Understanding Burns: Types, Treatments, and Prevention

Burns are wounds brought on by exposure to radiation, heat, chemicals, or electricity. It's critical that both the general public and healthcare professionals comprehend the various forms of burns, how they should be classified, and the proper courses of action. We will examine the complexities of burns, their classifications, and critical topics including acute admission criteria, assessment, and first aid protocols in this blog.

Types of Burns

• Thermal Burns: These are brought on by heat sources such as liquids, hot surfaces, or fires.
• Chemical Burns: Caused by coming into contact with alkalis or acids.
• Electrical Burns: Caused by coming into touch with low- or high-voltage electrical equipment.
• Extreme cold can cause cold burns that result in frostbite.

Acute Admission Requirements for a Burn Unit 

Specific treatment is needed in some burn instances. Individuals who fit the following description ought to be admitted to a burn unit:
• Possible inhalation damage or airway impairment.
• Burns that need to be treated with fluid.
• Burns that probably need surgery, particularly full-thickness burns.
• Including the hands, face, foot, or lower leg.
• Burn injuries, especially in regions that are vital.
• Individuals dealing with social or mental health issues.
• Doubts about non-accidental injuries.
• Burns in the youngest or oldest age groups.
• Burns brought on by exposure to concentrated acid or high voltage electricity.

Examining for Burns That Aren't Accidental 

It's critical to identify possible cases of non-accidental burns, particularly in populations that are more susceptible. Among the warning signs are:

• A delayed presentation or caregivers who seem unconcerned.
• A discrepancy in the pattern or depth of the burn history.
• Injuries that go undiagnosed, such as fractures or bruising.
• Frequent trips to the hospital.

Also Read: Maxillofacial Injury - Investigation, Treatment

Categorization of Burns 

• Burns of the first degree: They just affect the epidermis, blanch, and recover without leaving scars.
• Second-degree superficial burns: Causes painful blisters on the epidermis and superficial dermis.
• Deep second-degree burns: They heal more slowly, cause diminished feeling, and reach the reticular dermis.
• Third-degree burns: requiring grafting, anesthesia, and full-thickness damage through the epidermis and dermis.
• Burns of the fourth degree: They spread to the muscle or bone and require flap restoration.

Also Read: High Yield Trauma Questions

Evaluation of Burns

• Rule of Nines: Applicable to vast surface areas, this rule calculates the percentage of burns in adults and children.
• Rule of Palms: For minor burns, this allows for rapid estimation.
• Lund and Browder chart: Better for kids, particularly when figuring out body surface area.

Jackson's Thermal Wound Theory 

Explains the coagulation, stasis, and hyperemia zones that surround a burn wound. Making sense of these zones aids in treating decisions. 

Burns' Effects on the Body

 Burns interfere with the skin's ability to produce vitamin D, respond to an immune system, waterproof the skin, and regulate body temperature. Complications such as sepsis and multiorgan failure syndrome are attributed to vascular alterations, fluid loss, and inflammatory reactions.

 It's critical to assess whether fluid resuscitation is necessary, particularly in cases of burns over 10% TBSA in children and over 15% TBSA in adults. Fluid administration is governed by the Parkland formula, which emphasizes the significance of sustaining urine production.

Types of Burns

1. Respiratory Burns

• Blisters inside the mouth, as well as burns on the face and neck.
• Hoarseness or voice changes.
• Stridor, or high-pitched respiration noises.
• Nasal and facial hair burning.
Recognizing respiratory burns early on is essential. Even if the patient is still breathing normally, there are situations where an early elective intubation is recommended. Respiratory distress and trouble intubating a patient can result from delayed action.

Metabolic Poisoning in Burns

Production of hydrogen cyanide and carbon monoxide; poisoning risks from carbon monoxide.  Impacts on cellular respiration and oxygen transport.  High-flow, high-concentration oxygen treatment.
Carbon monoxide is a silent yet deadly gas that can be produced by burns in enclosed areas with incomplete combustion. For patients to survive, carbon monoxide poisoning must be identified and treated quickly.

Escharotomy: Emergency Surgery for Full-Thickness Burns

• Loss of elasticity and circumferential full-thickness burns.
• Pressure accumulation and compartment syndrome. 

Surgical emergency intervention

For full-thickness burn patients, escarotomy—a surgical treatment to release pressure—is crucial in avoiding sequelae such compartment syndrome. Prompt action can enhance results and save limbs.

Topical Treatments for Deep Burns

The benefits and drawbacks of each treatment; silver sulfadiazine cream, silver nitrate solution, and mafenide acetate cream.
Using potent topical therapies is essential for treating serious burns. Healthcare providers can make well-informed decisions depending on the patient's condition when they are aware of the benefits and drawbacks of various solutions.

2.Chemical Burns: Immediate Actions

Eliminating everything that comes into contact with skin.  Using distilled or regular saline water for irrigation; taking particular precautions for various contaminants.
Treating chemical burns requires prompt and deliberate treatment. Acid and alkalis can cause damage that can be lessened by removing the source and using appropriate watering.

3.Electric Burns and Rhabdomyolysis

Elements affecting the severity of the damage.
• Electric injuries at low and high voltages.
• Rhabdomyolysis and the ensuing effects.
Electric burns provide particular difficulties because they damage underlying tissues in addition to the surface. Taking a thorough approach is necessary to manage problems such as rhabdomyolysis.

4.Cold-Related Injuries: Hypothermia, Frostbite, and Trench Foot

Injuries brought on by the cold require quick and adequate care. Long-term harm can be avoided by identifying the stages and using appropriate rewarming techniques.

Conclusion

Burn injuries are difficult and necessitate a multifaceted treatment from medical practitioners. The goal of this thorough guide is to provide light on the various facets of burns, highlighting the significance of prompt diagnosis, suitable interventions, and customized care for the best possible outcomes for patients.

Hope you found this blog helpful for your NEET SS Surgery Trauma Preparation. For more informative and interesting posts like these, keep reading PrepLadder’s blogs.

Frequently Ask Questions About Burns

1. What is the characteristic feature of third degree burn?

Ans: Leathery skin which does not blanch.

2. Does every patient with burns require admission?

Ans:  No

3. Calculate the % of burns for a person who came with flame injury to the front of chest right upper extremity and external genitalia?

Ans: 28%

4. What is the best method to calculate the surface area burns in children?

Ans: Berkow formula

5. A 32 year old male comes to an emergency room with a history of burns involving the front of chest and hands 2 hours before. On evaluation, he is found to have 10% superficial second degree burns, 10% deep degree burns and 10% first degree burns. Will this man require fluid resuscitation?

Ans: Yes

6. If the time of injury of burns is 1pm and the patient reaches the hospital at 3 pm. Will you consider the time from 1 pm or 3 pm?

Ans: the time is taken from 1 pm (i.e, from the time when the burn occurs.

7. A 24 year old man is admitted to an emergency room with 35% full thickness burns after being involved in a house fire. Which fluid is normally avoided during resuscitation in the 1^st 8-12 hours?

Ans: Albumin solution

8. When you have a patient with flame burns which occurred 15-20 min back coming to the emergency room, you will use water at what temperature to irrigate the burn wound?

Ans: Tap water at 15°C

9. A 22 year old man has a full thickness burn of his leg after being trapped in a burning car. There are no fractures of the limb. The burn is well circumscribed. After 2 hours, he complained of tingling of his leg and it appeared dusky. What is the best management for this?

Ans: Escharotomy. In this particular scenario, for monitoring, microcirculation at the distal part should be looked at with the help of pulse oximeter.

10. What is the most common cause of immediate death in patients of burns?

Ans: Carbon monoxide

11. What is the most common cause of early death in patients of burns?

Ans: Asphyxia

12. What is the most common cause of death overall in patients of burns?

Ans: Sepsis

13. What is the most common organism causing infections in burn patients?

 Ans: Pseudomonas

14. What is the overall choice of fluids for burns?

Ans: Ringer lactate

15. What is the overall choice of fluids for burns in children?

Ans: Dextrose normal saline

16. What is the most commonly used colloid?

Ans: Human albumin solution

17. What is the most common immediate cause of death from fire?

Ans: Carbon monoxide poisoning

18. Which is the most commonly used topical agent for deep burns?

Ans: Silver sulfadiazine cream (1%)

19. What is the first thing you do when you receive a patient with chemical burns?

Ans: Remove everything which is in contact with the skin of the person.

20.Which are the tissues of less resistance in the electric burns?

Ans:  Blood vessels and the nerves

21. Which are the tissues of greater resistance in the electric burns?

Ans: Muscles and the bones

Hope you found this blog helpful for your NEET SS Surgery Trauma preparation. For more informative and interesting posts like these, keep reading PrepLadder’s blogs.