Burns

Burns are very common skin lesions. Location, surface area, depth and cause are what determine the severity of a burn. Burns of course, can be minor but can also be life threatening.

Causes

The most common causes of burns are scald burns from boiling water and contact with flames. In children, burns most commonly occur in the home and involve scalding from unsupervised casseroles or playing too close to the fireplace. There are however, many other sources that can cause burns:

• Hot liquids (the more consistent the liquid the more serious the burn)
• Electricity
• Radiation
• Hot objects
• Chemical products

Symptoms

Burn symptoms vary according to the type of burn. There are three types of burns based on the skin layer affected. The three types of burns are first, second and third degree.

First degree burn

First degree burns affect the epidermis - the superficial layer of the skin. The skin is usually red and there may or may not be swelling. During the first few days, the area affected may itch. This however, should disappear quite rapidly. First degree burns usually heal within one week and are occasionally followed by a scaling of the skin. There is no scaring. Sunburns or coming into contact with a hot object can cause this type of burn.

Second degree burn

Second degree burns affect the dermis, burning through the epidermis. The epidermis is therefore completely destroyed and the dermis may be affected in part or in whole. The skin takes on a pinkish color and appears humid and soft and is very painful. Liquid may seep from the skin and blisters may form on the burn. There is a risk of infection since the skin no longer provides a protective barrier. The healing process generally takes 2 to 6 weeks and may leave a scar. Second degree burns may occur as a result of severe sunburn or scalding from boiling water.

Third degree burn

Also known as carbonization, a third degree burn destroys the epidermis, the dermis and the hypoderm which is the deepest skin layer. Muscles, nerves, tendons and even bones may be affected. This type of burn, over a large surface area, can be life threatening. Affected areas appear white or brownish. Once the burn has been sustained, there is very little pain since the nerve endings have been destroyed. The area around the burn however, can be very sensitive. The skin, which regenerates at a very slow pace, will be severely scarred. Elderly persons whose sense of touch is damaged or persons suffering from desensitizing diseases are more at risk for this type of burn.

Diagnosis

The severity of a burn, regardless of its type, takes into consideration the affected surface area and the age of the burn victim. A burn that covers more than 10% of the body requires medical attention.

Treatment

Treatment varies according to the type of burn.

First degree burn

1. Run cool water over the burn for at least 5 minutes or cool with a cold, damp compress.
2. Do not cover or cover with a non adherent sterile dressing.
3. To help the healing process, apply a water-based hydrating lotion.

Second degree burn

1. Run cool water over the burn for at least 5 minutes.
2. Remove any clothing that may be in contact with the burn. If a piece of clothing has adhered to the burn area, do not attempt to remove.
3. Cover with a sterile non adherent dressing.
4. To help alleviate the pain, acetaminophen tablets (Tylenol^TM) may be administered.

Third degree burn

1. *** Do not immerse in cold water ***
2. Remove any clothing that may be in contact with the burn. If a piece of clothing has adhered to the burn area, do not attempt to remove.
3. Cover burn with a pillow case or bed sheet.
4. Keep the person warm and seek medical care.

It is important, regardless of the type of burn, to consult a physician if:

• Burns cover more than 10% of the body
• The eyes, toes, face or feet are affected
• It is an electrical burn
• There are signs of infection (inflammation, redness, heat, pain, pus, fever)

Note

Never apply butter or margarine to a burn. It will not lessen the pain but may in fact increase the burning feeling and will increase the risk of infection. Do not apply ice directly to a burn as it may cause frostbite.

Do not expose burnt skin to UV rays or direct sunlight for at least one year as this could lead to pigmentation changes. The burn must be covered with sunscreen or clothing.