Playing with fire rarely ends well. But thermal burns can be obtained without contact with an open flame. It is enough to touch the grill, touch the iron unsuccessfully, knock over a plate of hot borscht on yourself, or get burned by steam.
Our skin is the largest and most amazing organ; it protects the body from damage, ultraviolet radiation, and the penetration of harmful substances. But the thickness of the epidermis is very small, no more than 2 mm, and it is very important to protect it, including from thermal burns.
A dermatologist at the “Be Healthy” clinic on Frunzenskaya, Anton Samoilov, explained to Mail.ru Health what types of burns there are and how to provide first aid for such injuries.
Thermal skin burns occur when exposed to too much heat, usually from contact with flames, hot surfaces, liquids, hot steam, or electricity. The impact must be so strong that the cells of the epidermis (and sometimes adjacent tissues) are damaged or destroyed.
Fortunately, most burns are minor and can be treated at home after consulting with your doctor. But some injuries of this type require hospitalization or a burn center. According to some data, about 6.5% of all burn patients require specialized medical care. (1)
There are risk factors for burns. First of all, these are young age (children have less life experience and are less careful in everyday life ), professions associated with the possibility of getting such an injury, alcohol consumption, as well as regular cooking over an open fire or using unsafe stoves. In addition, the lack of smoke detectors in the house or apartment is a risk factor.
The main causes of burns:
- scalding with hot liquid (water, soups, tea, coffee and others)
- contact burns from hot solids (for example, touching hot household appliances and objects)
- burn from flame (during fires, making fires, etc.)
- electrical injury (burn from electric shock or lightning)
Degrees of thermal burn
There are four degrees of damage: from slight redness of the skin to the 4th stage – charring. The depth and severity of damage depend on the duration of exposure to the damaging factor, area, temperature and localization of the impact.
| 1st degree (superficial) | Redness of the skin, with swelling and pain. The upper layers of the epidermis are affected, the nerve endings are not damaged. It goes away within 3-6 days. After healing, post-inflammatory pigmentation may remain |
| 2nd degree (superficial) | Blistering of the skin, more pronounced inflammatory reaction and pain. The epidermis is damaged to its full depth, including partially damaged nerve endings. Treatment under medical supervision is required. In the absence of infection, the healing period is up to 2 weeks. Burn marks remain on the skin |
| 3rd degree (deep) | It is characterized by necrosis of all layers of the skin (necrosis). The patient will undergo long-term treatment and rehabilitation (up to a month); skin grafts may be required. Large scars remain after |
| 4th degree (deep) | With charring of fabrics. Not only the skin is affected, but also muscles, fatty tissue, bones, and ligaments. Rehabilitation can be long, up to a year. When treating, the priority is to preserve the life and general health of the patient rather than saving the affected area of skin |
Determination of the area of damage from a thermal burn
A burn is measured not only qualitatively (its degree), but also quantitatively (its area). To do this, doctors often use the following rules.
Palm rule
A person’s palm makes up about 1% of the total area of their body. Therefore, it is convenient to measure the size of the burn with your palms – it immediately becomes clear how badly the person is injured.
Rule of nines
This is almost the same, only here doctors proceed from the fact that the surface of the skin of the hand makes up 9% of the surface of the body, the legs – 18%, the front and back of the torso – also 9% each.
What is burn disease
Burn disease, as you might guess from its name, occurs after exposure of the skin to high temperature. This is our body’s response to trauma.
Stages of burn disease
Burn disease, like any other disease, has its own stages of progression, which smoothly transform into one another. There are four of them: burn shock, acute burn toxemia, burn septicotoxemia and convalescence. Let’s look at each in more detail.
1. Burn shock. The very first stage that follows after thermal effects on the skin. Usually it lasts several hours, less often – several days. Shock occurs due to severe circulatory impairment. (2) In addition to severe pain and burning, a person often feels chills, thirst, his temperature drops, tachycardia, and nausea occur. Shock may develop if more than 10% of the skin is burned.
Burn shock also has degrees – from mild to extremely severe.
2. Acute burn toxemia. The stage following shock occurs as a result of damage to the body by toxins and protein breakdown products due to the death of the affected tissues. It usually occurs on the third day, but can begin later. Toxemia lasts 7-9 days.
3. Burn septicotoxemia. The body begins to fight the infection, and wounds may become covered with pus and scabs. This is usually the fourth or fifth day after the injury. This stage can last a week or more. Often at this moment there is a decrease in immunity and general exhaustion of the body.
4. Convalescence . The period of recovery when wounds heal and a person’s condition stabilizes. (3)
Severity factors for burn disease
After burns, people recover at different rates, even if the degree of damage was the same. The time it takes to fully recover depends on many factors.
We list the main ones:
- The degree of thermal burn (everything is obvious here: first and second degree burns are much easier to tolerate than third and fourth degree burns).
- The area of the lesion (we described above how it is determined. Accordingly, the larger the area, the more severe the course of the burn disease).
- What caused a thermal burn (for example, contact with molten metal on the skin causes much more complex burns than spilling hot tea).
- How quickly first aid was provided and treatment started (the sooner the better).
- What is the age of the patient (burn disease is especially severe in people under 10 or over 50 years of age).(4)
First aid for thermal burns: sequence of actions
The depth of the injury, and therefore the health and, in some cases, the life of a person, depends on how quickly first aid is provided. If you do not get help in time, the severity of the burn may increase.
1. Remove the person from the influence factor
Extinguish the flame as soon as possible and remove the person from the area of high temperatures. For example, let him roll on the ground or floor, knocking down the fire.
2. Cool the affected area with water
Gently (and briefly!) run cool running water or saline onto your skin to reduce the temperature of the burn.
IMPORTANT! This recommendation is relevant for minor burns. If the victim has large area burns, then extreme cooling can lead to hypothermia. (1)
3. Remove smoldering clothing
If clothing is “stuck” to the body, it should not be torn off so as not to infect the wound. Clothes where they are not stuck can be trimmed carefully (trim the fabric around the edges of the stuck areas).
4. Apply an aseptic dressing
It is advisable to do this to prevent infection of burn surfaces. You can use a sterile bandage or an ironed piece of cotton fabric.
5. Wait for an ambulance or take the victim to the hospital
You can help the person wrap himself in a clean cloth and take him to the nearest hospital or wait for the doctors to arrive (whichever is faster).
When to see a doctor or call an ambulance
If you have a slight burn (slight redness without blistering, with mild pain), then it is enough to treat the surface with chlorhexidine. You can cool the skin a little with running water if the wound is not very large. In the future, you can use panthenol for speedy healing.
For more serious burns, you should definitely consult a doctor. Treatment may include bandaging, therapy, skin grafts, and other surgery, depending on the extent of the damage.
But how do you know when to call an ambulance and when it’s enough to just make an appointment with a doctor at a clinic? There are clear criteria when you cannot do without an ambulance:
- if a child or elderly person is injured;
- if a burn of any degree is larger in area than five palms of the patient;
- if the head, eyes are injured, two arms or two legs, genitals or respiratory tract are affected;
- 3rd or 4th degree burn.
It is not always possible to understand how serious the patient’s condition is by appearance. Especially when it comes to a baby.
Therefore, if in doubt, it is better to play it safe and call an ambulance.
The person may need hospital treatment. (5)
Expert reviews and recommendations
Anton Samoilov, a dermatologist at the “Be Healthy” clinic on Frunzenskaya, talks about what you should and should not do in case of burns .
“Under no circumstances provide assistance until you are sure of your own safety (there is no fire, hot appliances, or electric current nearby).
If the patient has extensive burns (2–4 degrees) and shock, he must be placed in a position in which pain will be less bothersome, given water, and called an ambulance.
It is important not to treat burns yourself: you do not need to apply anything to the wound or open the blisters – this will only cause an infection.
Common myths, for example, that a burn needs to be lubricated with sour cream or butter, can lead to a 1st degree burn under the influence of the “greenhouse effect” from a thick mixture turning into a 2nd degree burn.
Also, do not apply ice or cool the burn under water for too long. It is necessary to act only on the doctor’s recommendations.”
Memo to the victim: what to do in case of a thermal burn
It is important for everyone to know this simple instruction so that if necessary, you can help yourself or a loved one.
Note that burns mainly occur at home and at work. Women and children most often suffer at home (overturned boiling water, explosions of gas cylinders), and at work – men (fire, electrical injuries).
- Inspect the burn site. If you can move, consult a surgeon, traumatologist, or a specialist who specializes in burns, such as a combustiologist or burn surgeon. If the burn is serious, call an ambulance.
- Remove clothing from the affected areas, but do not forcefully remove it if it is stuck.
- Drink some water.
- Apply an aseptic dressing or bandage to the burn site. You can cool the skin a little with running water if the wound is not very large.
- Wait for an ambulance or have someone take you to the nearest hospital. Don’t waste time: the sooner you receive qualified assistance, the easier your recovery will be.