Burns and Scalds

Burns and scalds are types of injuries that result from damage to the skin and underlying tissues caused by heat, electricity, chemicals, or radiation. They can be classified based on their severity and depth.

Classification of Burns

• First-degree burns (superficial burns): affect only the outermost layer of skin (epidermis), causing redness, swelling, and pain. Examples include sunburns and minor scalds from hot water.
• Second-degree burns (partial-thickness burns): extend into the middle layer of skin (dermis), leading to blisters, redness, swelling, and pain. These can be further divided into superficial second-degree burns and deep second-degree burns based on the depth of damage.
• Third-degree burns (full-thickness burns): destroy both layers of skin (epidermis and dermis) and may reach subcutaneous tissues, causing charred skin that is white or black, and little to no pain due to nerve damage. These are the most severe type of burn.
• Fourth-degree burns: extend into muscles, tendons, and bones, causing extensive damage and potentially leading to long-term disability or death.

Causes of Burns and Scalds

Burns and scalds can result from various sources, including:

• Heat from fires, stoves, ovens, or other appliances
• Scalds from hot liquids or steam
• Electrical burns from contact with live electrical sources
• Chemical burns from exposure to corrosive substances
• Radiation burns from prolonged exposure to UV radiation (such as sunburn) or ionizing radiation

Symptoms of Burns and Scalds

The symptoms of burns and scalds can vary depending on the severity and depth of the injury, but common signs include:

• Pain or numbness in the affected area
• Redness, swelling, and blistering of the skin
• Charred or white skin in severe cases
• Fever, especially if the burn becomes infected
• Difficulty moving or using the affected area due to pain or damage

Treatment and Management

The treatment of burns and scalds depends on their severity but generally includes:

• Cooling the burn with cool (not cold) water for about 10 minutes to reduce heat and ease pain, but not using ice or ice water as it can cause further damage
• Removing clothing and jewelry near the burned area, unless stuck to the burn
• Covering the burn with a non-stick dressing or bandage to protect it from infection
• Taking pain relievers such as acetaminophen or ibuprofen for discomfort
• Seeking medical attention immediately for severe burns, electrical burns, chemical burns, or if there are signs of infection (such as increased redness, swelling, pus, or fever)

Prevention

To prevent burns and scalds, it is essential to:

• Be cautious with fire and heat sources, ensuring they are safely managed and monitored.
• Avoid leaving children alone in the kitchen or near hot surfaces.
• Use protective gear when working with chemicals or electrical equipment.
• Install smoke alarms and ensure they are functioning properly.
• Keep emergency phone numbers handy, including that of the local fire department and poison control center.

Complications

Burns and scalds can lead to several complications, including:

• Infection: Bacteria can infect burned skin, leading to serious infections like sepsis.
• Scarring: Burns can result in significant scarring, which may be permanent.
• Contractures: Deep burns can cause the skin to tighten as it heals, potentially limiting movement if the burn is over a joint.
• Respiratory problems: Inhaling smoke or hot air can damage lungs and lead to respiratory issues.

Recovery and Rehabilitation

The recovery process for burns and scalds varies based on the severity of the injury. For minor burns, healing may occur within a few days without significant intervention. More severe burns require medical attention, potentially including surgical interventions like debridement (removal of dead skin) or skin grafting to promote healing and minimize scarring.

Physical therapy may be necessary for patients with extensive burns to maintain range of motion and prevent contractures. Psychological support is also crucial as the recovery process can be long and emotionally challenging, especially for those with significant scarring or disability.