From one combustion respectively scalding one always speaks when the body is exposed to heat of more than 45 degrees Celsius. In this case, the cells are not only damaged, but in the worst case can even die.
What is a burn (scald)?
Reddening of the skin on the top of the hand after scalding with hot water.If heat, i.e. temperatures of more than 45 degrees Celsius, affects the body, its cells are damaged and one speaks of one combustion respectively scalding. There are four degrees of severity:
Depending on how long the heat acts on the body and how high the temperatures are. From one First degree burn one speaks already in case of a sunburn - the typical symptom here is the reddened skin. In this case, only the top layer of the epidermis is affected.
In the Second degree burn In addition to redness and swelling, blisters usually appear. If both the epidermis and the dermis are affected by the injury, one speaks of one Third degree burn - in this case the skin is completely destroyed.
In this case, this is whitish to brownish in color. The worst form of the disease is that Fourth degree burn - Muscles, tendons, bones and joints are affected as well as the skin. The skin itself is black in color due to the charring.
causes
Between 10,000 and 15,000 people are in hospitals annually due to Burns treated - so this is a very common injury.
More than two thirds of the injuries occur in the household or in traffic, while around one third of the burns are caused by accidents at work. Scalds in most cases caused by hot water. Burns, on the other hand, can result from the effects of flames or explosions as well as from radiation or electrical current.
Symptoms, ailments & signs
Blistering of the hand and arm after pouring boiling water over it after an accident.For burns and scalds, symptoms depend on the severity of the injury. A distinction is made between four degrees of damage. In the first-degree burn, only the outermost layer of skin is affected. The symptoms are such that the skin is painful, red and dry and also slightly swollen - such as after sunburn or contact with hot liquids or objects, it should heal in a short time.
The superficial second-degree burn manifests itself with severe pain, a red burn wound, a damp surface. Burn blisters can also form. If one speaks of another second degree burn, the wound is deeper. Since the burn blisters can be open, there is a risk of infection. With this type of burn, it is possible that the skin will scar.
It can take more than three weeks for recovery. Third degree burns are so severe that the entire structure of the skin is destroyed. Due to the destruction of the nerve endings, the patient feels no pain, but a feeling of numbness. This is also where scars develop. This can be caused by contact with electricity, fire or chemicals. A fourth degree burn can involve the complete destruction of the affected body part and is therefore also called charring.
Diagnosis & course
The doctor makes the first diagnosis by not only checking the actual skin area of the burn, but also the patient's cardiovascular functions and breathing. The course of a combustion Of course, it basically depends on the severity of the injury - but age and any previous illnesses also play a not insignificant role.
The initial treatment at the scene of the accident is also very important - the healing process clearly depends on this. Very severe burns may require lifelong follow-up treatment.
Complications
A burn or scald can result in a variety of complications. This is especially true for deep burns or large areas of the body surface. The acute sequelae of severe burns or scalds include infections and the loss of fluids.
In addition, there is a risk of burn disease. In some cases, this can even be life-threatening. Another possible risk of burns is inhalation trauma, which is caused by inhaling soot. Those affected suffer from breathing problems, coughs and a lack of oxygen. The treatment requires the supply of oxygen or even artificial respiration.
Various pre-existing conditions can also play a role in the severity of the complications. These include severe metabolic diseases, diabetes mellitus, nicotine addiction or alcoholism. If there are extensive burns or scalds, this results in a more difficult healing process, which is especially true for older patients.
The effects of a burn also include permanent impairment of the quality of life. These are also possible if, for example, only five percent of the facial skin is affected. There is a risk of severe scarring, the extent of which cannot be predetermined. If the joints are affected by the burn, movement restrictions are possible. Furthermore, there may be impairments of feeling or touch.
When should you go to the doctor?
If you experience slight discomfort after contact with a heat source or an open fire, you should try to cool the affected part of the body to provide relief. Redness of the skin and mild pain can be minimized by holding the body regions under running cold water. A doctor is not needed if there is a significant improvement or freedom from symptoms after a few minutes. A doctor is generally required for more severe burns. If the upper layers of the skin loosen, severe pain or blisters appear on the skin, a medical check-up must be made.
Restrictions in the possibilities of movement, the loss of the grip function or general mobility as well as a loss of physical strength indicate an acute need for action. If the entire body or parts have been in or directly next to a hot heat source for several minutes, a medical clarification of the complaints is advisable.Dysfunction, skin numbness, or shortness of breath should be investigated and treated. If the person concerned stays in an environment with direct sunlight for a long time, the symptoms can also occur. A doctor will be needed to determine the extent of the disorder. Sudden malaise, dizziness and changes in heart rhythm are other signs that need to be clarified.
Treatment & Therapy
Treating a combustion depends on the depth of the injury. You can usually only assess this exactly a few days after the actual accident. First aid at the accident site is very important for treating a burn.
The first step should be to cool the injured area of the skin with water at around 15 to 25 degrees Celsius in order to prevent so-called "afterburn" of the skin. Ice water, on the other hand, should by no means be used; the cooling should not last longer than 20 minutes in order to rule out hypothermia. In addition, the injured person should be wrapped in a blanket, ideally a rescue blanket.
If it is necessary to have the injured person admitted to a hospital, further treatment takes place here. Here the main focus is initially on pain therapy and fluids are now also administered to the patient. It is also important that the injured person has received a vaccination against tetanus.
In the case of burns that affect more than 15 percent of the body surface, patients are usually taken to a special center for severe burns. In some cases, mostly from burn level three, skin grafts are necessary. If large areas of the skin are burned, the patient may have to be placed in an artificial coma.
prevention
Especially in small children is a prevention Burns and Scalds very important. This is where most of the accidents occur in the home. Such accidents can be prevented with the appropriate safety measures.
But adults can also prevent burns - you can avoid sunburn in particular by avoiding the blazing sun, especially at lunchtime. Just as many accidents occur when grilling - here too, special care is required when handling alcohol.
Aftercare
Depending on the degree and location of the burn, the patient may need physiotherapy after treatment to regain or improve mobility. This treatment can already be started in the form of physiotherapy during the inpatient treatment in the hospital. In the case of particularly severe burns that required skin grafts, additional interventions may be required after the acute treatment to make corrections.
Bandages must be changed regularly after acute treatment. Most burns develop scarring. If large scars appear, they must be treated with compressions or massages. This is particularly important in areas of the body with high elasticity such as the hands. The scar tissue can also be treated with additional skin grafts.
Regular greasing of the scars and application with medicinal baths specially tailored to the scar tissue are also useful. In addition to the physical impairment, the person affected can also experience psychological problems. These can be post-traumatic stress reactions. Psychological counseling is therefore advisable in the case of severe burns. In addition, it can lead to persistent pain, which should be treated with pain therapy. Acupuncture is often used here.
You can do that yourself
In the event of a burn, the cause of the burn should first be determined. However, there must no longer be any acute danger. Clothing that has already been burned in must not be removed from the skin. In any case, the burn should only be cooled after consulting a doctor. Only small burns or scalds can be cooled with cold water and then with ice packs. The affected area must be covered in a sterile manner.
After the burn has subsided and, if necessary, has received medical treatment, the affected area should be spared. Depending on the severity of the burn, it can take a few days to weeks for the injury to completely subside. Until then, the affected area should be treated regularly with suitable ointments. Natural aloe vera products are ideal for sensitive skin. The use of alternative remedies should be discussed with the responsible general practitioner or dermatologist.
Larger burns require special treatment. Massages and the use of special anti-scar creams counteract the skin changes. In addition, the cause of the burn must be determined. Preventive measures prevent a new burn.