acetic acids.

Then a sterile gauze bandage is applied to the affected skin and the patient is given an analgesic drug.

Cow parsnip is a fairly common plant in Russia, the juice of which contains furocoumarin, therefore, upon contact with any part of this plant, a burn appears on the skin.

Immediately after contact with cow parsnip, redness and itching appear on the skin, but over time, rather large blisters form in the affected area, which burst, forming an open wound.

Such burns should be treated under the supervision of a dermatologist or surgeon. But since it is not always possible to turn to a specialist in time, we represent to your attention an algorithm of actions for a burn with this plant.

  1. Eliminate contact with the plant.
  2. Eliminate exposure to sunlight on the affected skin area.
  3. Wash the affected part of the body abundantly with clean water and soap or a mild baking soda solution if there are no blisters.
  4. Apply a sterile bandage.
  5. Treat the burn with a solution of Furacilin or potassium permanganate.
  6. Lubricate the burn surface with Panthenol or any other anti-burn agent.
  7. Avoid sunlight for 2-3 days.
  8. If necessary, take an analgesic, and in case of severe itching, an antihistamine.

In case of severe coughing, suffocation, angioedema, huge blisters, scalp burns, vomiting, you should immediately call an ambulance. Also, only stationary burns are treated with cow parsnip in children.

Observing the listed rules, you can avoid prolonged healing of burns, the appearance of infectious complications and gross residual effects.

As you can see, regardless of the nature of the burn, the central place in the first aid algorithm is the cooling of the affected skin area and only then the application of the anti-burn agent. In addition, there are a number of prohibited actions, such as lubricating the burn with oil, fat, kefir, sour cream or other folk remedies, which can aggravate the burn.

It is also important to assess the severity of the burn, since only 1-2 degree damage can be treated at home. Moreover, children, regardless of the severity of the burn, must be examined by a specialist.

Burn- tissue damage caused by local exposure to high temperatures (more than 55-60 C), aggressive chemicals, electric current, light and ionizing radiation. According to the depth of tissue damage, 4 degrees of burn are distinguished. Extensive burns lead to the development of the so-called burn disease, a dangerous fatal outcome due to disturbances in the work of the cardiovascular and respiratory systems, as well as the occurrence of infectious complications. Local treatment of burns can be carried out in an open or closed way. It is necessarily complemented by anesthetic treatment, according to indications - antibacterial and infusion therapy.

General information

Burn- tissue damage caused by local exposure to high temperatures (more than 55-60 C), aggressive chemicals, electric current, light and ionizing radiation. Light burns are the most common injury. Severe burns rank second in the number of fatalities resulting from accidents, second only to road traffic accidents.

Classification

By localization:
  • skin burns;
  • eye burns;
  • inhalation injuries and burns of the respiratory tract.
By the depth of the lesion:
  • I degree. Incomplete damage to the surface layer of the skin. It is accompanied by redness of the skin, slight swelling, burning pain. Recovery in 2-4 days. The burn heals without a trace.
  • II degree. Complete damage to the surface layer of the skin. It is accompanied by burning pain, the formation of small blisters. When the bubbles are opened, bright red erosion is exposed. Burns heal without scarring within 1-2 weeks.
  • III degree. Damage to the superficial and deep layers of the skin.
  • IIIA degree. The deep layers of the skin are partially damaged. Immediately after the injury, a dry black or brown crust forms - a burn scab. When scalded, the scab is whitish-grayish, moist and soft.

The formation of large, prone to merging bubbles is possible. When the blisters are opened, a motley wound surface is exposed, consisting of white, gray and pink areas, on which, subsequently, with dry necrosis, a thin scab resembling parchment forms, and with wet necrosis, a wet grayish fibrin film forms.

Pain sensitivity of the damaged area is reduced. Healing depends on the number of preserved islets of intact deep layers of skin at the bottom of the wound. With a small number of such islets, as well as with subsequent wound suppuration, self-healing of the burn slows down or becomes impossible.

  • IIIB degree. Death of all layers of the skin. Damage to the subcutaneous fat is possible.
  • IV degree. Carbonization of the skin and underlying tissues (subcutaneous fat, bones and muscles).

Burns of I-IIIA degrees are considered superficial and can heal on their own (if there is no secondary deepening of the wound as a result of suppuration). With burns of IIIB and IV degrees, removal of necrosis with subsequent skin grafting is required. An accurate determination of the degree of burn is possible only in a specialized medical institution.

By type of damage:

Thermal burns:

  • Flame burns. As a rule, grade II. Possible damage to a large area of ​​the skin, burns to the eyes and upper respiratory tract.
  • Liquid burns. Mostly II-III degree. As a rule, they are characterized by a small area and a large depth of the lesion.
  • Steam burns. Large area and shallow depth of the lesion. Often accompanied by a burn of the respiratory tract.
  • Burns with hot objects. II-IV degree. A clear border, considerable depth. Accompanied by the detachment of damaged tissues when contact with the object is terminated.

Chemical burns:

  • Acid burns. When exposed to acid, coagulation (folding) of the protein in the tissues occurs, which causes a shallow depth of the lesion.
  • Alkaline burns. Coagulation, in this case, does not occur, so the damage can reach a considerable depth.
  • Burns with heavy metal salts. Usually superficial.

Radiation burns:

  • Sunburns. Usually I, less often - II degree.
  • Burns from laser weapons, air and ground nuclear explosions. Cause instant damage to parts of the body facing the direction of the explosion, may be accompanied by eye burns.
  • Burns from exposure to ionizing radiation. As a rule, superficial. They heal poorly due to concomitant radiation sickness, in which the fragility of blood vessels increases and tissue repair worsens.

Electrical burns:

Small area (small wounds at the points of entry and exit of the charge), great depth. Accompanied by electrical injury (damage to internal organs when exposed to an electromagnetic field).

Damage area

The severity of the burn, the prognosis and the choice of therapeutic measures depend not only on the depth, but also on the area of ​​the burned surfaces. When calculating the area of ​​burns in adults in traumatology, the "rule of the palm" and the "rule of nines" are used. According to the “rule of the palm,” the palmar surface area of ​​the hand is approximately 1% of the owner's body. According to the "rule of nines":

  • the area of ​​the neck and head is 9% of the entire surface of the body;
  • chest - 9%;
  • belly - 9%;
  • back surface of the body - 18%;
  • one upper limb - 9%;
  • one thigh - 9%;
  • one lower leg with the foot - 9%;
  • external genitals and perineum - 1%.

The child's body has different proportions, so the “rule of nines” and “rule of the hand” cannot be applied to it. To calculate the area of ​​the burn surface in children, the Land and Brower table is used. In specialized honey. institutions, the area of ​​burns is determined using special film meters (transparent films with a measuring grid).

Forecast

The prognosis depends on the depth and area of ​​the burns, the general condition of the body, the presence of concomitant injuries and diseases. To determine the prognosis, the lesion severity index (ITP) and the rule of one hundred (PS) are used.

Severity index

Applicable in all age groups. With ITP, 1% of superficial burn is equal to 1 unit of severity, 1% of deep burn is equal to 3 units. Inhalation lesions without impaired respiratory function - 15 units, with respiratory impairment - 30 units.

Forecast:
  • favorable - less than 30 units;
  • relatively favorable - from 30 to 60 units;
  • doubtful - from 61 to 90 units;
  • unfavorable - 91 and more units.

In the presence of combined lesions and severe concomitant diseases, the prognosis worsens by 1-2 degrees.

Rule of the Hundred

It is usually used for patients over 50 years of age. Calculation formula: sum of age in years + area of ​​burns in percentage. A burn of the upper respiratory tract equates to 20% of the skin lesion.

Forecast:
  • favorable - less than 60;
  • relatively favorable - 61-80;
  • doubtful - 81-100;
  • unfavorable - more than 100.

Local symptoms

Superficial burns up to 10-12% and deep burns up to 5-6% occur mainly in the form of a local process. Disruption of the activity of other organs and systems is not observed. In children, the elderly and people with severe concomitant diseases, the "border" between local suffering and the general process can be halved: up to 5-6% for superficial burns and up to 3% for deep burns.

Local pathological changes are determined by the severity of the burn, the period of time from the moment of injury, secondary infection, and some other conditions. Burns of the first degree are accompanied by the development of erythema (redness). For second-degree burns, vesicles (small vesicles) are characteristic, for third-degree burns, bullae (large bubbles with a tendency to merge). When the skin is peeled off, spontaneous opening or removal of the bladder, erosion is exposed (a bright red bleeding surface, devoid of the surface layer of the skin).

With deep burns, an area of ​​dry or wet necrosis is formed. Dry necrosis is more favorable, looks like a black or brown crust. Wet necrosis develops with a large amount of moisture in tissues, large areas and a large depth of the lesion. It is a favorable environment for bacteria, often spreads to healthy tissues. After rejection of areas of dry and wet necrosis, ulcers of various depths are formed.

Burn healing occurs in several stages:

  • Stage I. Inflammation, cleansing the wound from dead tissue. 1-10 days after injury.
  • Stage II. Regeneration, filling the wound with granulation tissue. Consists of two substages: 10-17 days - cleansing the wound from necrotic tissues, 15-21 days - the development of granulations.
  • Stage III. Scar formation, wound closure.

In severe cases, complications may develop: purulent cellulitis, lymphadenitis, abscesses and gangrene of the extremities.

Common Symptoms

Extensive lesions cause burn disease - pathological changes on the part of various organs and systems, in which protein and water-salt metabolism is disturbed, toxins accumulate, the body's defenses are reduced, and burn exhaustion develops. Burn disease in combination with a sharp decrease in motor activity can cause dysfunctions of the respiratory, cardiovascular, urinary system and gastrointestinal tract.

Burn disease proceeds in stages:

Stage I. Burn shock. It develops due to severe pain and significant loss of fluid through the surface of the burn. Dangerous to the patient's life. Lasts 12-48 hours, in some cases - up to 72 hours. A short period of excitement is replaced by increasing lethargy. Thirst, muscle tremors, chills are characteristic. Consciousness is confused. Unlike other types of shock, blood pressure rises or remains within the normal range. The pulse becomes more frequent, the flow of urine decreases. The urine turns brown, black, or dark cherry and develops a burning smell. In severe cases, loss of consciousness is possible. Adequate treatment of burn shock is possible only in a specialized honey. institution.

Stage II. Burn toxemia. It occurs when the products of tissue decay and bacterial toxins are absorbed into the blood. It develops within 2-4 days from the moment of damage. Lasts from 2-4 to 10-15 days. The body temperature is elevated. The patient is agitated, his consciousness is confused. Convulsions, delusions, auditory and visual hallucinations are possible. At this stage, complications appear from various organs and systems.

From the side of the cardiovascular system - toxic myocarditis, thrombosis, pericarditis. From the gastrointestinal tract - stress erosions and ulcers (may be complicated by gastric bleeding), dynamic intestinal obstruction, toxic hepatitis, pancreatitis. From the respiratory system - pulmonary edema, exudative pleurisy, pneumonia, bronchitis. From the side of the kidneys - pyelitis, nephritis.

Stage III. Septicotoxemia. It is caused by a large loss of protein through the wound surface and the body's response to infection. Lasts from several weeks to several months. Wounds with a lot of purulent discharge. Healing of burns is suspended, areas of epithelialization decrease or disappear.

Fever with large fluctuations in body temperature is characteristic. The patient is lethargic, suffering from sleep disturbances. No appetite. Significant weight loss is noted (in severe cases, a loss of 1/3 of body weight is possible). Muscles atrophy, joint mobility decreases, bleeding increases. Bedsores develop. Death occurs from general infectious complications (sepsis, pneumonia). With a favorable scenario, the burn disease ends with recovery, during which the wounds are cleansed and closed, and the patient's condition gradually improves.

First aid

Contact with a damaging agent (flame, steam, chemical, etc.) must be stopped as soon as possible. In thermal burns, the destruction of tissues due to their heating continues for some time after the termination of the destructive effect, therefore, the burnt surface must be cooled with ice, snow or cold water for 10-15 minutes. Then, carefully, taking care not to damage the wound, the clothing is cut off and a clean bandage is applied. A fresh burn should not be lubricated with cream, oil or ointment - this can complicate subsequent treatment and impair wound healing.

In case of chemical burns, rinse the wound abundantly with running water. Burns with alkali are washed with a weak solution of citric acid, burns with acid - with a weak solution of baking soda. You cannot rinse the burn with quicklime with water; instead, use vegetable oil. With extensive and deep burns, the patient must be wrapped up, given an anesthetic and warm drink (preferably soda-salt solution or alkaline mineral water). A victim with a burn should be taken to a specialized honey as soon as possible. institution.

Treatment

Local curative activities

Closed burn treatment

First of all, the burn surface is processed. Foreign bodies are removed from the damaged surface, the skin around the wound is treated with an antiseptic. Large bubbles are trimmed and emptied without removing. The exfoliated skin adheres to the burn and protects the wound surface. The burned limb is placed in an elevated position.

At the first stage of healing, drugs with anesthetic and cooling effect and drugs are used to normalize the condition of tissues, remove wound contents, prevent infection and rejection of necrotic areas. Dexpanthenol aerosols, ointments and hydrophilic solutions are used. Antiseptic solutions and hypertonic solution are used only when providing first aid. In the future, their use is impractical, since the dressings dry out quickly and prevent the outflow of contents from the wound.

With burns of IIIA degree, the scab is preserved until the moment of independent rejection. First, aseptic dressings are applied, after rejection of the scab - ointment. The goal of local treatment of burns at the second and third stages of healing is to protect against infection, activate metabolic processes, and improve local blood supply. Medicines with hyperosmolar action, hydrophobic coatings with wax and paraffin are used, which ensure the preservation of the growing epithelium during dressings. With deep burns, the rejection of necrotic tissues is stimulated. Salicylic ointment and proteolytic enzymes are used to melt the scab. After cleansing the wound, skin grafting is performed.

Open burn treatment

It is carried out in special aseptic burn chambers. Burns are treated with drying antiseptic solutions (solution of potassium permanganate, brilliant green, etc.) and left without a bandage. In addition, burns of the perineum, face and other areas that are difficult to apply a bandage are usually treated openly. To treat wounds in this case, use ointments with antiseptics (furacilin, streptomycin).

A combination of open and closed methods of treating burns is possible.

General therapeutic measures

Patients with fresh burns have an increased sensitivity to analgesics. In the early period, the best effect is provided by the frequent administration of low doses of painkillers. Subsequently, an increase in the dose may be required. Narcotic analgesics depress the respiratory center, therefore, they are administered by a traumatologist under respiratory control.

The selection of antibiotics is carried out on the basis of determining the sensitivity of microorganisms. Antibiotics are not prescribed prophylactically, as this can lead to the formation of resistant strains that are resistant to antibiotic therapy.

In the course of treatment, it is necessary to compensate for the large loss of protein and fluid. For superficial burns of more than 10% and deep burns of more than 5%, infusion therapy is indicated. Under the control of pulse, diuresis, arterial and central venous pressure, the patient is injected with glucose, nutrient solutions, solutions to normalize blood circulation and acid-base state.

Rehabilitation

Rehabilitation includes measures to restore the physical (therapeutic exercises, physiotherapy) and psychological state of the patient. Basic principles of rehabilitation:

  • early onset;
  • clear plan;
  • exclusion of periods of prolonged immobility;
  • constant increase in physical activity.

At the end of the period of primary rehabilitation, the need for additional psychological and surgical assistance is determined.

Inhalation lesions

Inhalation injuries result from the inhalation of combustion products. They develop more often in persons who have received burns in a confined space. They make the victim's condition heavier, and can be life-threatening. Increases the likelihood of developing pneumonia. Along with the area of ​​burns and the age of the patient, they are an important factor influencing the outcome of the injury.

Inhalation lesions are classified into three forms, which can occur together or separately:

Carbon monoxide poisoning.

Carbon monoxide interferes with the binding of oxygen to hemoglobin, causes hypoxia, and with a high dose and prolonged exposure - death of the victim. Treatment - artificial ventilation of the lungs with the supply of 100% oxygen.

Burns of the upper respiratory tract

Burns of the mucous membrane of the nasal cavity, larynx, pharynx, epiglottis, large bronchi and trachea. It is accompanied by hoarseness of the voice, shortness of breath, sputum with soot. When bronchoscopy reveals redness and swelling of the mucous membrane, in severe cases - blisters and areas of necrosis. The swelling of the respiratory tract increases and reaches its peak on the second day after the injury.

Lower airway involvement

Damage to the alveoli and small bronchi. Difficulty breathing. If the outcome is favorable, it is compensated within 7-10 days. May be complicated by pneumonia, pulmonary edema, atelectasis, and respiratory distress syndrome. Changes on the radiograph are visible only on the 4th day after the injury. The diagnosis is confirmed when the partial pressure of oxygen in the arterial blood drops to 60 mm and below.

Treatment of respiratory tract burns

Mostly symptomatic: intensive spirometry, removal of secretions from the respiratory tract, inhalation of a humidified air-oxygen mixture. Prophylactic antibiotic treatment is ineffective. Antibiotic therapy is prescribed after bacterial culture and determination of the sensitivity of pathogens from sputum.

Traumatic damage to the skin from exposure to high temperatures or contact with chemicals leads to burns. Almost every person, from their own experience, has come across burns, which were of varying degrees and appeared after prolonged exposure to the sun, non-compliance with safety precautions with electrical appliances, or through negligence, which is more typical of children.

Light burns can be treated at home using both traditional methods and over-the-counter pharmaceuticals. It is important to remember that only a 1 or 2 degree burn can be treated at home. If the burn damage is severe enough or has damaged most of the skin, then home treatment is not permissible and can not only harm human health, but also lead to serious consequences. Let's briefly consider the main types and degrees of burns, as well as first aid and remedies that will help restore the skin after a burn at home.

Traditional medicine recipes and medicines for the treatment of burns, which will be mentioned in this article, can only be used for minor burns (1 and 2 degrees) of the skin. If there is a burn of the respiratory tract, mucous membranes, or the percentage of burn injuries occupies more than 40% of the skin and has stage 3 or more, then the only way out is to immediately consult a doctor or call emergency medical care.

Types of burns

You can get a burn in several ways, which is why there are several types of burn damage to the skin.

  • Thermal (thermal) burns - appear as a result of exposure to the human skin of fire, steam, hot liquids or objects.
  • Electrical burns - caused by contact with electrical appliances or lightning.
  • Chemical burns - close contact with chemicals that have local irritant properties.
  • Radiation burns - appear after prolonged contact with ultraviolet rays (sun rays, solarium).

Regardless of the origin of the burn, with the resulting injury, the integrity and irritation of the skin occurs, which causes severe pain in a person, reddening of the skin in the area of ​​damage, followed by the formation of blisters (grade 2).

Burns

There are many reasons that can cause skin burns, but before starting treatment, you need to establish how severe the burn is. All burns, regardless of the cause of their occurrence, are divided into first, second and third degree burns.

First degree burn

Minor skin damage from high temperatures is a first-degree burn. Such a burn on the skin only causes redness and pain. A first-degree burn does not require a person to be hospitalized and can be successfully treated at home.

Second degree burn

Second-degree burns penetrate deeper into the skin. This type of burn injury is characterized not only by reddening of the skin, but also by the appearance of blisters, which are filled with a transparent liquid inside. Most often, 2nd degree burns appear when scalding with boiling water, prolonged exposure to the sun or contact with chemicals. If a 2nd degree burn is extensive, then a large loss of fluid occurs in the human body.

These burns may leave scars or scars on the skin. Important: If a 2nd degree burn is larger in area than a person's palm or is on the face, you definitely need to see a doctor, this will help to avoid cosmetic problems in the future. Treatment of 2nd degree burns is carried out at home and is successfully treated with pharmaceutical preparations in combination with traditional medicine.

Third degree burn

Third-degree burns are pretty dangerous. When they are obtained, the skin is destroyed, subcutaneous tissues and nerve endings are affected. You can get these burns as a result of contact with chemicals, oily substances, from electrical appliances or lightning. The condition of the victim with the 3rd degree of burns can be both moderate and severe. Treatment is only inpatient. Usually, after getting a 3rd degree burn, a person needs a skin graft.

In the case when the burn damages 20% - 40% of the human skin, the injuries are deep, there is a violation of the internal organs, the condition of the victim is serious, then it makes sense to talk about the 4th degree of burns, which are often fatal.

First aid for burns

After receiving a burn, it is considered important to provide first aid to the victim, which will help at times to minimize the consequences and alleviate the person's condition. It is important to remember that further treatment and the recovery process often depend on how first aid is provided. Therefore, it is very important to behave correctly when getting burned. One of the most important in providing first aid for burns is calmness and the absence of panic. Only a “collected” and self-confident person can carry out pre-medical medical measures. So, first aid for burns consists in the following actions:

1. Stop contact of the injured person with a source of high temperatures as soon as possible. If a person is under an electric current, then you cannot touch the person or the source itself. It is necessary to use any insulated object and eliminate the current. In the case when, after the termination of contact with a high temperature, further destruction of tissues occurs, it is necessary to apply cold (ice, snow, cold water) to the burnt surface, but not more than for 10 - 15 minutes.

2. Given that the injured person feels severe pain, you can give any pain reliever, anti-inflammatory drug (Ibuprofen, Ketanov and others).

3. The damaged area of ​​the skin after anesthesia should be treated and a sterile gauze bandage should be applied. A good result can be obtained by using a special dressing material "Combixin" or "Diosept", which can be used for burns of varying degrees.

4. You can treat chemical or thermal burns with running water. Alkali burns - a weak solution of citric acid. If a person has received a chemical burn to the skin, home treatment is carried out depending on the substance that caused the damage to the skin.

Usually, professional medical attention is required for chemical burns, but if the burn is small, you can rinse with a strong jet of cold water. In the case when the burn is caused by quicklime, it is strictly forbidden to cool the surface of the body with water, since such substances, when in contact with water, have the opposite effect and burn the skin even more. Also, when providing first aid after a chemical burn, it is forbidden to independently use any external medicines. Since the reaction of a chemical substance in combination with a medicinal composition can be very different and not always favorable.

If you receive severe burns, after providing first aid, you need to wait for the arrival of an ambulance and be sure to tell the duty team about your actions. If the burns are minor and the face or mucous membranes are not damaged, then you can do without the help of a doctor. Children are an exception.

What not to do with burns

Incorrectly or untimely first aid for burns can lead to complications that will affect the treatment process and increase the recovery period. In case of burns, it is strictly prohibited:

  • lubricate the skin after burns with vegetable oil;
  • use products containing alcohol;
  • to open up "blisters" on their own;
  • clean the wound from the remnants of clothing;
  • use urine.

In case of burns, it is recommended to put cold on the damaged area, but you need to remember that for no more than 10 - 15 minutes. If the amount of time is increased, death of nerve endings may occur, followed by the development of skin necrosis.

Complications after burns

Minor skin burns do not cause any complications, but if a blister appears at the site of damage, which indicates a grade 2 burn, there is a risk of infection with subsequent suppuration and inflammation of the blister. The presence of an inflammatory process can cause an increase in body temperature, general weakness of the body and other ailments. After suppuration of the burn, a scar or scar may remain on the damaged area.

In case of grade 3 burns, the complications are much more serious and can negatively affect the work of internal organs and systems.

Pharmacy preparations for skin burns

The main thing in the treatment of burns is considered to reduce pain syndrome, accelerate healing and disinfection of the skin. The pharmaceutical industry provides a large number of drugs for the treatment of 1st and 2nd degree burns. These medicines come in the form of an ointment, cream, or aerosol for external use. Each of the medicines for the treatment of burns has a different composition and mechanism of action, therefore, before using any remedy, you need to read the instructions for the medicine or consult a doctor. Consider the most effective drugs for burns, which have an antiseptic, wound healing, regenerating effect.

  • Betadine is an antimicrobial drug that contains povidone - iodine. It is widely used to treat 1st and 2nd degree burns. Apply the ointment to the skin with a thin layer 2 - 3 times a day.
  • Levomekol is an effective drug that has bactericidal, analgesic properties. The use of Levomekol for burns allows you to relieve pain, accelerate healing, and quickly restore the skin after burns.
  • Solcoseryl is a biogenic regeneration stimulant often used for skin burns. Apply to the skin 1 - 2 times a day, only after the burn wound stops getting wet.
  • Panthenol is a popular burn remedy, which contains dexpanthenol and B vitamins. The use of Panthenol improves tissue regeneration and has an anti-inflammatory effect. Apply as an aerosol or cream. This drug should always be in the home medicine cabinet, especially in a home where there are children.
  • Amprovisol is an aerosol. Combined drug for the treatment of burns, which contains propolis, anesthesin, menthol and vitamin D. This drug has an anti-burn, anti-inflammatory, antiseptic, analgesic and cooling effect, accelerates skin healing. Recommended for thermal and sunburns of 1 or 2 degrees.

  • Olazol is a wound-healing, anti-burn agent. The preparation contains sea buckthorn oil. Available in the form of a topical aerosol. Has anesthetic, antibacterial effect, reduces exudation, accelerates the process of epithelialization of wounds.
  • Karipazim is a herbal preparation that has a wide range of indications, including for burns. The preparation contains vitamin complexes, amino acids, carbohydrates and other substances. The use of caripazim - treatment for burns allows you to relieve inflammation, accelerate healing, and restore the skin after injury. Available in bottles. Karipazim can be used to treat 2nd degree burns at home, but before using you need to read the instructions for the drug.

Thermal burns are one of the most common household injuries and, of course, people are most often burned with boiling water. The number of victims of careless handling increases in the summer. Obviously, this is due to the widespread blackouts of hot water, which forces people to often boil water in large volumes. Unfortunately, many children suffer through negligence and neglect of adults.

Symptoms and severity of boiling water burns

Normal skin and skin with varying degrees of burn.

Probably, there is not a single person who, at least once in his life, has not been burned with boiling water or just a hot liquid. Fortunately, most often such burns are minor and heal quickly without leaving any marks. But with extensive lesions and prolonged exposure to hot water on the skin, you can get a serious, even deadly (due to possible complications) injury.

It is very important to assess the area of ​​the lesion. If up to 10% of the body surface is burned with boiling water, then the burn is considered local, if more than 10%, then extensive. It is believed that the area of ​​the palm is 1% of the surface of the skin. Children have a much smaller body surface area than adults, so for them a seemingly small burn can be a very serious injury.

  • 1 tbsp. A burn with boiling water is characterized by reddening of the skin area, which has gotten hot liquid, severe burning pain, and slight edema may also appear.
  • 2 tbsp. A hot water burn manifests itself with more serious symptoms: at the site of the lesion, in addition to redness and swelling, bubbles are formed, filled with a light liquid, their surface is tense, and the contents are transparent. If the bladder cover is damaged, the wound surface may be exposed, which after a few days becomes covered with a thin crust (scab).

The biggest danger for burns with boiling water is 2 tbsp. lies precisely in the formed bubbles. It is known that the skin is one of the protective barriers preventing the entry of various microorganisms into the body. When the top layer of the skin peels off, an unprotected surface is formed under it, which significantly increases the likelihood of a bacterial infection.

  • Deep burns of the 3rd and 4th degree, affecting the deepest layers of the skin, subcutaneous fat, muscles and bones, with careless handling of boiling water in everyday life are extremely rare. Such serious injuries, covering up to 100% of the body surface, can be the result of a violation of safety at work or accidents with a spill of boiling water.

First aid for burns with boiling water

Usually, with burns with boiling water, the matter is limited to skin damage of 1 and 2 tbsp., And they can be cured on their own. First aid, quickly provided in this situation, can significantly speed up wound healing, and after a few days you can forget about the burn.

The first thing to do is to gently remove clothing from the affected skin area and cool it down. The limb can be held under running cold, but not ice-cold water, and this should be done for a long time - about 10-20 minutes. If this is not possible, then ice can be placed on the wound (through several layers of tissue) or a towel moistened with cold water, which must be re-cooled as it warms up.

The victim should be taken to a medical facility as soon as possible in cases where he received extensive and deep burns (if blisters appear, even with a thin tire). During transportation or waiting for an ambulance, a person needs to be warmed up, given painkillers and warm drinks.

Home treatment of burns


In case of a I-II degree burn, the affected skin should be treated with Panthenol or Solcoseryl gel.

For burns of 1 and 2 tbsp., When there is no violation of the integrity of the skin, it is recommended to apply products containing panthenol to the lesion site (spray and ointment Panthenol, ointment Bepanten, D-Panthenol, Dexapanthenol, etc.). Solcoseryl gel also has a wound-healing and anti-inflammatory effect. The preparations should be applied in a thin layer to the skin, there is no need to rub in the medicines or saturate the bandage with them, it is necessary to let them soak on their own.

Please note that many medicines are sold in pharmacies in several forms (ointments, gels, creams). For the treatment of burns, you need to choose exactly those that relate to medicinal (ointments and gels), and not to cosmetics (creams).

After treatment and application of the medication, the wound should be covered with a clean, dry dressing. The application of wound-healing preparations should be repeated several times a day (usually 3-4 is enough).

Is it possible to break the blisters in case of burns?

The answer to this question worries everyone who has been burned with boiling water. On the one hand, the lid of the bladder is a protection against infection from entering the wound, on the other hand, under this very lid there is a liquid that will not dissolve by itself and without a puncture it simply has nowhere to go. That is why even doctors cannot find a definite answer.

We can say for sure that if the fluid in the bladder becomes cloudy, then this may be a sign of infection and the development of inflammation. In this case, the bladder must definitely be opened, its contents removed and local treatment with antibacterial drugs (baneocin, levomkol, etc.) carried out. However, if the matter has gone this far, then it is better to entrust the opening of the bladder to a doctor who will do it under sterile conditions, treat the wound and give recommendations for further treatment.

You should definitely consult a doctor if the blisters resulting from a burn have a thick tire, and the area of ​​the affected body surface is large.

In other cases, the bladder can be opened by yourself using a sterile syringe needle and pretreating the area around the bladder with alcohol. After opening, the bladder cap does not need to be removed, it still continues to protect the wound from dirt and infection. If the bubble is not opened, then sooner or later damage to its tire will still occur and the contents will flow out. You can treat the wound with a non-alcoholic antiseptic (chlorhexidine, miramistin, etc.), gently lubricate the surface with an antibacterial agent and apply a dry, clean bandage to it.

Is it possible to lubricate burns with brilliant green and iodine?

Do not lubricate the affected area of ​​the skin with solutions of brilliant green, iodine or potassium permanganate. This is not only useless and causes unnecessary pain, but it can also create difficulties in diagnosis for the doctor, if you have to contact him.

Can oil burns be treated?

It is impossible to lubricate the skin with any oil immediately after a burn. First, the skin needs to be cooled, and the oil, on the contrary, will prevent the release of heat, thereby aggravating the burn. But you can use oils at the healing stage, sea buckthorn oil boasts good wound healing properties.


Folk remedies for the treatment of burns


Lubricating the burn site with aloe juice is unsafe, as it can cause an allergic reaction and aggravate the patient's condition.

Folk remedies should be used with caution; it is often recommended to apply potato gruel to already cooled skin or sprinkle the burn area with potato starch, soda, grease with kefir or sour cream. Judging by the reviews, such methods are quite effective, and you can use them if there are no drugs at hand. However, you should not experiment with extensive burns with blisters; it is worth trying folk remedies only for burns of 1 degree.

When to see a doctor

Many people consider burns to be minor injuries, but sometimes a small burn can cause serious complications. In fact, cases of infection and the development of inflammation at the site of the burn are not uncommon, and this is fraught with formation after healing.

See a doctor if the burn is localized to the face. If opening the bladder after a burn on the leg seems to be a harmless procedure, then risking your face is still not worth it.

If the fluid filling the burn bladder becomes cloudy, red or brown, the surface of the bladder continues to remain tense even several days after the burn, and pulsating pain appears in the wound area - this is a sign of inflammation. It is best to see a surgeon to open the bladder and clean the wound.

You should be especially careful with children, even with a seemingly frivolous burn, it is better to consult a doctor, since bacterial complications in a child develop much faster than in an adult. And not everyone will be able to assess the degree of damage on their own and choose the correct treatment tactics.

Which doctor to contact

In case of burns, you need to call an ambulance or go to the emergency room yourself. Mild injuries are treated by a surgeon. If, due to intoxication, a burn disease has developed or the area of ​​damage is large, the victim is sent for treatment to a hospital. This can be a department of pure surgery or combustiology.

Many people are worried about whether the temperature can rise with a burn. The intensity of the manifestation of this symptomatic symptom depends on a number of factors such as the area of ​​skin lesions, the degree of tissue damage and the general condition of the person.

Causes of temperature rise in burn injuries

With burns, the temperature rises for several reasons:

  1. In this way, the body forms an immune response to exposure to boiling water, fire, or harsh chemicals.
  2. High fever is a person's response to intense pain.
  3. If this symptom is observed 3 days after injury, which was accompanied by the occurrence of burn blisters, then we are talking about the addition of a secondary infection. An increase in body temperature indicates the development of an inflammatory process.

The temperature can rise from a burn if the victim was not provided with first aid in a timely manner: they did not perform external treatment of the wound and did not apply a sterile bandage.

What burns are accompanied by a temperature?

There are the following types of burns:

  1. Solar... The temperature rise is observed for several hours. Even loss of consciousness is possible. Additionally, a child or an adult has vomiting urge, the skin becomes red. Severe pain is characteristic even with light touch to the affected area.
  2. Thermal... Even with grade 2 burns, there is no fever. This symptom is observed with large areas of damage.
  3. Chemical... The degree of temperature rise depends on the size of the skin lesions. With a severe burn (chemicals corrode not only soft tissues, but also muscle fibers, bones), a high temperature is observed in most clinical cases.
  4. From electric shock... Dangerous and can lead to death of the victim. An increase in temperature is the main symptomatic symptom in this case.

The violation of the temperature balance is more typical for young children. The body of an adult does not always react in a similar way to a sun or thermal burn of the skin.

The manifestation of this symptom also depends on the severity of the injury:

  1. With a burn of 1 degree, subfebrile body temperature is observed, which can be easily reduced with antipyretic drugs. In most cases, this symptom does not occur.
  2. In the case of moderate injury, intramuscular injections are required.
  3. A high degree of burn injury is characterized by painful shock, accompanied by high fever.
  4. In the case of charring, death occurs almost in the first hours after receiving burns.

Is the temperature rise normal?

There are a number of such features:

  1. If the temperature has risen, then this indicates pathological processes in the body as a result of the injury.
  2. The violation of the temperature balance can be considered as a natural reaction of the body to destructive factors from the outside, but this does not mean that such a phenomenon does not require treatment.
  3. High temperature also occurs against the background of fright, nervous shock, even if we are talking about slight tissue damage. In this case, taking a herbal sedative will be effective.

How to bring down the temperature?

The following activities will be expedient:

  1. Enhanced drinking regimen to restore water and electrolyte balance in the body.
  2. Compress: Soak a clean cloth in cool water and place it on your forehead.
  3. The use of non-steroidal anti-inflammatory drugs (Ibuprofen, Paracetamol).
  4. Use of analgesics. Relief of pain syndrome can lead to positive dynamics of clinical symptoms.
  5. Inhibition of the growth of the number of pathogens, if the formation of purulent exudate is observed in the affected area.

The exact dosage, time interval and frequency of taking medications can only be prescribed by a doctor. Do not self-medicate.

Temperature in children

After a child burns, seek medical advice. You cannot treat it yourself, because only a doctor can do this.

It is important to prevent dehydration. Paracetamol is used in most cases to normalize the temperature balance in young children.

Do not use traditional medicine to avoid an allergic reaction.

How to avoid fever in case of burns?

It is not enough to take antipyretics in various dosage forms. It is necessary to eliminate not only the symptom, but also the cause of the inflammatory process.

It is important to follow a number of such rules:

  1. Rinse the wound under running water. If a grade 4 burn is observed, then the first aid is to cool the affected area with a clean cloth soaked in cool water.
  2. Do not use ice. Many people use it to eliminate painful sensations, but such manipulations exacerbate the problem.
  3. Apply a bandage to the wound to prevent the attack of various bacteria. The victim's body is weakened, which causes purulent inflammation of the tissues.
  4. It is imperative to consult a doctor, because possible intoxication of the body with extensive and deep lesions. In severe cases, treatment is required in a hospital setting.

Each person has their own pain threshold and way of responding to external stimuli. There are times when preventive measures are ineffective. The temperature can persist for a week when any methods of dealing with the symptom do not give the desired result.