Burns
Definition
Burns are injuries caused by heat, cold, electricity, chemicals, or radiation that result in damage to the skin and underlying tissues.
-
Types of Burns a. First-degree burn: affects only the outermost layer of the skin (epidermis) and is characterized by redness, swelling, and pain. b. Second-degree burn: affects both the epidermis and the dermis (the layer beneath the epidermis) and is characterized by blistering, redness, and swelling. c. Third-degree burn: affects all layers of the skin and underlying tissues and is characterized by charring, eschar formation, and loss of sensation. d. Fourth-degree burn: extends through the skin and into deeper tissues, such as muscle and bone, and is characterized by charring, eschar formation, and loss of sensation.
-
Causes of Burns a. Heat burns: caused by contact with flames, hot surfaces, hot liquids, or electrical fires. b. Electrical burns: caused by contact with electrical sources, such as power lines or appliances. c. Chemical burns: caused by contact with corrosive substances, such as acids or bases. d. Radiation burns: caused by exposure to ionizing radiation, such as X-rays or gamma rays.
Other Types of Burns
- Partial-thickness burns (first- and second-degree burns): damage only the epidermis and papillary dermis.
- Full-thickness burns (third-degree burns): extend through the dermis and into the subcutaneous tissue.
- Scalds: caused by hot liquids or gases.
- Contact burns: caused by direct contact with a hot surface.
- Electrical burns: caused by electrical current.
- Chemical burns: caused by exposure to corrosive substances.
- Radiation burns: caused by exposure to ionizing radiation.
Causes
Causes of burns include:
- Accidents
- Electrical malfunctions
- Flammable liquids or gases
- Fire or flames
- Chemical spills or leaks
- Radiation therapy
Clinical Features
Clinical features of burns include:
- Redness and swelling
- Blisters or peeling skin
- Pain or numbness
- Charring or eschar formation
- Systemic complications (e.g., hypovolemic shock)
Investigations
Investigations for burns include:
- Physical examination
- Imaging studies (e.g., X-rays, CT scans)
- Laboratory tests (e.g., blood counts, electrolyte levels)
Complications
Complications of burns include:
- Infection
- Sepsis
- Hypovolemic shock
- Respiratory failure
- Renal failure
- Cardiac complications
Management
Management of burns includes:
- Initial care (e.g., cooling, cleaning, dressing)
- Fluid resuscitation
- Wound care (e.g., debridement, grafting)
- Pain management
- Nutritional support
- Monitoring for complications
Assessment of Burn Wound
Assessment of burn wound involves:
- Size: measured in percent of total body surface area (TBSA)
- Depth: assessed using the "rule of nines" or by examining the wound's appearance
- Location: noted to determine the need for wound management and monitoring
Assessing Size and Depth of Burns
Assessing size and depth of burns involves:
1 → Measure the length and width of the burn in centimeters 2 → Calculate the area using the formula: area = length x width 3 → Convert the area to percent of TBSA using the "rule of nines" 4 → Assess the depth of the burn by examining the wound's appearance (e.g., blisters, charring)
Principles of Fluid Resuscitation in Burn Cases
Principles of fluid resuscitation in burn cases include:
- Early fluid administration: within 24 hours of injury
- Crystalloid solutions: used as initial fluid resuscitation
- Colloid solutions: used as secondary fluid resuscitation
- Titration of fluid: based on urine output and blood pressure
- Monitoring: for signs of fluid overload or under-resuscitation
Management of Burn Wound
Management of burn wound involves:
- Debridement: removal of dead tissue
- Grafting: application of skin grafts or other tissue
- Dressing: application of dressings to promote healing
- Wound care: regular cleaning and dressing changes
- Monitoring: for signs of infection or complications
Scope of Homoeopathy in the Management of Burns
Homoeopathy is a system of medicine that uses highly diluted substances to treat various conditions, including burns. Its scope in the management of burns is:
- Pain management: homoeopathic remedies can help alleviate pain and discomfort
- Wound healing: homoeopathic remedies can promote wound healing and reduce the risk of infection
- Systemic complications: homoeopathic remedies can help manage systemic complications such as hypovolemic shock
Homoeopathic Therapeutics for Burns
Homoeopathic therapeutics for burns include:
- Cantharis: for burns of the face and neck
- Hepar Sulphuris: for burns of the hands and feet
- Calendula: for promoting wound healing
- Hypericum: for nerve damage and pain
Examination of Case of Burns
Examination of case of burns involves:
- History: taking a detailed history of the burn injury
- Physical examination: examining the burn wound and surrounding tissues
- Laboratory tests: ordering laboratory tests to evaluate for systemic complications
- Imaging studies: ordering imaging studies to evaluate for complications
- Monitoring: continuously monitoring the patient for signs of complications
Assessment of Burn Wound
Assessment of burn wound involves:
- Size: measured in percent of TBSA
- Depth: assessed using the "rule of nines" or by examining the wound's appearance
- Location: noted to determine the need for wound management and monitoring
- Stage: assessed using the "rule of nines" or by examining the wound's appearance
Fluid Resuscitation in Burn Cases
Fluid resuscitation in burn cases involves:
- Early fluid administration: within 24 hours of injury
- Crystalloid solutions: used as initial fluid resuscitation
- Colloid solutions: used as secondary fluid resuscitation
- Titration of fluid: based on urine output and blood pressure
- Monitoring: for signs of fluid overload or under-resuscitation