Burns

Encyclopedia of Alternative Medicine, Apr 06, 2001 by Patience Paradox

The first act of treating a burn is to stop the burning process. Small thermal burns should be immediately placed in cold water if possible. To avoid infection, the wound should be cleaned with soap and water, and all dirt should be carefully removed. Butter, shortening, or similar salve should never be applied to the burn since it prevents heat from escaping and drives the burning process deeper into the skin. Minor burns should be cleaned gently with soap and water. If the skin is broken or apt to be disturbed, the burned area should be coated lightly with an antibacterial ointment and covered with a sterile bandage. Pain relievers such as aspirin or non-steroidal anti-inflammatory drugs (NSAIDs) may be used as needed. A doctor should be consulted if signs of infection appear: increased warmth, redness, pain, or swelling; pus or similar drainage from the wound; swollen lymph nodes; or red streaks spreading from the burn.

At an accident site, the victim should be immediately removed from the burning process. Clothing should be removed from all affected areas. Any clothing embedded in the burn should not be disturbed. Dry chemicals should be brushed from the skin; burns caused by acids, alkalis, phosphorus, or organic compounds, such as phenols and cresols, should be flushed with water continuously over an extended time.

In cases of moderate and major burn damage, further medical treatment may include assessment of breathing and treatment if the patient's airways or lungs have been damaged; a flush of any chemicals; and the administering of intravenous fluids, since burns may dramatically deplete body fluids. Antibiotic ointments are usually applied to burns, and the patient is also given antibiotics intravenously to prevent infection. A tetanus shot may also be given. Dead tissue is surgically removed, or debrided. Once the burned area is cleaned and treated, it is usually covered with sterile bandages. Oral narcotics such as codeine may be required for pain relief. The burn patient may have to undergo physical and occupational therapy. If there is extensive scarring, a skin graft is usually performed.

Prognosis is dependent upon the degree of the burn, the amount of body surface covered, whether critical body parts are affected, any additional injuries or complications, and the promptness of medical treatment. The epidermis in first-degree burns regenerates rapidly; not much scarring results unless infection develops. With deeper burns, the process of healing is slow, and scars often develop. This may limit mobility and function, making physical therapy necessary. In some cases, surgery may be advisable to remove scar tissue and restore appearance. Some people, especially young women and people with dark skin, may develop keloids.

Secondary infections are common, and may be a major cause of loss of function, disfigurement, and death. Patients with burns over more than 40% BSA, those older than 60 years old, and those with inhalation injuries are at risk for burn injuries that result in death.