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Health
About Burns

A burn is a type of injury to flesh or skin caused by heat, electricity, chemicals, friction, or radiation. Burns that affect only the superficial skin are known as superficial or first-degree burns. When damage penetrates into some of the underlying layers, it is a partial-thickness or second-degree burn. In a full-thickness or third-degree burn, the injury extends to all layers of the skin. A fourth-degree burn additionally involves injury to deeper tissues, such as muscle or bone.

The treatment required depends on the severity of the burn. Superficial burns may be managed with little more than simple pain relievers, while major burns may require prolonged treatment in specialized burn centers.

While large burns can be fatal, modern treatments developed since 1960 have significantly improved the outcomes, especially in children and young adults. Globally, about 11 million people seek medical treatment, and 300,000 die from burns each year.In the United States, approximately 4% of those admitted to a burn center die from their injuries.The long-term outcome is primarily related to the size of burn and the age of the person affected.

Thermal

In the United States, fire and hot liquids are the most common causes of burns. Of house fires that result in death, smoking causes 25% and heating devices cause 22%. Almost half of injuries are due to efforts to fight a fire.Scalding is caused by hot liquids or gases and most commonly occurs from exposure to hot drinks, high temperature tap water in baths or showers, hot cooking oil, or steam.Scald injuries are most common in children under the age of five and, in the United States and Australia, this population makes up about two-thirds of all burns

Chemical

Chemicals cause from 2 to 11% of all burns and contribute to as many as 30% of burn-related deaths. Chemical burns can be caused by over 25,000 substances, most of which are either a strong base (55%) or a strong acid (26%).Most chemical burn deaths are secondary to ingestion.

Pathophysiology
Three degrees of burns

At temperatures greater than 44 C (111 F), proteins begin losing their three-dimensional shape and start breaking down. This results in cell and tissue damage. Many of the direct health effects of a burn are secondary to disruption in the normal functioning of the skin. They include disruption of the skin's sensation, ability to prevent water loss through evaporation, and ability to control body temperature.Disruption of cell membranes causes cells to lose potassium to the spaces outside the cell and to take up water and sodium

Prevention

Historically, about half of all burns were deemed preventable.Burn prevention programs have significantly decreased rates of serious burns. Preventive measures include: limiting hot water temperatures, smoke alarms, sprinkler systems, proper construction of buildings, and fire-resistant clothing.Experts recommend setting water heaters below 48.8 C (119.8 F).Other measures to prevent scalds include using a thermometer to measure bath water temperatures, and splash guards on stoves.

Prognosis

The prognosis is worse in those with larger burns, those who are older, and those who are females. The presence of a smoke inhalation injury, other significant injuries such as long bone fractures, and serious co-morbidities (e.g. heart disease, diabetes, psychiatric illness, and suicidal intent) also influence prognosis.

History

Guillaume Dupuytren (1777–1835) who developed the degree classification of burns Cave paintings from more than 3,500 years ago document burns and their management. The earliest Egyptian records on treating burns describes dressings prepared with milk from mothers of baby boys,and the 1500 BCE Edwin Smith Papyrus describes treatments using honey and the salve of resin.

 

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