Treating a burn under the eye with cream or ointment. Thermal burns part 2 General therapeutic measures

It seems that the topic of burns is the richest in myths and folk methods of treatment. At the same time, traditional methods of treatment in most cases not only do not help, but can also harm the victim. But we still believe in their effectiveness... And this despite the fact that medical science has long developed clear rules for both first aid for burns and the treatment of these injuries at all stages. Let's find out how to effectively and safely treat thermal skin burns with the help of modern drugs, as well as how to correctly diagnose them in order to choose the appropriate treatment tactics.

Thermal skin burns: how to assess the extent of damage

According to statistics, most burns occur in domestic conditions and are caused by exposure to flame, boiling water, hot steam or hot objects. And - alas! – children often receive them. That is why every adult should be guided in determining the degree of burns, since the choice of the method of first aid, the method of further treatment of the burn and the assessment of the need for medical (including inpatient) care depends on this.

So, due to the fact that with thermal burns (as opposed to chemical burns and eye burns) it is quite easy to determine their degree, every person should be able to do this. To begin with, you should, if possible, clarify with the victim or others what happened, in order to make sure that the victim has a thermal burn, then examine the affected surface and assess the area of ​​the burn and the degree.

There are 4 degrees of burns

First degree: redness and swelling of the skin at the site of a thermal burn. Small bubbles with transparent contents may appear.

Second degree: redness and swelling of the skin at the site of the thermal burn, as well as tense or ruptured blisters and a thin scab that begins to form.

Third degree. With the third degree of thermal injury, there is a deep burn to the muscles and bones with the formation of a scab. Bubbles in the third degree, as a rule, have already burst. In this case, around the deep burn area there may be small bubbles with transparent contents (second degree burn) and redness (first degree burn).

Fourth degree. With a fourth degree burn, the burned part of the body becomes charred. It is possible to combine the fourth degree with the first, second and third.

That is, one victim may have burns of varying degrees. In this case, the severity of the victim’s condition is assessed by the deepest burns, depending on the area of ​​the affected surface.

Thermal skin burns: how to assess the affected area

It is extremely important to be able to determine the area of ​​a thermal burn - this allows you to choose the right treatment tactics and sometimes even save the victim’s life. One of the simplest ways to estimate the area of ​​a burn is the “rule of palm.” The area of ​​a person's palm is on average 1% of the area of ​​their body. So, using the palm of your hand, you can determine how many percent of the body is affected.

There is also a rule of nine for adults: arm, half leg, half back, chest, stomach, head - 9% each, and crotch - 1%. But in children, the head and neck make up about 21% of the body area.

Thermal skin burns: how to choose the right first aid strategy

For superficial thermal burns of more than 10% of the body area of ​​adults (for children - more than 5%) and for deeper burns of 5% of the adult’s body (respectively, more than 2.5% of the child’s body), after first aid, mandatory medical assistance is required, followed by hospitalization. Such burns lead to disruption of the general condition, threaten the life of the victim and may subsequently require surgical intervention.

In addition to these cases, mandatory hospitalization is required for victims with deep burns of the hands and feet and superficial extensive burns of the hands and feet, with burns to the eyes, ears, face and perineum, as well as with suspected burns of the respiratory tract due to inhalation of extremely hot air.

Thermal skin burns: how to provide first aid

The algorithm for providing self- and mutual assistance for any thermal burns of the skin is as follows:

• Immediately extinguish the flame on the victim’s clothing and skin by covering it with a cloth (this will stop the flow of air), or throwing off burning clothing. You can extinguish a burning area of ​​clothing by covering it with earth, sand or snow, dousing it with water or lowering it into water.
• Calm the victim and others around.
• Carefully remove the smoldering remnants of clothing from the victim that are not fixed in the wound. It is forbidden to remove any remaining clothing that has stuck to the wound. You should also not touch the burned surface with your hands.
• In case of sunburn, simply move the victim to the shade.
• If you don’t know what happened, briefly and quickly clarify the circumstances (“the child poured a cup of hot broth on himself,” “clothes caught fire from the flames of the fire”).
• Keep the affected surface of the body under running cold water for 10-20 minutes (can be in a container with clean, cool water). This is necessary in order to prevent further deepening and expansion of the wound by heating the burned area. This will also improve blood circulation in the wound. But in no case should you use ice to cool the burn area, since, in addition to the existing burn, the victim will experience an additional injury - frostbite. In extreme cases (in the complete absence of running water), it is possible to cool the wound with urine, but in real life there is almost never a reason to use this method.
• Apply an anti-burn agent (gel, ointment) to the burned surface, then apply a dry sterile bandage on top. Do not use cotton wool under any circumstances: you can only use a bandage, gauze - fabric materials. If there is no emergency treatment for burns nearby and there are no sterile bandages, you just need to apply a clean, dry bandage. It is forbidden to apply ointments, creams, vegetable oil, beaten egg, sour cream, kefir, alcohol solutions and other products to the burned skin, as well as apply aloe leaves, Kalanchoe juice, golden mustache and others to the wound. For minor first-degree burns without extensive damage to the skin and blisters, you may not need to apply a bandage, but only apply the gel.
• In case of extensive burns of the arms and legs, it is necessary to fix the limb with a splint or improvised means and give the limb an elevated position.
• In case of extensive burns and if signs of burn shock occur (pallor, weakness, anxiety, cold sweat, tachycardia, drop in blood pressure, impaired cardiac activity and breathing), give the victim plenty of fluids to drink - clean water, tea, compote. The liquid reduces intoxication, which occurs due to the absorption of decay products of burned skin, subcutaneous tissue, and muscles into the blood.
• In case of severe pain, to prevent painful shock, the victim is given any painkiller (analgin, paracetamol, etc.).
• Proceed with cardiopulmonary resuscitation (artificial respiration and chest compressions) if the victim has no respiratory and (or) cardiac activity.
• If hospitalization is indicated, call an ambulance or take the victim to a medical facility. It is better to use the services of an ambulance, since we usually do not know which department of which hospital treats burns. If possible, this should be a specialized clinic or specialized department.

When can thermal skin burns be treated at home?

Not all burns require further treatment in a hospital or even a clinic. At home, you can independently treat superficial small burns without infection (without red swollen edges of the wound, without purulent discharge from the wound, increased body temperature, chills, increased pain in the wound, the appearance of twitching pain in the wound, etc.).

Adults can begin to treat at home burns covering an area of ​​up to 1% of the body (the size of the person’s palm), unless these are extensive burns of the hand, foot, face, or genitals. This is important to know because healing can cause scarring that will impair the function of these body parts. Only uninfected burns of the hand, foot, or face (about the size of a coin) can be treated at home.

It should be remembered that in the case of a long-term non-healing burn, especially of the lower extremities with concomitant neurovascular pathology of the legs, deepening of the wound, the appearance of purulent discharge, an unpleasant odor from the wound, with increased pain and a violation of the general condition, you should definitely contact a surgeon at the clinic.

Any burns in newborns require medical attention and, as a rule, treatment in a hospital.

If soil gets into the wound during a burn, or the burn was received in nature, you should go to any emergency room or clinic surgeon on the same day to get vaccinated against tetanus, a dangerous infectious disease. It’s good if the doctor also treats this burn surface. In the future, it will be possible to continue treatment at home.

What you need to prepare to treat burns at home

• Sterile bandage - 1-2 packs per day (size and volume - depending on the area of ​​the burn).
• Hand sanitizer (antiseptic).
• Sterile medical gloves - 1 pair of gloves per dressing.
• Hydrogen peroxide (3% solution) – 1-2 bottles per dressing.
• Alcohol solutions of iodine or brilliant green (the so-called “brilliant green”) – 1 bottle.
• Solcoseryl ® gel – 1-2 tubes. In the future - as necessary. By the way, one tube of Solcoseryl ® gel should always be in your home medicine cabinet.
• Solcoseryl ® ointment – ​​1-2 tubes.
• Cotton swabs – 1 pack.
• Gauze swabs (for wound treatment) - you can make them yourself from a sterile bandage, wearing sterile gloves. Store them in a sterile bandage package. It is better to prepare new gauze swabs before each dressing.
• Scissors.
• Plaster (sometimes necessary to secure the bandage to intact skin).

How to treat thermal skin burns at home

Attention! You cannot open burn blisters yourself and use cotton wool and adhesive tape when treating the wound surface. The maximum that is permissible is that a dense bladder filled with contents can be carefully cut along one of the edges with a sterile blade or pierced with a sterile needle.

Dressings (burn treatment) are performed 1-2 times a day. First you need to prepare all the materials and sanitize the hands of the person who will do it. If a bandage has been applied, it should be removed. If the inside of the bandage is fixed to the wound, moisten it with 3% hydrogen peroxide and wait for it to separate from the wound.

Intact skin around the wound must be treated with a solution of iodine or brilliant green, and a preparation must be applied to the wound that will improve tissue nutrition and activate wound healing.

As a local treatment for burns to achieve the fastest possible healing, the Swiss preparations – Solcoseryl ® gel and ointment – ​​are optimal. Due to the active substance - deproteinized hemoderivative of the blood of dairy calves - they are able to effectively and safely activate restoration (reparative) processes in the wound and ensure wound healing by stimulating cells and increasing collagen synthesis.

In addition, Solcoseryl ® was developed taking into account the stages of local treatment of burns. That is why two forms of the drug Solcoseryl® have been developed - gel and ointment. In the first stages of treating a burn surface, only gel is used. Solcoseryl ® gel promotes the formation of granulation tissue, in which the healing process begins, as well as easy removal of discharge from the wound. In addition, it does not contain fat, which means it does not prevent the wound from “breathing,” which reduces its weeping. At the second stage of burn treatment (as the wound dries), ointment is more preferable. Solcoseryl ® ointment performs two functions at once: it creates a protective film on the wound and ensures reliable and rapid healing of the burn.

Thus, Solcoseryl gel and ointment

are the drugs of choice for the effective complex treatment of burns of varying severity and are widely used in home and medical practice for the modern treatment of thermal skin burns.

Burn– tissue damage caused by local exposure to high temperatures (more than 55-60 C), aggressive chemicals, electric current, light and ionizing radiation. There are 4 degrees of burns based on the depth of tissue damage. Extensive burns lead to the development of the so-called burn disease, which is dangerously fatal due to disruption of the cardiovascular and respiratory systems, as well as the occurrence of infectious complications. Local treatment of burns can be carried out open or closed. It is necessarily supplemented with analgesic 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. Minor burns are the most common injury. Severe burns are the second leading cause of accidental death, second only to motor vehicle accidents.

Classification

By localization:

• skin burns;
• eye burns;
• inhalation injuries and burns of the respiratory tract.

According to the depth of the lesion:

• I degree. Incomplete damage to the surface layer of the skin. Accompanied by redness of the skin, slight swelling, and burning pain. Recovery in 2-4 days. The burn heals without a trace.
• II degree. Complete damage to the surface layer of the skin. Accompanied by burning pain and the formation of small blisters. When the blisters are opened, bright red erosions are 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 bubbles prone to coalescence is possible. When the blisters are opened, a motley wound surface is exposed, consisting of white, gray and pink areas, on which a thin scab resembling parchment is subsequently formed during dry necrosis, and a wet grayish fibrin film is formed during wet necrosis.

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

• IIIB degree. Death of all layers of skin. Possible damage to subcutaneous fat tissue.
• IV degree. Charring of the skin and underlying tissues (subcutaneous fat, bones and muscles).

Burns of degrees I-IIIA are considered superficial and can heal on their own (unless secondary deepening of the wound occurs as a result of suppuration). For IIIB and IV degree burns, removal of necrosis followed by 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, II degree. Possible damage to a large area of ​​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 large depth of damage.
• Steam burns. Large area and shallow depth of damage. Often accompanied by a burn of the respiratory tract.
• Burns from hot objects. II-IV degree. Clear boundary, significant depth. Accompanied by detachment of damaged tissues when contact with the object ceases.

Chemical burns:

• Acid burns. When exposed to acid, coagulation (folding) of the protein in the tissue occurs, which causes a shallow depth of damage.
• Alkali burns. In this case, coagulation does not occur, so the damage can reach significant depth.
• Burns from heavy metal salts. Usually superficial.

Radiation burns:

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

Electrical burns:

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

Damage area

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

• the area of ​​the neck and head is 9% of the total surface of the body;
• breast – 9%;
• belly – 9%;
• posterior surface of the body – 18%;
• one upper limb – 9%;
• one hip – 9%;
• one lower leg with foot – 9%;
• external genitalia and perineum – 1%.

The child’s body has different proportions, so the “rule of nines” and “rule of the palm” cannot be applied to it. To calculate the burn surface area in children, the Land and Brower table is used. In specialized medical In 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 (ISI) and the rule of hundreds (RS) are used.

Lesion severity index

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

Forecast:

• favorable – less than 30 units;
• relatively favorable – from 30 to 60 units;
• doubtful – from 61 to 90 units;
• unfavorable – 91 or more units.

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

Hundred Rule

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

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 predominantly in the form of a local process. There is no disruption of the activity of other organs and systems. In children, the elderly and people with severe concomitant diseases, the “borderline” between local suffering and the general process can be reduced by half: to 5-6% for superficial burns and up to 3% for deep burns.

Local pathological changes are determined by the degree of the burn, the period of time since the injury, secondary infection and some other conditions. First degree burns are accompanied by the development of erythema (redness). Second degree burns are characterized by vesicles (small blisters), while third degree burns are characterized by bullae (large blisters with a tendency to merge). When the skin peels off, spontaneously opens or removes the blister, erosion (bright red bleeding surface, devoid of the superficial layer of skin) is exposed.

With deep burns, an area of ​​dry or wet necrosis forms. Dry necrosis is more favorable and looks like a black or brown crust. Wet necrosis develops when there is a large amount of moisture in the tissues, large areas and a large depth of the lesion. It is a favorable environment for bacteria and often spreads to healthy tissue. After rejection of areas of dry and wet necrosis, ulcers of varying 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 of necrotic tissue, 15-21 days - development of granulations.
• Stage III. Scar formation, wound closure.

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

General symptoms

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

Burn disease occurs in stages:

Stage I. Burn shock. Develops due to severe pain and significant loss of fluid through the surface of the burn. Represents a danger 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 retardation. Characterized by thirst, muscle tremors, chills. Consciousness is confused. Unlike other types of shock, blood pressure rises or remains within normal limits. The pulse quickens and urine output decreases. The urine becomes brown, black or dark cherry, and has a burning smell. In severe cases, loss of consciousness is possible. Adequate treatment of burn shock is possible only in specialized medical care. institution.

Stage II. Burn toxemia. Occurs when tissue breakdown products and bacterial toxins are absorbed into the blood. Develops within 2-4 days from the moment of injury. Lasts from 2-4 to 10-15 days. Body temperature is increased. The patient is excited, his consciousness is confused. Convulsions, delirium, auditory and visual hallucinations are possible. At this stage, complications from various organs and systems appear.

From 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 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 large amount of purulent discharge. Healing of burns stops, areas of epithelialization decrease or disappear.

Characterized by fever with large fluctuations in body temperature. The patient is lethargic and suffers from sleep disturbances. No appetite. There is a significant weight loss (in severe cases, a loss of 1/3 of body weight is possible). Muscles atrophy, joint mobility decreases, and bleeding increases. Bedsores develop. Death occurs from general infectious complications (sepsis, pneumonia). In a favorable scenario, the burn disease ends with recovery, during which the wounds are cleaned and closed, and the patient’s condition gradually improves.

First aid

Contact with the damaging agent (flame, steam, chemical, etc.) must be stopped as quickly as possible. With thermal burns, the destruction of tissue due to their heating continues for some time after the cessation of the destructive effect, so the burned surface must be cooled with ice, snow or cold water for 10-15 minutes. Then, carefully, trying not to damage the wound, cut off the clothing and apply a clean bandage. A fresh burn should not be lubricated with cream, oil or ointment - this can complicate subsequent treatment and impair wound healing.

For chemical burns, rinse the wound thoroughly 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. A burn with quicklime should not be washed with water; instead, vegetable oil should be used. For extensive and deep burns, the patient must be wrapped up, given painkillers and a warm drink (preferably a soda-salt solution or alkaline mineral water). A burn victim should be taken to a specialized medical facility as quickly as possible. institution.

Treatment

Local therapeutic measures

Closed treatment of burns

First of all, the burn surface is treated. Foreign bodies are removed from the damaged surface, and the skin around the wound is treated with an antiseptic. Large bubbles are trimmed and emptied without removal. The peeled 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 analgesic and cooling effects and medications are used to normalize the condition of tissues, remove wound contents, prevent infection and reject necrotic areas. Aerosols with dexpanthenol, ointments and solutions on a hydrophilic basis 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.

In case of IIIA burns, the scabs are preserved until they are rejected on their own. First, aseptic dressings are applied, and after the scab is rejected, ointment dressings are applied. The purpose of local treatment of burns at the second and third stages of healing is protection against infection, activation of metabolic processes, and improvement of local blood supply. Medicines with hyperosmolar action, hydrophobic coatings with wax and paraffin are used to ensure the preservation of the growing epithelium during dressings. For deep burns, the rejection of necrotic tissue is stimulated. Salicylic ointment and proteolytic enzymes are used to melt the scab. After cleansing the wound, skin grafting is performed.

Open treatment of burns

It is carried out in special aseptic burn wards. Burns are treated with drying antiseptic solutions (potassium permanganate solution, 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. In this case, ointments with antiseptics (furacilin, streptomycin) are used to treat wounds.

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

General therapeutic measures

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

The selection of antibiotics is based on 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.

During treatment, it is necessary to replace large losses 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 administered glucose, nutrient solutions, solutions to normalize blood circulation and acid-base status.

Rehabilitation

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

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

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

Inhalation lesions

Inhalation injuries occur as a result of inhalation of combustion products. They develop more often in people who have received burns in a confined space. They aggravate the victim’s condition and can pose a danger to life. Increase 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 divided into three forms, which can occur together or separately:

Carbon monoxide poisoning.

Carbon monoxide prevents the binding of oxygen to hemoglobin, causing hypoxia, and with a large dose and prolonged exposure, death of the victim. Treatment is artificial ventilation with 100% oxygen.

Burns of the upper respiratory tract

Burn of the mucous membrane of the nasal cavity, larynx, pharynx, epiglottis, large bronchi and trachea. Accompanied by hoarseness of voice, difficulty breathing, sputum with soot. Bronchoscopy reveals redness and swelling of the mucous membrane, in severe cases - blisters and areas of necrosis. Swelling of the airways increases and reaches its peak on the second day after injury.

Damage to the lower respiratory tract

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

Treatment of burns of the respiratory tract

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

The blisters that appear after a burn are not as safe as many people think. With large blisters after a burn, and especially in the case of an infection, if they are not treated correctly, there is a real threat to the skin.

After a burn: why are blisters a threat to the skin?

Blisters after a burn are the main criterion for classifying such damage as a second degree burn. That is, such a burn can already pose a threat to the skin.

If blisters after a second-degree burn cover more than 10% of the body, such a burn also poses a threat to the life of the victim and requires immediate hospitalization. Regardless of the area of ​​the blisters after a burn, burns of the perineum, face, and burns in newborns and children under 1 year of age pose a threat.

The most common threatening condition after a skin burn with the formation of blisters is inflammation of the blisters after the burn.

Inflammation of blisters after a burn occurs as a result of infection (most often bacterial, less often viral).

After a burn, blisters are fraught with infection

After a burn, the blister can initially be considered infected, because normally, up to 150 species of different microbes live on human skin, including many pathogenic and conditionally pathogenic. Also, sources of infection can be any objects and even the air that came into contact with the bladder after the burn and during the burn. The infection can enter the bladder after a burn directly from the skin, as well as from the sebaceous or sweat glands.

As a result of inflammation in the bladder after a burn, the normal course of regeneration is disrupted. Normally, healing of a bladder after a burn occurs within 1-2 weeks, but if an infection occurs, this process may be delayed. Post-burn blisters can “delay” healing for months.

Damage after a burn initiates three stages of the wound process:

• Purulent-necrotic phase
• Granulation.
• Epithelization.

During the purulent-necrotic phase, the contents of the bladder after a burn become cloudy and then become purulent. Inflammation may also occur around the bladder after a burn, accompanied by redness and increased pain. The cells of the wound surface under the blister after a burn die under the influence of infection.

With proper treatment of an infected bladder after a burn (using antiseptics and surgical opening of the bladder after a burn), the wound is gradually cleared of pus and dead cells. And the process of granulation begins - the formation of new skin cells in the blister area after a burn. This is actually the beginning of healing. At this stage, there is always a risk of wound infection and a return to the first stage, purulent-necrotic. During the granulation stage, it is important that the new skin cells remain protected from drying out, receive enough oxygen and are not injured by the drying bandage. At the stage of epithelization, the skin actually requires only protection from external influences so that the epithelization process does not stop and dryness of the wound surface, cracks and infection do not occur. Unfortunately, blisters infected after a burn most often heal with the formation of a scar.

After a burn: blisters. How to prevent danger?

The most important measures that reduce the threat to skin with blisters after a burn:

• Mechanical cleansing of the skin from pus and dead tissue with minimal trauma to living skin cells. As a rule, this requires opening the infected blister after a burn. This should be done by a doctor.
• Local use of antiseptics that will destroy the infection in the bladder after a burn.
• Creating favorable conditions for the formation of skin cells from granulation tissue at the site of a blister after a burn. It is provided with a hydrophilic base for local treatment of blisters after a burn - this prevents the wound from drying out and also being injured by the drying bandage. Moreover, after a burn, the bladder must receive enough oxygen, that is, drugs for local treatment should not create a greasy film.

These three approaches to the treatment of a blister after a burn will prevent infection of the wound and ensure its speedy (no more than 2 weeks) and permanent healing. In the event of an existing infection, these measures will allow for rapid cleansing of the skin, destruction of microbes in the wound and activation of cells from which new skin is formed. In this case, the risk of scarring after a burn with the formation of a bubble will be minimal.

It is ideal when one drug for local treatment of a blister after a burn meets all three requirements:

• Protecting the wound from injury and drying out.
• Detrimental effect against most bacteria and viruses.
• Hydrophilicity, the absence of a greasy film on the damaged area when using a local remedy - this promotes granulation of the wound at the site of the blister after a burn.

And such drugs now exist: Argosulfan cream is a silver-containing hydrophilic agent for the local treatment of wounds, including blisters after burns. The cream protects the wound without leaving a greasy film. And the antiseptic effect of silver has been known for a long time. The active ingredient of Argosulfan cream - silver sulfathiazole - has a wide spectrum of antimicrobial and antiviral effects with a high degree of safety.

By applying Argosulfan immediately after a burn, you can avoid the development of blisters - the cream protects the skin from their formation. Argosulfan is safe for humans (it is allowed to be used even in children from 2 months of age) and a germ-killing cream, best suited for the local treatment of blisters after burns. Argosulfan also promotes faster healing of wounds!

Burns are a very common, but rather unpleasant and painful injury. Minor burns can heal on their own, but serious burns require medical attention and require special care to avoid infection and speed healing. Before treating a burn, you need to understand what degree of burn you have.

Steps

Part 1

First degree burn. First degree burns are the most common and occur due to scalding, brief contact with hot objects, or exposure to ultraviolet rays. With such burns, only the surface layer of the skin is affected. The burn areas will likely be red, slightly swollen, and painful. Such burns can be treated at home because they do not require special medical treatment. The surface layer of skin is restored over time if you carefully handle the burn site.

• First degree burns are classified as “minor burns,” which is what they are. In some cases, a first-degree burn can be quite extensive. For example, you can get a burn all over your body. But it does not require special medical care.

1. Second degree burn. With such a burn, the skin becomes lumpy, blisters form on it, and the pain will be much more intense. Second degree burns occur due to contact with very hot liquids (such as boiling water), heated objects, or strong exposure to sunlight. If you receive a second-degree burn on your arm, leg, face, or groin area, it should be treated in the same way as a minor burn. If blisters appear on the skin, do not try to squeeze them out or burst them. If the blister bursts on its own, try to keep the area clean by rinsing it with water and applying antibacterial ointment. You can cover the ointment with a bandage or sterile bandage. This dressing needs to be changed regularly.

   Third degree burn. Third degree burns are more serious and require medical attention to treat. A third degree burn occurs from prolonged exposure to a hot object on the skin. The superficial and deep layers of the skin are damaged, and in some cases, muscles, subcutaneous fat and bones may be damaged. The burn site appears very wrinkled with a white or black tint. The degree of pain can vary depending on the level of damage to the nerve endings in the skin (pain receptors). These burns appear “wet” due to the destruction of cells and the abundance of intercellular fluid with proteins.

   Frostbite or “cold burns.” These lesions occur when the skin is exposed to cold temperatures for a long time (such as contact with ice or snow). In this case, the frostbite area will be bright red, white or dark. A person feels a strong burning sensation in the frostbite area when it is treated. Frostbite is considered a “cold burn” because it also damages layers of skin.

   You may have a chemical burn. Chemical burns are a type of burn that occurs when there is contact with hazardous chemicals that damage the layers of the skin. These burns may appear as red spots, rashes, blisters and open sores on the skin. The first step is to determine what caused the burn and immediately get rid of the harmful chemical on the skin.

   Apply a cold compress. If you cannot expose the burn area to running cold water, apply a cold compress or just an ice pack wrapped in a towel to the area. Place this compress over the burn. Leave the compress on for 10-15 minutes, wait 30 minutes, and then apply the compress again for 10-15 minutes.

   • Never apply ice directly to a burn because this can damage the skin! There must be a towel between the skin and the ice.

2. Buy a painkiller. For example, you can buy ibuprofen, acetaminophen, aspirin, and Nise if you are worried about the pain of a burn. If the pain does not decrease after a few hours, take another tablet. Do not give aspirin to young children, and it should not be taken if you have recently had the flu or chickenpox.

   • Follow the instructions on the package. Recommendations for use vary depending on which drug you choose.

3. Clean the burn area. Wash your hands, then wash the burn area with soap and water to prevent infection. After this, apply antibiotic ointment (Neosporin) to the burn site. Aloe vera will help soothe your skin. You can find aloe vera ointment or cream with additives. In addition, thanks to antibiotic ointment or aloe vera, the bandages do not stick to the burn site.

   Apply some ointment to the burn area and then cover the area with sterile gauze. You probably won't need to apply a bandage to first-degree burns, unopened blisters, or unexposed skin. But minor second-degree burns often need to be covered with a bandage to prevent infection. Cover the burn area with sterile gauze and carefully secure it with medical tape. Change the gauze every day!

   Do not treat these burns with home remedies such as egg whites, oil and tea. There are a whole bunch of “miracle” solutions for treating burns on the Internet, but only a few of them have been proven to be effective by research. Many reputable sources (for example, the Red Cross) have concluded that such products aggravate the condition of burns because they contain bacteria and provide a breeding ground for them, which can lead to infection of the wound.

   • Natural moisturizers (aloe vera or soy) may be helpful in treating sunburn.

4. Watch for signs of burn infection. Watch to see if the wound changes color to red, brown, or black. In addition, it is worth monitoring whether there is a greenish tint in and around the wound. If the burn does not heal within a few weeks, consult a doctor. Failure to heal may be a sign of complications, infection, or a more severe burn. Contact your doctor if you notice any of the following symptoms:

   You can relieve the itching with home remedies. Itching is a fairly common complaint among patients in the first days after a burn. Home remedies (such as aloe vera, argan oil) can help reduce the discomfort associated with itching. In addition, antihistamines taken orally can help against itching.

Part 3

Call an ambulance immediately. Do not attempt to treat serious burns at home! Treatment of such burns requires specialized medical care. Seek immediate medical attention or call an ambulance.

• Never Do not attempt to treat a serious (third degree) burn yourself. The following steps in this article describe the first aid that can be provided before emergency medical services arrive.

1. Help the victim move away from the heat source. Try your best to prevent further burns. Move the victim or stop contact with the hot object or liquid.

   • Never move a victim while leaning on the injured area. Otherwise, you may damage the skin and make the wound worse. In addition, it will cause severe pain to the victim and may even cause shock.

2. Cover the burn area. Cover the burn area with a damp towel to protect it until emergency services arrive. Do not put ice on the burn area or immerse the area in cold water. This can lead to hypothermia and further damage to the burn area.

   Eliminate chemical irritants. If the burn was caused by contact with a chemical, try to remove any remaining chemicals from the victim's skin. You can apply some cold water or a cool compress to the area while you wait for emergency help. Do not try to treat a chemical burn with home remedies!

   Elevate the burn area so that it is above the level of your heart. You just need to make sure in advance that you can lift this area without damaging it.

3. In case of shock, immediate medical attention is needed. Symptoms of shock: weak or fast pulse, low blood pressure, clammy skin, confusion, loss of consciousness, nausea, aggressiveness. If you notice symptoms of shock from a third-degree burn, seek immediate medical attention. Call an ambulance to get the victim to the hospital as soon as possible. This situation is life-threatening for the victim.

   • Severe third-degree burns can cause shock because the body loses large amounts of fluid (when a large surface area is damaged). The body cannot function normally when body fluid levels and blood volume are significantly reduced.

If you are burned, it will take quite a long time for healthy skin to form at the burn site. Fortunately, there are quite a few ways to help speed up the regeneration process. If you have a serious burn, be sure to seek medical attention. Minor burns can be treated on your own if you properly treat the area and then ensure the wound is clean and properly treated. It is also important to eat properly to provide the body with the fuel it needs to heal the burn.

Attention: The information in this article is for informational purposes only. Before using any folk remedies or medications, consult your doctor.

Steps

Part 1

Determine the extent of skin damage. Some burns can be treated at home, while others require treatment under medical supervision. If you receive a burn, immediately try to assess the extent of the skin damage. Additionally, in some cases, the injured area may worsen within the first five days after the injury, so monitor the healing process closely.

Place the affected area in cold water. This helps stop further damage to the tissue around the burn site, which reduces pain and speeds up the healing process. If you are burned, immerse the injured area in a container of cold water or under running water as soon as possible. You will want the burned skin to remain in the water for at least 20 minutes or longer.

Place a cool, clean cloth over a serious burn and wait for medical attention. This will help cool the affected area, thereby stimulating the healing process to begin. In addition, a clean cloth will help protect the wound from germs. Lift and move the cloth occasionally to prevent it from sticking to the burn surface.

Elevate the injured body part above the level of your heart. If you have a second or third degree burn, try to elevate and hold the injured part of your body above the level of your heart. This will help reduce pain and prevent swelling from developing.

• For example, if a person has a burn on his forearm, he needs to lie on his back and place the affected arm on a high pillow lying next to him.

1. Seek medical attention immediately if you have a third or fourth degree burn. The surface of such a burn may have a white, yellow or bright red color, since there is deep damage to the layers of the epidermis and dermis. Place the victim in a safe place and get medical help as soon as possible. If you have a serious burn and no one is nearby, call 911 immediately. If this is not done immediately, you may go into shock and be unable to call for help.

   Seek medical attention immediately if the burn is in a sensitive area. If the burn is located in a sensitive area (face, hands, feet, groin, buttocks, or major joints), seek immediate medical attention regardless of the severity of the burn.

   Take antibiotics or steroid medications if your doctor prescribes them. If you have been prescribed treatment with antibiotics or steroid drugs, then the doctor has reason to fear the development of a concomitant disease or infection. If the burn is complicated by an infectious process, this can significantly slow down the healing of damaged tissue. This is why it is important to undergo a course of treatment with medications prescribed by your doctor.

   • Your doctor may prescribe you a course of antibiotics (such as amoxicillin) to prevent an infection from developing. In some cases, doctors prescribe steroid medications (orally or intramuscularly) to speed up the process of tissue regeneration. Do not self-medicate under any circumstances: never take steroid drugs or antibiotics without consulting your doctor!

2. Apply a topical medication prescribed by your doctor to the skin around the burn. Never use cosmetics or over-the-counter lotions until the burn is completely healed. Ask your doctor for topical medications that can be used to relieve itching and prevent scarring. Typically, such products are applied to the skin four times a day.

   • Apply the recommended product to your fingertips and gently rub in circular motions into the damaged area. This will allow the product to be distributed evenly, and it will be better absorbed into the skin.

3. Wear compression garments recommended by your doctor. For minor first and second degree burns, loose clothing should be worn to prevent irritation to the regenerating skin. However, if we are dealing with deep second and third degree burns, your doctor may recommend special compression garments that help speed up the healing process. Such clothing exerts uniform pressure on the regeneration area, due to which the skin is restored evenly and does not form scars.

   • Compression clothing for the treatment of burn scars is made individually for each patient, so ask your doctor to recommend a reliable manufacturer.

Part 3

1. Take medications that reduce inflammation. Ibuprofen helps reduce swelling, which helps optimize the recovery process of damaged skin. Before taking the medicine, carefully read the instructions for the medicine. If your doctor has prescribed you a course of medication, be sure to check with your doctor before taking any additional medications. Anti-inflammatory drugs are usually taken 3-4 times a day.

   Use over-the-counter medications to treat the burn. Pharmacies sell many external medications that help reduce pain and speed up burn healing. If your doctor has not given you specific instructions, ask your pharmacist for advice. Usually, complex-action drugs such as Olazol or Levomekol are recommended for the treatment of burns. You can also use gels and creams containing aloe vera or hydrocortisone. Do not use petroleum jelly-based ointments, or medications that contain iodine or benzocaine, as these may worsen skin irritation.

   • Before using an over-the-counter medicine, read the instructions carefully and follow the instructions.
   • Aloe vera helps replenish nutrients in your skin, while hydrocortisone reduces itching in the affected area.

2. Ask your doctor if you can use vitamin E capsules to treat a burn. Vitamin E capsules can be purchased at the pharmacy. To use this product externally, take a sterile needle (you can use a needle from a disposable syringe) and pierce the capsule at one end. Then squeeze the gel from the capsule directly onto the burn surface. Vitamin E promotes skin regeneration and accelerates the formation of new epidermal cells at the burn site. You can also take vitamin E capsules orally.

   Use honey to heal the wound. For these purposes, you will need natural honey from your home apiary. Take a spoon of honey and apply it on your fingertips. Using circular motions, spread the honey over the damaged skin. Repeat the procedure 2-3 times a day. Honey protects the burn surface from harmful bacteria and helps reduce swelling, thereby speeding up the healing process.

   Drink plenty of water. Try to drink at least eight glasses of water a day, and if possible even more. Your body requires a significant amount of water to heal the burn and stay hydrated. To assess whether you're drinking enough, look at the color of your urine. If your body doesn't have enough water, your urine will be almost colorless. Yellow urine indicates a lack of water in the body, in which case you need to drink more fluid.

   Eat a balanced diet. To restore damaged tissue, the human body spends quite a lot of calories. This is due to the fact that during the healing period of a burn, the body's metabolism accelerates significantly. Try to include plenty of protein foods, such as eggs or peanut butter, in your diet during this time. Limit your intake of junk foods and foods containing empty calories, such as juices.

   • One burn can speed up your metabolism by 180%.

3. Eat foods or take dietary supplements that contain omega-3 acids. The healing process of a burn includes reducing inflammation around the wound. Certain foods, such as fresh fish, can help reduce swelling around a burn and provide the body with the nutrients it needs to heal the wound.

   • Include other foods rich in omega-3 fatty acids in your diet: soybeans, walnuts and flaxseeds.

4. Wear loose clothing. Choose cotton fabrics and loose-fitting clothing that does not fit tightly to the body. If you wear tight clothing, the fabric may stick to the surface of the burn, and you will only make the wound worse when you pull the fabric away. Loose clothing allows air to circulate near the burn site, speeding up scab formation and wound healing.

5. Do not pick at the damaged area. Never puncture blisters or tear off damaged skin - this can lead to pathogenic bacteria entering the wound. Wait until the dead layers of skin spontaneously separate from the burn surface - this will happen when new integumentary tissue forms underneath them.

   • If the bandage is stuck to the wound, wet the cloth generously with clean water, then gently pull the bandage away from the wound.

• Even if at first glance it seems that the burn is not very severe, trust your intuition: seek medical help if you feel that it is necessary.
• If the burn affects your facial skin, do not apply makeup to the wound. Cosmetics can slow down the healing process or even cause infection.

Sources

1. https://www.childrenscolorado.org/doctors-and-departments/departments/surgery/programs/burn/treatment-for-burns/
2. https://www.ayzdorov.ru/lechenie_ozhog_chto.php#part6
3. https://www.askdrsears.com/topics/health-concerns/skin-care/burns
4. https://www.mayoclinic.org/first-aid/first-aid-burns/basics/art-20056649
5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3195355/
6. https://chemm.nlm.nih.gov/burns.htm