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What is the treatment? Second-degree burn Soak the burn in cool water for 15 minutes. American Academy of Family Physicians What are the classifications of burns? What causes burns? How long does it take for burns to heal? How are burns treated? What do I need to know about electrical and chemical burns? How are burns classified? What is the significance of the amount of body area burned? How important is the location of a burn? What about electrical burns? What about chemical burns? What are the potential complications of being severely burned? What is the prognosis of burn injury? |
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What is the treatment? Second-degree burn Soak the burn in cool water for 15 minutes. What causes burns? You can get burned by heat and fire, radiation, sunlight, electricity or chemicals. There are 3 degrees of burns: * First-degree burns are red and painful. They swell a little. They turn white when you press on the skin. The skin over the burn may peel off after 1 or 2 days. * Thicker burns, called second-degree burns, have blisters and are painful. The skin is very red or splotchy, and it may swell a lot. * Third-degree burns cause damage to all layers of the skin. The burned skin looks white or charred. These burns may cause little or no pain because the nerves in the skin are damaged. How long does it take for burns to heal? * First-degree burns usually heal in 3 to 6 days. * Second-degree burns usually heal in 2 to 3 weeks. * Third-degree burns usually take a very long time to heal. How are burns treated? The treatment depends on what kind of burn you have. If a first- or second-degree burn covers an area larger than 2 to 3 inches in diameter, or is on your face, hands, feet or genitals, you should see a doctor right away. Third-degree burns require emergency medical attention. Do not put butter, oil, ice or ice water on burns. This can cause more damage to the skin. First-degree burn Soak the burn in cool water. Then treat it with a skin care product like aloe vera cream or an antibiotic ointment. To protect the burned area, you can put a dry gauze bandage over the burn. Take an over-the-counter pain reliever, such as acetaminophen (one brand name: Tylenol), ibuprofen (some brand names: Advil, Motrin) or naproxen (brand name: Aleve), to help with the pain. Second-degree burn Soak the burn in cool water for 15 minutes. If the burned area is small, put cool, clean, wet cloths on the burn for a few minutes every day. Then put on an antibiotic cream, or other creams or ointments prescribed by your doctor. Cover the burn with a dry nonstick dressing (for example, Telfa) held in place with gauze or tape. Check with your doctor's office to make sure you are up-to-date on tetanus shots. Change the dressing every day. First, wash your hands with soap and water. Then gently wash the burn and put antibiotic ointment on it. If the burn area is small, a dressing may not be needed during the day. Check the burn every day for signs of infection, such as increased pain, redness, swelling or pus. If you see any of these signs, see your doctor right away. To prevent infection, avoid breaking any blisters that form. Burned skin itches as it heals. Keep your fingernails cut short and don't scratch the burned skin. The burned area will be sensitive to sunlight for up to one year. Third-degree burn For third-degree burns, go to the hospital right away. Don't take off any clothing that is stuck to the burn. Don't soak the burn in water or apply any ointment. You can cover the burn with a sterile bandage or clean cloth until you receive medical assistance. What do I need to know about electrical and chemical burns? A person with an electrical burn (for example, from a power line) should go to the hospital right away. Electrical burns often cause serious injury inside the body. This injury may not show on the skin. A chemical burn should be washed with large amounts of water. Take off any clothing that has the chemical on it. Don't put anything on the burned area. This might start a chemical reaction that could make the burn worse. If you don't know what to do, call 9-1-1 or your local poison control center, or see your doctor right away. Common Causes The first step in helping to prevent kids from being burned is to understand these common causes of burns: * scalds, the No. 1 culprit (from steam, hot bath water, tipped-over coffee cups, hot foods, cooking fluids, etc.) * contact with flames or hot objects (from the stove, fireplace, curling iron, etc.) * chemical burns (from swallowing things, like drain cleaner or watch batteries, or spilling chemicals, such as bleach, onto the skin) * electrical burns (from biting on electrical cords or sticking fingers or objects in electrical outlets, etc.) * overexposure to the sun Types of Burns To distinguish a minor burn from a serious burn, the first step is to determine the degree and the extent of damage to body tissues. The three classifications of first-degree burn, second-degree burn and third-degree burn will help you determine emergency care: First-degree burn The least serious burns are those in which only the outer layer of skin is burned. The skin is usually red, with swelling and pain sometimes present. The outer layer of skin hasn't been burned through. Treat a first-degree burn as a minor burn unless it involves substantial portions of the hands, feet, face, groin or buttocks, or a major joint. Second-degree burn When the first layer of skin has been burned through and the second layer of skin (dermis) also is burned, the injury is called a second-degree burn. Blisters develop and the skin takes on an intensely reddened, splotchy appearance. Second-degree burns produce severe pain and swelling. If the second-degree burn is no larger than 3 inches (7.5 centimeters) in diameter, treat it as a minor burn. If the burned area is larger or if the burn is on the hands, feet, face, groin or buttocks, or over a major joint, treat it as a major burn and get medical help immediately. For minor burns, including first-degree burns and second-degree burns limited to an area no larger than 3 inches (7.5 centimeters) in diameter, take the following action: * Cool the burn. Hold the burned area under cold running water for at least five minutes, or until the pain subsides. If this is impractical, immerse the burn in cold water or cool it with cold compresses. Cooling the burn reduces swelling by conducting heat away from the skin. Don't put ice on the burn. * Cover the burn with a sterile gauze bandage. Don't use fluffy cotton, which may irritate the skin. Wrap the gauze loosely to avoid putting pressure on burned skin. Bandaging keeps air off the burned skin, reduces pain and protects blistered skin. * Take an over-the-counter pain reliever. These include aspirin, ibuprofen (Advil, Motrin, others), naproxen (Aleve) or acetaminophen (Tylenol, others). Never give aspirin to children or teenagers. Minor burns usually heal without further treatment. They may heal with pigment changes, meaning the healed area may be a different color from the surrounding skin. Watch for signs of infection, such as increased pain, redness, fever, swelling or oozing. If infection develops, seek medical help. Avoid re-injuring or tanning if the burns are less than a year old — doing so may cause more extensive pigmentation changes. Use sunscreen on the area for at least a year. Caution * Don't use ice. Putting ice directly on a burn can cause frostbite, further damaging your skin. * Don't apply butter or ointments to the burn. This could prevent proper healing. * Don't break blisters. Broken blisters are vulnerable to infection. Third-degree burn The most serious burns are painless, involve all layers of the skin and cause permanent tissue damage. Fat, muscle and even bone may be affected. Areas may be charred black or appear dry and white. Difficulty inhaling and exhaling, carbon monoxide poisoning, or other toxic effects may occur if smoke inhalation accompanies the burn. For major burns, dial 911 or call for emergency medical assistance. Until an emergency unit arrives, follow these steps: 1. Don't remove burnt clothing. However, do make sure the victim is no longer in contact with smoldering materials or exposed to smoke or heat. 2. Don't immerse large severe burns in cold water. Doing so could cause shock. 3. Check for signs of circulation (breathing, coughing or movement). If there is no breathing or other sign of circulation, begin cardiopulmonary resuscitation (CPR). 4. Elevate the burned body part or parts. Raise above heart level, when possible. 5. Cover the area of the burn. Use a cool, moist, sterile bandage; clean, moist cloth; or moist towels. What's the best way to protect my children from being accidentally burned? Common complications from severe burns include the following. * Serious breathing problems from smoke inhalation, which can take up to 24 hours to develop. * Poisoning from inhalation of toxic gases released by burning materials such as plastic. * Dehydration and shock due to massive fluid loss. * Infection due to improper cleaning and dressing of injuries, which can lead to a serious bacterial infection of your blood (septicaemia). * Thick, crusty surfaces produced by deep burns, which can become too tight and cut off blood supply to your healthy skin and tissues. * Widespread muscle damage, which can lead to kidney failure. * Extensive scarring, which can cause disfigurement or immobility if you're burned around your joints. What is the prognosis of burn injury? It can be roughly calculated by adding the patients age + percentage of body area having full thickness burns and if the total value exceeds 100, the patient's chance of survival is low. Cold Water Treatment Of Thermal Burns Cool burns with cold running water for 20 minutes. Remove clothes and jewellery from the burnt area immediately. When you burn yourself not all the damage happens at once. Because the body holds heat, the burning process can last for several minutes on up to several days or even longer in the case of serious burns. Immediate application of cold water or a cold compress is a treatment that has been found to decrease the degree and depth of a burn. Speed is the most important single factor in burn treatment. The more quickly you cool down the burn the better your chances are of reducing its effects. Use water from a drinking fountain, sink, hose, shower or whatever water source is closest. Hold the burn under cool running water, submerge the burn in a sink full of water or place a water-soaked cloth over the burn. Add more cool water to the cloth as it absorbs the heat from the burn. It’s also important for you to continue the water treatment for a long enough period of time. This may take 30 minutes or 3 days, depending on the burn. The first appearance of the burn can be misleading. Sometimes it doesn’t look as bad as it really is until the third or fourth day. What the burn looks like then depends on what you did right after the burn and how quickly you did it. If the burn was cooled down immediately there might be almost no pain or swelling and very little change in the skin’s appearance. If the pain is still there when the injured area returns to normal body temperature, it means further cold water treatment is necessary. As long as the burned area feels warmer to the touch than the surrounding skin area, treatment should be continued. First-degree burn First-degree burns cause minimal skin damage. They are also called “superficial burns” because they affect the outermost layer of skin. Signs of a first-degree burn include: redness minor inflammation, or swelling pain dry, peeling skin occurs as the burn heals Since this burn affects the top layer of skin, the signs and symptoms disappear once the skin cells shed. First-degree burns usually heal within 7 to 10 days without scarring. You should still see your doctor if the burn affects a large area of skin, more than three inches, and if it’s on your face or a major joint, which include: knee ankle foot spine shoulder elbow forearm First-degree burns are usually treated with home care. Healing time may be quicker the sooner you treat the burn. Treatments for a first-degree burn include: soaking the wound in cool water for five minutes or longer taking acetaminophen or ibuprofen for pain relief applying lidocaine (an anesthetic) with aloe vera gel or cream to soothe the skin using an antibiotic ointment and loose gauze to protect the affected area Make sure you don’t use ice, as this may make the damage worse. Never apply cotton balls to a burn because the small fibers can stick to the injury and increase the risk of infection. Also, avoid home remedies like butter and eggs as these are not proven to be effective. Second-degree burn Second-degree burns are more serious because the damage extends beyond the top layer of skin. This type burn causes the skin to blister and become extremely red and sore. Some blisters pop open, giving the burn a wet or weeping appearance. Over time, thick, soft, scab-like tissue called fibrinous exudate may develop over the wound. Due to the delicate nature of these wounds, keeping the area clean and bandaging it properly is required to prevent infection. This also helps the burn heal quicker. Some second-degree burns take longer than three weeks to heal, but most heal within two to three weeks without scarring, but often with pigment changes to the skin. The worse the blisters are, the longer the burn will take to heal. In some severe cases, skin grafting is required to fix the damage. Skin grafting takes healthy skin from another area of the body and moves it to the site of the burned skin. As with first-degree burns, avoid cotton balls and questionable home remedies. Treatments for a mild second-degree burn generally include: running the skin under cool water for 15 minutes or longer taking over-the-counter pain medication (acetaminophen or ibuprofen) applying antibiotic cream to blisters However, seek emergency medical treatment if the burn affects a widespread area, such as any of the following: face hands buttocks groin feet Third-degree burn Excluding fourth-degree burns, third-degree burns are the most severe. They cause the most damage, extending through every layer of skin. There is a misconception that third-degree burns are the most painful. However, with this type of burn the damage is so extensive that there may not be any pain because of nerve damage. Depending on the cause, the symptoms third-degree burns can exhibit include: waxy and white color char dark brown color raised and leathery texture blisters that do not develop Without surgery, these wounds heal with severe scarring and contracture. There is no set timeline for complete spontaneous healing for third-degree burns. Never attempt to self-treat a third-degree burn. While you’re waiting for medical treatment, raise the injury above your heart. Don’t get undressed, but make sure no clothing is stuck to the burn. Complications Compared with first- and second-degree burns, third-degree burns carry the most risk for complications, such as infections, blood loss, and shock, which is often what could lead to death. At the same time, all burns carry the risk of infections because bacteria can enter broken skin. Tetanus is another possible complication with burns of all levels. Like sepsis, tetanus is a bacterial infection. It affects the nervous system, eventually leading to problems with muscle contractions. As a rule of thumb, every member of your household should receive updated tetanus shots every 10 years to prevent this type of infection. Severe burns also carry the risk of hypothermia and hypovolemia. Dangerously low body temperatures characterize hypothermia. While this may seem like an unexpected complication of a burn, the condition is actually prompted by excessive loss of body heat from an injury. Hypovolemia, or low blood volume, occurs when your body loses too much blood from a burn. Preventing all degrees of burns The obvious best way to fight burns is to prevent them from happening. Certain jobs put you at a greater risk for burns, but the fact is that most burns happen at home. Infants and young children are the most vulnerable to burns. Preventive measures you can take at home include: Keep children out of the kitchen while cooking. Turn pot handles toward the back of the stove. Place a fire extinguisher in or near the kitchen. Test smoke detectors once a month. Replace smoke detectors every 10 years. Keep water heater temperature under 120 degrees Fahrenheit. Measure bath water temperature before use. Lock up matches and lighters. Install electrical outlet covers. Check and discard electrical cords with exposed wires. Keep chemicals out of reach, and wear gloves during chemical use. Wear sunscreen every day, and avoid peak sunlight. Ensure all smoking products are stubbed out completely. Clean out dryer lint traps regularly. It’s also important to have a fire escape plan and to practice it with your family once a month. In the event of a fire, make sure to crawl underneath smoke. This will minimize the risk of passing out and becoming trapped in a fire. Outlook for burns When properly and quickly treated, the outlook for first- and second-degree burns is good. These burns rarely scar but can result in a change in pigment of the skin that was burned. The key is to minimize further damage and infection. Extensive damage from severe second-degree and third-degree burns can lead to problems in deep skin tissues, bones, and organs. Patients may require: surgery physical therapy rehabilitation lifelong assisted care It’s important to gain adequate physical treatment for burns, but don’t forget to find help for your emotional needs. There are support groups available for people who have experienced severe burns, as well as certified counselors. Go online or talk to your doctor to find support groups in your area. You can also use other resources such as Burn Survivor Assistance and the Children’s Burn Foundation. |