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Introduction and treatment of burn wounds

زخم سوختگی

There are many types of burn wounds caused by thermal, radiation, chemical, or electrical contact.

  • Thermal burnsThese burns are due to heat sources which raise the temperature of the skin and tissues and cause tissue cell death or charring. Hot metals, scalding liquids, steam, and flames, when coming into contact with the skin, can cause thermal burns.

 

  • Radiation burns. These burns are due to prolonged exposure to ultraviolet rays of the sun, or to other sources of radiation such as X-ray.

 

  • Chemical burns. These burns are due to strong acids, alkalies, detergents, or solvents coming into contact with the skin or eyes.

 

  • Electrical burns. These burns are from electrical current, either alternating current (AC) or direct current (DC).

 

What are the classifications of burns?

Burns are classified as first-, second-, or third-degree, depending on how deep and severely they penetrate the skin’s surface.

  • First-degree (superficial) burns
    First-degree burns affect only the epidermis, or outer layer of skin. The burn site is red, painful, dry, and with no blisters. Mild sunburn is an example. Long-term tissue damage is rare and usually involves an increase or decrease in the skin color.

 

  • Second-degree (partial thickness) burns
    Second-degree burns involve the epidermis and part of the dermis layer of skin. The burn site appears red, blistered, and may be swollen and painful.

 

  • Third-degree (full thickness) burns
    Third-degree burns destroy the epidermis and dermis. Third-degree burns may also damage the underlying bones, muscles, and tendons. When bones, muscles, or tendons are also burned, this may be referred to as a fourth-degree burn. The burn site appears white or charred. There is no feeling in the area since the nerve endings are destroyed.

 

wound vacuum therapy in burn wound

Third degree burns, after adequate debridement, may benefit from NPT, which may be applied as an adjuvant in bed preparation for subsequent skin grafting, or as a method of optimizing the integration of skin grafts. Patients with electrical trauma, which generally cause deep burn wounds with extensive tissue destruction and progressive tissue damage, are also NPT candidates. The increase in blood perfusion secondary to NPT use is beneficial to burn injury. Kamolz et al. observed this in 2003, in a prospective study comparing the blood perfusion of burned hands that underwent conservative therapy and NPT. In the conservatively treated group, the authors observed reduced limb blood perfusion, which did not occur in the NPT-treated group.

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