Burn is one of the dreaded disease not only for the medical complications it has on the individual who suffers from it but also for the big social as well as financial impact it has on his/her life as well on the life of their family.
Burn is the injury to the layers of skin, mainly epidermis and dermis and underlying tissues/ organs caused due to coming in contact with extreme heat, electricity, friction, radiation or chemicals.
Commonly seen as accidental injury, a person can sustain burn due to coming in contact with either a flame (which leads to Thermal burns) or due to hot/boiling liquids (known as Scald burns).Burn injuries due to other causes are comparatively rare.
The estimated new cases of burn in India are approximately 6-7 million per year and these are the numbers which seek medical management.
In our Indian population the overall scenario of distribution of burns have been seen as adults people tend to suffer from Flame burns more, whereas children suffer generally from coming in contact with hot liquids.
Classification of Burns:
Burns sustained are mainly classified into Three degrees:
- First Degree: Burns involving only the most superficial layer of skin (epidermis).These are red and very painful but do not form blisters. Most sun-burns fit this category. Healing starts within 3–4 days and generally scarring is not seen.
Second Degree: Superficial dermal burns extend into the papillary dermis and are characterized by formation of blisters. Wound is pink, wet, and hypersensitive to touch. Such wounds heal within 3 weeks without scarring and need of surgery.
Deep partial thickness burns involve the deeper layers of dermis, tend to be pinkish to white, associated with pain, and may require operation if healing is not progressing optimally.
- Third Degree: Burns involving full thickness of skin (both epidermis and dermis is destroyed). It may also involve the underlying fatty layer, the subcutaneous tissue. The burn site looks white or blackened and charred. Not associated with pain. Such type of burns would require surgical intervention as healing by self is never optimal
What to do in case of Burns?
- If your clothes are burning try to extinguish it by rolling on floor
- Move away from place with fire
- Keep the burnt area under running water till you are having burning sensation. You can use cool water for pouring but avoid direct application of ice onto burnt skin as it might cause more damage.
- Burning clothing should be removed as soon as possible to prevent further injury(only if they are loose).If they are stuck to skin please do not attempt to remove by self.
What not to do in case of Burns?
- Do not apply potato/Toothpaste/Ratanjot/egg or other lotions immediately after sustaining burns as this may lead to masking of depth of burn and sub optimal treatment of burn injuries
- Do not hide your medical history from your doctor as patients with diabetes/hypertension/liver disease/asthma are at higher risk of complications
- Do not pop the blisters if they are formed
When to seek medical Advice:
As per the recommendations of AMERICAN BURN ASSOCIATION (MAJOR BURN INJURY CRITERIA) any person having these should be hospitalized and given in patient care. Rest of burns can be treated on out-patient basis
- Second- and third-degree burns greater than 10% of the total body surface area in patients under 10 or over 50 years of age
- Second- and third-degree burns greater than 20% of the total body surface area in other age groups
- Significant burns of face, hands, feet, genitalia, or perineum and those that involve skin overlying major joints
- Third-degree burns greater than 5% of the total body surface area in any age group
- Inhalation injury
- Significant electric injury including lightning injury
- Significant chemical injury
- Burns with significant preexisting medical disorders that could complicate management, prolong recovery, or affect mortality (e.g. diabetes mellitus, cardiopulmonary disease)
- Burns with significant concomitant trauma (may require initial treatment in a trauma center)
- Burn injury in patients who will require special social and emotional or long-term rehabilitative support, including cases of suspected child
Whom to contact in case of burn:
The right person to seek medical advice for a burn injury is a Burn Specialist/Plastic Surgeon. A Plastic surgeon is trained in various aspects in managing burn injuries as well as managing the post burn complications. They are trained to use specialized dressings, medications as well as to intervene in cases which need surgical interventions for optimal healing.
Is Burn Injury Dangerous/ Can I die from burns?
Burn injury could be dangerous. Your doctor would assess for the depth and severity of the burn and would be able to counsel you regarding the outcome. Young patients with larger surface area of burns or older patients with co morbidities are always at a higher risk of complications as well as mortality from burn injury.