Scorch is tissue damage due to exposure to excessive heat, electric current, radiation, or chemical agent. These traumatic factors have a similar clinical picture, as it causes protein denaturation. In addition to local, burn causes total loss of the body, due to the release and contact with blood products necrotic disintegration of the destroyed tissue. The total defeat of the body, cause burns, burn disease called. With the defeat of more than 30% of the surface of the skin, the blood enters the amount of toxic substances, causing damage of life-supporting systems of the body that is incompatible with life.
Diseased tissue at a burn has three zones:
- zone of necrosis, or scab in the center of the burn, where the impact of a traumatic factor was strongest;
- paranecrosis zone or intermediate zone. Here stops normal blood circulation, and subsequently, if it is not recovered, this area may also be a zone of necrosis, i.e. burn wound may increase after cessation of exposure traumatic factor due to the death of tissues in the zone paranecrosis;
- zone of hyperemia at the periphery of a burn. This area is bordered by healthy tissue is not involved in the pathological process. Here, tissue edema and congestive.
Degree burns vary depending on the depth of the lesion. There are four degrees of burns:
- First-degree burns, or epidermal burns. This degree burn involves the destruction of a surface layer of skin, the epidermis. Clinically it is manifested by hyperemia (redness) of the skin, swelling and blistering. The bubbles of small size, light-filled liquid serous content. Despite the fact that the pain may be significant, such burns heal on their own, the skin recovers completely, without the formation of scar tissue. The period of complete healing of one and a half to two weeks.
- Second-degree burns, or superficial dermal burns. In this case, not only impressed epidermis and deeper layers of the skin, however, the affected area is within the dermis. In the area of necrosis also formed serous bubbles, but more dense, intense and extensive. Paranecrosis area in this case is already beyond the dermis, the subcutaneous fat tissue, so the death of tissues in that area, necrosis extends beyond the dermis, and becomes a third-degree burns;
- Third-degree burns, or deep dermal burns. With this degree burn affects not only the skin on the entire depth, but its appendages to the subcutaneous fat. Bubbles that are not peculiar degree burns as a violation of the integrity of the dermis, in the area of necrosis formed a scab. The depth of burns can reach the surface of muscle fascia;
- Fourth-degree burns. This is the most severe degree burns, in which the direct effect of damaging agent affects the deep tissues of the body: the tendons, blood vessels, nerves, muscles, bones, joints and sometimes internal organs. With burns the third and fourth degrees of burn disease inevitably arises, and tissue healing takes place with the formation of scars.
A feature of burns is that the degree of the burn, especially deep or extensive damage, can be set only 48 hours after the injury, because even after the removal of the damaging agent tissue destruction may continue.
Chemical burns caused by exposure to a chemical agent, which reacts with the tissues of the body, causing their destruction. Chemical burn has some features that distinguish it from thermal or electrical.
Thus, the extent of tissue damage depends on the concentration of the chemical substance, the degree of its activity as well as the nature of the reaction caused in the tissues. The general rule is that, as a rule, tissue damage by chemical burns deeper than it seems at first glance. Each active ingredient in contact with skin or mucous membranes, causes specific, peculiar reaction to him. Yet clinical lesions in chemical burns can be combined into two groups: acid burn and burn alkali.
Chemical burns acid protein causes rapid coagulation necrosis in the area, forming a dense, so-called "dry" scab. Defeat thus clearly distinguished from the surrounding tissue due to the coagulated tissue.
Alkali chemical burn causes liquefactive necrosis. The nature of the defeat at this is that a dense crust is formed, and the softening of "dilution" of tissue, allowing necrotic area does not have a clear boundary, and damaged tissue "float", and the affected area is increased. Alkali chemical burn a less favorable course and prognosis than chemical burn acid.
First aid for burns
Burn always formed as a result of the accident, so everyone should know the principles of first aid for burns. Help for burns must be literate because of that sometimes human life depends. When any kind of trauma: chemical, fire, scalding treatment should be immediate.
The most important thing to do is to eliminate the influence of traumatic agent. If a person is burning clothes, it must be put out. Thus burning can not be run, which often happens in a panic as the fire flared up from it even stronger, and extends up to the side of the head and the respiratory tract. Man must be laid, and put out the clothes, donning a thick cloth (a blanket, coat, etc.) - it will block the access of oxygen and the flame goes out.
First aid for chemical burns is to reduce the concentration of a substance causes burns by copious rinsing with water.
Further action aid for burns should be directed at maintaining vital functions pending the arrival of an ambulance. It is necessary to monitor the breathing of the victim, and, if necessary artificial respiration.
Treatment of burns
Treatment of burns can be conservative and surgical. The tactic is determined by the depth and area of the lesion.
Treatment of first-degree burn is in the local treatment of burns, including anti-inflammatory and wound healing activities. Appointed by the painkillers as pills or injections.
Treatment of second degree burns is to prevent shock applied topically biological bandage, which is applied by the drug to the ointment base. Also, the treatment can be carried out by open burning.
Treating burns the third and fourth degrees of surgery, and surgery to remove necrotic tissue should be held as early as possible to reduce the penetration of toxins in the blood. Treatment of burns fourth and sometimes third degree, suggests tissue transplantation, in order to close extensive tissue defect.
At any rate defeat treatment of burns should be urgent, because without the provision of skilled care tissue destruction may continue after the injury, and continued supply of products of decay in the blood significantly worsens the patient's condition.