Treatment of first degree burns is not difficult. As a rule, after 1-3 days the inflammatory reaction completely subsides, swelling and hyperemia disappear. The consequence of such lesions may be slight peeling and in rare cases short-term hyperpigmentation.
In the treatment of first degree burns, ointments and creams containing antioxidants (in particular, superoxide dismutase) are helpful. When such drugs are applied to wounds, pain and swelling quickly subside.
Second degree burns are characterized by the presence of blisters on the surface of the skin. Depending on the size and condition of the blisters, treatment may vary. If there are destroyed or tense blisters, the epidermis is removed, further treatment is carried out under bandages.
There are currently three main approaches to intact blisters:
Maintaining the integrity of the blisters until the final completion of epithelization.
Puncture with a sterile needle or cut the cover of the bladder (after appropriate treatment of their surface with antiseptic solutions or alcohol) and releasing its contents out. Next, the bladder cover descends and serves as a kind of wound covering.
Removal of exfoliated epidermis, further treatment under bandages.
First approach. It is known that the liquid inside the bladder contains a large amount of protein. Its composition is close to plasma. It contains a large number of various substances with biological activity. Thanks to this, in the absence of infection, epithelization occurs quickly. The liquid inside the bubble gradually thickens, turning into a gel-like mass. Apparently, this method of treatment is preferable, because in this case the natural mechanisms of wound healing are realized. However, it is not always possible to prevent damage to the bladder wall. Small blisters are more preserved, not exceeding 3-5 cm in diameter and located in areas of the body that are not subject to pressure and in places where the skin is inactive. In functionally active areas, it is much more difficult to preserve bubbles. However, under certain conditions, even large bubbles can be preserved. Sometimes the bladder cover is treated with a solution of potassium permanganate, which has a sterilizing and tanning effect.
The second approach does not have the advantage of the first, which is associated with the removal of biologically active substances contained in the bladder. At the same time, after a puncture (or a cut in the tire), bubbles appear entrance gate for infection, and the remaining one in small quantity the liquid serves as an excellent growth medium for microorganisms. The effectiveness of using damaged and exfoliated epidermis as a kind of wound covering is questionable. The only positive aspect is that the splint prevents the underlying wound tissue from drying out.
The third approach - removal of the bladder cover and further implementation of controlled drug treatment - is very widespread and has its advantages. This option is more suitable for treating victims with extensive burns, when wounds are localized in areas with mobile, functionally active skin (in the joint area, on the neck, etc.), in areas of complex configuration (perineum, etc.). Of course, this option is the method of choice in military field conditions.
Properties of liquid from burn blisters. The composition and properties of the liquid contained in the bubbles have not yet been sufficiently studied. Previously, increased concentrations of arachidonic acid derivatives - thromboxane and prostaglandin E3 - were found in the exudate. There are polar opinions about the properties of this liquid: some authors believe that it is toxic, others believe that it accelerates wound healing.
To study this issue, a study was conducted jointly by M. Yu. Eropkin, T. D. Smirnova, V. G. Konusova and A. S. Simbirtsev. Blood and fluid samples from the blisters were taken from victims with burns and frostbite for 7-10 days, which were subjected to a comprehensive analysis. Using an enzyme immunoassay with a test system developed at the State Research Institute of Highly Pure Biological Preparations, the content of interleukin-1 (IL-1) and interleukin-8 (IL-8) was determined. In these biological media, the content of malondialdehyde (MDA) and lactate dehydrogenase (LDH) was determined. In in vitro experiments on two types of test objects: diploid embryonic fibroblasts light man(FLECH), human lung carcinoma cell line (A-549) studied the effect of blood plasma and fluid on cell proliferation, and also performed a test with nitroblue tetrazolium (NBT).
It was found that plasma obtained from victims with mild and medium degree severity, has the ability to stimulate the activity of mitochondrial enzymes and does not inhibit cell proliferation (and sometimes even stimulates). In victims with extensive burns in the case of the development of multiple organ failure and sepsis, the opposite results were obtained. Extensive skin burns lead to an increase in the content of lipid peroxidation products in the blood. However, the analysis did not reveal a positive correlation between the content of malondialdehyde and lactate dehydrogenase in plasma and vesicular fluid. The properties of the fluid from the blisters largely depended on the severity of the injury. In most cases (including extensive skin burns) early dates after the injury, a slightly pronounced inhibitory effect on cell proliferation was noted, but after 5 days and later, the fluid from the blisters, on the contrary, stimulated the growth of the cell culture. No quantitative relationship was found between the level of MDA in the vesicular fluid and its ability to influence cell proliferation. A number of exudate samples with a high MDA content stimulated the growth of cell cultures, while others had the opposite effect. In a number of cases, the following relationship was noted between the LDH content and the results of the NBT test: when the level of LDH in the fluid of the blisters was low, it stimulated the proliferation of FLECH, and when it was high, it inhibited it. The content of IL-1 and IL-8 in most cases depended on the severity of the injury. In some cases, with the development of sepsis in the fluid of the blisters, the level of IL-8 was reduced.
On this basis, it was concluded that the content of IL-1 and IL-8 in the fluid from the blisters (second degree burn) depended on the severity of the injury. In some cases, with the development of sepsis, the level of IL-8 in the fluid of the blisters was reduced. N. Pejnovic et al. (1995) believe that slow healing may be due to an abnormal cytokine profile in the wound. L. S. Grayson et al. (1993) determined the levels of a number of cytokines in donor site wounds in victims with burns of various sizes. The liquid for analysis was aspirated from under the bandages. The levels of EGF and TNF-ot in all 143 patients were quite high; detectable p-FGF was detected in 5 patients. An increased level of IL-1 was noted in three patients with complicated wound healing. The properties of exudates may also differ depending on the microflora growing in the wounds.
I. Opo et al. (1995) found that the fluid from the blisters contains relatively large amounts of cytokines and growth factors and, as such, has the ability to accelerate wound healing. The content of epidermocyte growth factor (EGF) and fibroblast growth factor (p-FGF) was relatively low. At the same time, the levels of some other factors (PDGF, IL-6 and TGF-a) were relatively high, which determined the pronounced wound-healing effect of the liquid. Growth factor TGF-p, which plays important role in collagen metabolism and scar formation, was also detected in blister fluid. However, contrary to the authors’ expectations this study, the cytokines IL-la and IL-ip, which initiate inflammation, were found in relatively low quantities, and IL-8 in relatively high quantities. In the course of studying the effect of exudate from blisters on the growth of keratinocytes in vitro, data were obtained indicating the ability of this fluid to stimulate cell growth. At the same time, there is also contrary data. Thus, W. L. Garner et al. (1993) in the course of their studies found that fluid from the blisters leads to inhibition of keratinocyte proliferation and on this basis concluded that it was necessary to remove the wall of the bladder. R. W. Yurt, S. W. Goodwin, M. R. Madden (1996) also studied the effect fluid of burn blisters on the proliferation of keratinocytes. At the same time, they found that this fluid can have a diverse effect on the proliferation of CC: from inhibition by 67% to stimulation by 103%. The viability of CC also worsened by 4%. When using flow cytometry, cell size analysis and RNA/DNA ratios, the authors found a shift towards more and slower dividing large cells. Blister fluid had no significant effect on the expression of differentiation markers (filagrin and involucrin), based on this, it was concluded that blister fluid in the absence it contains acute inflammatory proteins and does not interfere with the proliferation and differentiation of keratinocytes. Thus, Y. Suzuki et al. (1998) showed that in exudates from wounds infected with Pseudomonas aeruginosa, the level of hydrolytic thrombin-like activity was significantly increased compared to exudate from uninfected wounds. The experiments also revealed increased level proteinase activity in these exudates.
IN last years It has been revealed that cytokines play an important role in the pathogenesis of burn disease. Thus, M. Mester et al. (1994) studied the distribution and kinetics of IL-1a expression in rats with deep burns of 20% of the body surface. They found that thermal injury leads to a marked increase in IL-1a levels in the liver and lungs within 2.5 hours after injury. Moreover, the level of IL-1 in the liver was the same for grades III6 and IV lesions. In other organs and blood plasma, the levels of cytokines were below the sensitivity level of the method. At the same time, the content of IL-1a in the skin remained at the same level. Studying the properties of wound exudates can be very useful, bringing additional features determining ways of drug correction of the course of the wound process. S. OSuilleabhain et al. (1996) in experiments on A/J mice with deep burns covering 25% of the body surface showed the possibility of using IL-12 to treat infectious complications. It has been shown that IL-12 restores the body's resistance to microbial infection and is more effective than interferon-gamma (IFN-y).
Thus, in the opinion of the author of this chapter, with burns limited in area, the composition of the fluid has a beneficial effect on the course of the wound process. With extensive lesions, in some cases the influence of exudate has a negative connotation. At the same time, in the early stages after injury, the exfoliated but intact epidermis protects the dermis compromised by the burn from drying out and therefore it is not advisable to remove the bladder cover.
After removing the bladder cover, the question arises about the choice of means for local treatment.
It should be noted that most drugs that have antibacterial properties or the ability to stimulate reparative processes are suitable for local treatment of second-degree burns, regardless of the specific type of dosage form.
Burns of both degrees can be treated with tanning agents (solutions of tannin, potassium permanganate, etc.) or dyes (ethacridine lactate and others). In this case, a crust is formed, under which epithelization occurs. It should be noted that such treatment is accompanied by a pronounced pain reaction! Currently, treatment with tanning substances is carried out mainly when burns are localized on the face.
Wound surfaces can be covered with wet-dry bandages and a wide range of antiseptic solutions can be used for this purpose.
Good results are achieved when using multicomponent ointments on a water-soluble basis (Levomekol, Levosin, etc.). In this case, the dressings can be changed after 1-3 days. Various specific treatment options are possible. For example, you can cover a layer of gauze soaked with such an ointment with a bandage. When burns are localized in areas with a flat surface (for example, on the front surface chest) you can put a napkin with ointment on the wound and not cover it with bandages. As a rule, a napkin with ointment adheres well to the wound surface, and the wound dries out somewhat. The antibacterial substance of the ointment prevents the development of microorganisms. Epithelization in this case goes well. This method can be called semi-open (see above).
For the treatment of second degree burns, other types of ointment-like preparations (hydrophilic-emulsion based, liniments, aerosols) can also be used. It should be noted that fat-based ointments, as a rule, have weak antibacterial properties.
After removing the bladder cover, wound coverings (any type made of various materials). At the same time, given the short healing time of wounds, expensive multicomponent coatings (Varihesive, Biobrane, etc.) should not be used. It is quite enough to use film or hydrogel preparations (Galagran, Inerpan, Aseplen, etc.). The use of porous film coatings of the Foliderm family of domestic production has great prospects, which, due to the imparting of electrostatic charge adhere well to the wound and are retained for a long time. The presence of pores ensures the transport of gases; these films can have various impregnations - analgesic, anti-inflammatory and antibacterial substances. It is permissible to use ointment-like preparations from different groups: gels, aerosol preparations, ointments on a fatty and water-emulsion basis.
Most traditional medicine preparations are suitable for treating these burns (see above).
Sha burns are much more difficult to treat. They are characterized by the presence of a surface layer of dead tissue, pronounced microcirculation disorders, as well as the whole complex of biochemical and cellular changes.
In relation to Sha degree burns (as well as deeper ones), phase I of the wound process takes the period from the moment of injury until the completion of the process of cleansing the wounds from dead tissue.
Treatment of Sha degree burns in the first phase of the wound process. Treatment tactics for Sha degree burns can be different, depending on the goals. As noted earlier, the choice of drugs for local treatment in the first phase of the wound process is determined by the characteristics of the processes occurring in the wounds. Consider the following treatment options.
One of the approaches is treatment aimed at reducing the severity of the pathological process, fastest recovery microcirculation and stimulation of reparative processes. In the first minutes and hours after injury, drugs can be applied topically, the action of which is aimed at reducing the severity of the inflammatory reaction. In general, there are not many such drugs. It is interesting that at present, local treatment aimed at reducing the severity of certain parts of the inflammatory reaction that occurs during burns is practically not carried out. However, such a possibility exists. In particular, you can use antioxidants (Flerenzyme cream; containing superoxide dismutase; Dibunol ointment; 10-15% dimethyl sulfoxide solutions), drugs that prevent blood clots (heparin ointment), and other substances; complete, reducing the activity of histamine (Trilon B), etc. In the early 80s, an ointment was developed that included parmidine, a bradykinin antagonist with angioprotective activity. Clinical trials have shown it high efficiency. However, the production of the ointment was not established.
In cases where burns are caused by the so-called. low-temperature agents, there is a wet scab in the wounds, the zone of vascular disorders is relatively wide, the severity of tissue hyperthermia is low. That is why it is necessary to focus efforts on restoring microcirculation in the area of vascular disorders. Forced drying of the surface scab in these cases is undesirable, since it leads to dehydration of the tissue and deepening of the burn. For the same reason, it is not advisable to remove the epidermis, since it (even dead) protects the dermis from drying out. It is more preferable to keep the scab moist. In these cases, it is advisable to use creams of 1% silver sulfadiazine, zinc or cesium sulfadiazine, cerium nitrate. You can also use dressings made of nylon impregnated with silver, after application of which it became possible to introduce an active antimicrobial substance onto wounds through electrophoresis.
In case of burns limited in area, a treatment option with a greenhouse effect can be used (see below).
Another direction in treatment is to dry the scab as quickly as possible in order to prevent infection in the wounds. It must be emphasized that at present, in the treatment of third-degree burns, this treatment option is predominantly used. Drying of dead tissue is achieved by physical methods treatment (see above) or through the use medications. In the latter case, the task is to select a drug for local treatment. In this case, the choice of an antibacterial agent and a specific dosage form is very important. the best way the corresponding phase of the wound process. Due to the presence of pronounced tissue edema and impaired blood circulation in the paranecrotic zone, it is advisable to use dosage forms, promoting the outflow of excess fluid. Solutions (isotonic and hypertonic) and ointments on a hydrophilic basis meet these requirements. Very common is the use of the so-called. wet-dry dressings with various antiseptic solutions (see Table 5.1), which to some extent drain wound fluid and provide protection against pathogenic microflora. At the same time, you should remember the need to periodically wet the bandages, since the effectiveness of treatment depends on this. Good results are obtained by using multicomponent drugs on a hydrophilic basis (Dioxidinovaya, Levosin, Levomekol, Mafenide, Nitacid, Oflotrimol, Oflotrimol-II, Dioxyzol, Streptonitol, etc.). Positive feature The drug Mafenide is its ability to penetrate under the scab, where it has an antimicrobial effect. During these periods, you can also use some aerosols: Gentamycin sulfate aerosol, etc.
Other legion options are also possible. For example, the primary goal may be to activate the inflammatory process and more quickly cleanse wounds of dead tissue. Realization of this goal can be achieved different ways. In particular, some natural substances (pine and fir resins), when applied to wounds, attract neutrophil granulocytes and macrophages and activate phagocytosis processes in them. Due to this, wounds are more quickly cleansed of dead tissue. The earlier arrival of macrophages into the wound is a very positive phenomenon. As mentioned earlier (see Chapter 1), the macrophage is the conductor of the cellular ensemble; it stimulates the growth of blood vessels, attracts fibroblasts and, thereby, triggers tissue repair mechanisms. Currently, ointments are produced that contain the resin of coniferous trees. These include the drug Biopin-5%, which contains pine resin (resin) and beeswax, and Rescuer ointment, which contains fir resin. There is reason to believe that the properties of this drug are similar to Biopin ointment, but it has not been seriously studied. Other promising drugs are also known. In particular, the use of an experimental ointment containing interleukin-ip on wounds also led to accelerated development of the wound process and faster cleansing of wounds from dead tissue. Currently, Inso-derm ointment, which contains interleukin-1p and superoxide dismutase, is undergoing preclinical testing, and a mixture of polyethylene oxide grades 1500 and 400 is used as a base.
The worst treatment option is the use of fat-based ointments during these periods. They do not have sufficient antibacterial properties and prevent the outflow of wound fluid. As a result, inflammation rapidly develops under the scab, and intoxication symptoms are pronounced. Thus, in the early stages after injury for Sha degree burns, fat-based ointments should not be used.
The use of ointments on a hydrophilic-emulsion basis during these periods, although acceptable, is significantly less effective compared to hyperosmolar preparations, which are based on polyethylene oxides and proxanol.
Rejection of superficial scab. The formation of a demarcation shaft in case of Sha degree burns occurs quite quickly and by the end of the 2nd week, as a rule, the scab is torn off on its own (see color insert, Fig. 2-5). Most often, there is no need to stimulate the process of rejection of dead tissue. It is permissible to remove the scab during dressings performed under anesthesia. Sometimes the creation of occlusion by applying moisture-proof dressings (made of polyethylene, waxed coatings, etc.) contributes to the rejection of the scab. In rare cases, you can use 40% salicylic or benzoic acid ointment.
Wound management after rejection of dead tissue. At
If only the superficial layers of the dermis are affected and after the thin crust of the scab has been rejected, as a rule, there is no need to use enzymes to completely cleanse the wounds of dead tissue. When the dermis is damaged at the level of the reticular layer of the dermis and in the presence of wet necrosis, such a need often arises.
Good healing effect is achieved by using drugs that absorb wound contents. In particular, wound sorbents such as Gelevin, Debrisan, Dezhizan, Tselosorb, Collasorb and the like can be used. In addition to the drainage effect, these drugs bind divalent ions (Ca++ and Mg++), which has a stimulating effect on the proliferation of keratinocytes. Hydrophobic sorbents, in comparison with water-swelling ones, have a lower ability to absorb water, plasma, and wound exudate, but actively sorb microbial bodies and some high-molecular substances. Nevertheless, they can be used, especially with the so-called. deep dermal burns (at the level of the reticular layer of the dermis) and borderline (Sha-Shb degrees) lesions. Among the drugs in this class there are: carbon (sorbent SNK-1K, activated fibrous material Dnepr, Volna dressings); from lignin (Polyphepan); spongy from alginic acid salts (Algipor, Algimaf); sorption carbon-collagen and lavsan-collagen dressings (Carpema) and some others. In the drug Actisorb plus (manufactured by Johnson and Johnson), in addition to activated carbon contains silver, which provides an antibacterial effect.
The color insert shows the view of a victim with a Sha degree burn at the stage of cleaning the wounds from scab (see Fig. 6) and after completion of epithelization (see Fig. 7).
After the scab is rejected and the wounds are cleaned, you can use any antiseptic solutions and ointments. However, the most favorable course of the wound process occurs when using ointments on a hydrophilic emulsion basis, foam aerosols and wound coverings (film, sponge and hydrocolloid).
Other substances used topically also have a stimulating effect on reparative processes: dalargin, insulin, heparin, collagen preparations, polysaccharide derivatives (chitosan, alginates, hydroxymethylcellulose).
For this purpose, physiotherapeutic procedures can be used: x-ray therapy, UHF therapy, cryotherapy of the marginal zone, laser therapy, EHF therapy.
Treatment of 3rd and 4th degree burns. Deep burns do not heal on their own, so treatment should be aimed at clearing dead tissue as quickly as possible and preparing wounds for plastic closure.
In the presence of circular deep burns of the torso or limbs, necrotomy incisions are made (Fig. 5.11). In the early stages after injury, it is advisable to ensure that the burn scab is dried with all available methods. Of course, there is another way - surgical removal of dead tissue. This treatment option will be described in the next chapter.
At the next stage, chemical necrectomy is performed by applying 40% salicylic and benzoic acid ointments to the wounds. After the scab is rejected, it is possible to use enzyme preparations for final cleaning of wounds from remnants of dead tissue or use various kinds sorbents.
After this, granulating wounds are prepared for autodermoplasty. During this period, fat-based ointments should not be used. It is best to carry out daily dressings with antiseptic solutions or apply dressings with water-soluble ointments.
In case of excessive (hypertrophic) watery granulations, ointments containing glucocorticoids are used, or wounds are irradiated ultraviolet radiation. Accelerated wound preparation can be carried out using the vacuum drainage method [Tatsyuk S.V., Osadchaya O.I., Kozinets K.G., 1998].
A second-degree burn can be classified as a superficial injury, since such damage does not extend to the germinal layer of the skin, and therefore, in areas of such burns, the skin is able to repair itself, without the need for surgical intervention. At the time of the burn, swelling and hyperemia (redness) of the skin are observed. A second-degree burn is also characterized by the formation of blisters filled with clear liquid. This is accompanied by burning pain, which can persist for two to three days.
Examination of a second degree burn
During examination, it is necessary to determine the area of the lesion using the rule of the palm or the rule of nines. This circumstance is important, since with a large area of damage, even if the degree of damage does not exceed the second, there is a danger of developing burn shock, as well as burn disease, and these serious complications require hospital treatment.
The indication for hospitalization is a second-degree burn with an area of more than 1-2% in children and more than 5% in adults.
The presence of bubbles with transparent contents allows one to accurately determine the degree of the burn.
In addition, a skin burn can also be combined with damage to the respiratory tract - in this case, hospitalization of the patient in a medical facility for intensive care is mandatory.
A 2nd degree burn can be easily recognized by its typical appearance. Damage to the underlying dermis and epidermis causes swelling and redness, and dilation of capillaries and impaired permeability leads to the formation of thin-walled blisters filled with translucent fluid. Typically, blisters form immediately after injury. Further, after the blisters burst, only a bright red wound remains in their place, which usually takes 10 to 12 days to heal. 2nd degree burns do not damage the germ layer of the skin and are classified as superficial injuries. Timely and correct treatment 2nd degree burn at home favors spontaneous recovery skin without scar formation.
Treatment of 2nd degree burns
If the damage has a small affected area, then the most in a simple way How to treat a 2nd degree burn will include treatment without the help of a doctor at home. It is extremely important not to introduce an infection, as it can aggravate the condition of the victim, which leads to the need to take special care. In the event that a burn occupying more than 1-2% of a child’s body and more than 5% of an adult’s body has led to large quantity blisters or affects areas such as the face, hands, or groin, you should seek medical attention. 2nd degree burns cause severe pain and with serious lesions lead to the development of burn disease and burn shock. If these complications occur, the victim must be hospitalized.
For 2nd degree burn injuries, emergency care begins with cooling the affected area of the skin surface. This measure will have an effect that will stop tissue damage. This is necessary because after receiving a burn, the tissue of the affected area of the skin continues to heat up for several minutes. To cool the wound, you can place the affected area under running water or apply ice to the skin.
The water pressure should be weak so that it does not increase pain. This procedure should continue for 15-30 minutes until a feeling of numbness appears.
After cooling, apply a sterile dressing to the burn. In order to reduce pain and easily continue further treatment of the burn, you can moisten bandages and gauze pads in a solution of novocaine. It is not recommended to use cotton wool as a sterile material, as it can become a source of irritation for affected skin.
Emergency care must include an anesthesia procedure. Outside medical institution Any over-the-counter drug, such as analgin or paracetamol, can be used as an anesthetic. In more severe cases, drugs that have both analgesic and anti-inflammatory effects are recommended for use, for example ketorol, ketanov, ketoralak.
As a rule, second degree burns heal without medical intervention. To speed up tissue regeneration, it is recommended to use panthenol with any anti-burn agent. It is better to give preference to aerosols, since when applying them, your hands do not have to come into contact with the affected area, and therefore the risk of infection is reduced.
People who have suffered a 2nd degree burn are advised to continue taking analgesics and antihistamines(tavegil, suprastin, claritin, fenkarol) and disogregants (clopidogrel, aspirin, ascorbic acid). For massive burns, painkillers should be administered intravenously or intramuscularly, since with injury, the absorption properties of the skin sharply decrease and, accordingly, the effect of external drugs decreases. To replenish the missing blood volume in the presence of edema, it is recommended to drink plenty of fluids.
If a burn wound does not heal for a long time, if the fluid in the blisters becomes cloudy or pain increases, then you should seek help from a specialist, as he can correct ineffective treatment.
It is also necessary to remember that hospitalization is mandatory for persons who have received burns, the area of which is more than 5% of the surface of the body’s skin. Persons with burns are subject to hospitalization internal organs and electrical burns of any location and area. Inpatient treatment is indicated for elderly patients who have accompanying illnesses cardiac and respiratory systems.
What not to do?
Improper treatment of a 2nd degree burn is very dangerous and can provoke the development of numerous complications. Doctors strongly recommend not to use unverified advice from others in practice at home.
- 2nd degree burns cannot be treated with oil or other products with a greasy texture, since they all have a “greenhouse” effect and, instead of treating the burn, promote spontaneous heating of the tissue, which only increases pain;
- You cannot treat burns with the pulp of fresh fruits and vegetables or urine, or blindly adhere to any other generally accepted recommendations of traditional medicine;
- Do not lubricate 2nd degree burns with products such as cologne, alcohol, iodine or brilliant green. After a burn, the skin is severely dehydrated, so it does not need to be dried. Due to the use of any alcohol-containing products in the treatment of 2nd degree burns, the regeneration time of affected tissues may significantly increase;
- Do not pierce the blisters formed by the burn. This will protect the affected area from infection, and will also significantly reduce the likelihood of scarring, for the removal of which it will be necessary to seek help from a plastic surgeon or cosmetologist. Treatment of a 2nd degree burn after opening the bladder will be greatly complicated.
Treatment of 2nd degree burns at home is quite acceptable if certain rules are followed. IN Everyday life It is easy to get burned when cooking, due to unsuccessfully used explosive objects or carelessly pouring out a hot drink. What types of burns are there? Is it possible to treat a 2nd degree burn at home? How to treat a burn?
Degrees of skin burns
In medical practice, burns are classified as follows:
- with mild hyperemia of the skin and the appearance of blisters filled with liquid, declare 1st degree of damage;
- with the second, the skin not only turns red, but blisters also appear, which burst, and in their place a thin crust forms;
- the third degree is noted when muscle tissue is damaged and a scab forms on the skin. Around localization deep burn bubbles with a clear liquid form;
- Fourth degree burns are defined as complete damage to the muscle tissue down to the bone. With this degree it is possible to combine degrees.
First- and second-degree burns are mild tissue injuries and can be treated at home.
How to determine the extent of damage?
It's no secret that most cases involving burns occur at home. The first thing to do in case of a burn is to assess the extent of the damage. It is easy to determine using the palm of your hand. The human palm makes up up to 1% of the body. Of course, you should not put your palm on the burn. It is enough to roughly measure the affected area and determine the percentage of burn.
If more than 10% is affected by burns mild degree and 5% severe, you need to provide the first first aid, deliver the patient to a medical facility. Such extensive lesions require not only therapeutic treatment, but also surgical intervention. In addition, victims with burns to the extremities, eyes, face and upper respiratory tract should promptly seek medical help.
First measures for a second degree burn
If clothing catches fire, you should extinguish the flame on the fabric by first covering the victim or quickly undressing him. Burning clothing can be extinguished with sand or ordinary water and snow. Naturally, the person will be in a state of shock. Therefore, you need to calm him down and carefully remove the remnants of clothing that are not stuck to the wound.
Second degree burns can often be seen with excessive sun exposure. In this case, the person may experience dizziness and nausea, while arterial pressure. The first measure that others should take is to move the victim into the shade. But there are situations when you do not know the cause of the burn. Especially, this often happens with children.
First you need to find out under what circumstances the burn occurred. To relieve pain shock, you need to quickly place the affected surface under running cold water. This will localize the burn and prevent the hot burned surface from spreading to healthy tissue. It also promotes active blood circulation in the wound. It is not recommended to use ice for these purposes, because... In addition to burns, this can cause frostbite. Ice is used only in extreme cases if running water is not available.
At home, you will probably have a gel or ointment for burns in your first aid kit. These medicines lubricate the skin lesion and apply a sterile bandage. It is undesirable to use various improvised means that you have in the house: kefir, vegetable oil, egg white, sour cream and other “folk” methods in the form of aloe, Kalanchoe and other juices medicinal plants. These "grandmother's" methods can further aggravate further treatment.
Remember that the burn surface must be sterilely treated only with antiseptic agents.
This is first aid.
Subsequently, when regenerating the skin surface, therapeutic agents can be used. folk remedies. At severe burns second degree, the victim may feel dizziness, nausea, and vomiting. This is the physiological reaction of the body to an external stimulus. There is also an increase in body temperature and increased heart rate. To reduce intoxication, the patient is given a lot to drink. Analgesics are used to reduce the pain threshold. Next, you need to transport the victim to any medical facility.
Treating burns at home
After determining the severity of the burn and following the doctor’s recommendations, the patient can, according to medical indications, continue treatment at home.
Mostly, first and second degree burns are treated at home. Symptomatically, such burns do not cause fever, purulent wounds or severe pain. Doctors recommend spasmalgon and analgin for pain relief. If the temperature rises slightly, you can take paracetamol. In complex treatment, medications containing diphenhydramine are used.
During treatment at home, the patient should use a low-calorie diet using vitamin preparations. Small blisters or slight redness in such burns are lubricated with a solution of ethyl alcohol or vodka. These burns do not need to be bandaged.
It is strictly forbidden to remove blisters on the skin yourself. After spontaneous opening, the skin is pressed to the surface of the wound, and brilliant green is smeared around the wound. After opening, the crust of the wound is lubricated with any antiseptic, for example, furatsilin or a solution of potassium permanganate.
During skin regeneration, compresses from a decoction of St. John's wort herb are applied. To prepare this mixture use 1 tbsp. l. dry herbs per glass of boiling water. The mixture is kept in a steam bath for about 15 minutes. Then leave for an hour or two and filter. Wash the wound with the product. But this procedure should be done no more than 2-3 times a day, since abundant moisture slows down tissue regeneration.
Fresh tea leaves, cabbage juice, linden infusion, carrot and pumpkin puree can be used as an antiseptic. IN folk medicine Pomegranate peel is widely used to accelerate skin regeneration. To do this, take dry pomegranate peel and grind it. The powder is applied liberally to the wound on a gauze bandage. The effect of this treatment will be visible on the second day. The same “dry” remedy can be prepared using green tea. You need to buy any green tea and grind it in a coffee grinder. To enhance the effect, you can mix two products: tea and pomegranate peel.
The surface of the affected tissues is lubricated with panthenol-based ointments. Ointments activate skin collagen and launch regeneration processes. Doctors also recommend using Vishnevsky ointment and other medicinal ointments with antimicrobial action. They are applied later, after the bubbles have opened. It is not recommended to lubricate the affected areas with oily liquids. Only in certain cases can you use compresses made from sea buckthorn oil and medicinal product vitamin E. Despite the measures taken, treatment of a 2nd degree burn at home can be complicated by intoxication of the body. In any case, you need to keep an eye on general condition sick. For any violations of a local nature or general well-being you need to immediately contact a medical institution. After all, a burn is a dangerous skin lesion that can lead to wound infection and burn purulent processes. Such depletion of the body can lead to death.
In general, 2nd degree burns can be treated at home. But we must remember that a burn is a serious injury. Inept and frivolous treatment can lead to significant changes in health and put a person in a hospital bed for a long time.