A burn is an injury to the skin and, in the most serious cases, also to the subcutaneous tissues caused by heat. Burns and small burns to the hands, wrists, and face are one of the most frequent injuries that occur in the home or work environment.
Burns can be caused by direct contact with fire, boiling liquids (water, oil), steam, chemicals (bleach, muriatic acid), excessive exposure to the sun (including tanning lamps) and electric current (electrocution).
Dr. Stefano Ottolini, a specialist in Emergency Medicine at Humanitas, explains the difference between the various types of burns and how we should behave towards a burned person.
Severity of burn
The severity of a burn depends on two factors: the affected body surface and its depth. It can be very dangerous both a superficial but very extensive burn and a small but very deep burn.
If the surface burned is less than 20% in adults and 12-15% in children we speak of localized burns, but if the burn covers a greater percentage of the body we speak of widespread burns, whose general effects affect the whole body, including internal organs.
Consequences of burn
In addition to tissue damage or destruction, there is a possibility of infection due to the disappearance of the skin barrier against microbes; there may also be fluid leaks that could compromise the survival of the individual.
Types of burn
In order of severity, burns are distinguished by:
First degree burns, when they are light burns and affect only the most superficial layer of the epidermis. The only obvious sign is a reddening of the burnt area, due to the dilation of the capillaries on the surface, sometimes combined with a slight swelling and a strong burning. These are burns that usually do not require special medical care and heal within 5-7 days without leaving scars.
Second-degree burns, when they affect the superficial and deep layers of the skin (the dermis) and generally cause bubbles (flittene) due to the release of plasma from the skin capillaries involved. Also, in this case, the patient complains of intense pain and burning. The most superficial lesions generally heal in 10-15 days without leaving marks; the deepest ones, on the other hand, take longer and can leave scars.
Third degree burns (the most serious), when, in addition to the layer of the epidermis and dermis, the underlying tissues are also damaged (adipose tissue and muscle, up to the bones), causing the death (necrosis) of skin tissues and the formation of black spots and crusts (scabs). The skin appears brown, black or white in colour and is hard to touch. There is almost never any pain, as the nerve cells have been destroyed. These burns, which should be treated by medical personnel as soon as possible, usually leave obvious scars.
Interventions in case of burns
It is important that the rescuer is aware of some basic rules to intervene in the right way and not make the situation worse.
aware of some basic rules to intervene in the right way and not make the situation worse.
THINGS TO DO
- Never underestimate a burn. In particular, if the lesion is slow to heal, if it is believed that an infection is developing and if small, elderly or sick children are affected, a doctor should always be consulted. If the situation is particularly serious, call 118.
- Remove any clothing, without rubbing the injured area, and any jewelry, which could hinder the dressing.
- Keep the wound under running water (at approx. 15°) or pack it with fresh water for 15 minutes. Caution: In case of contact with chemicals (e.g. quicklime), avoid contact with water at all costs, as this could cause greater damage.
- Cover the burnt area with a sterile gauze or cotton fabric, well cleaned and wet, without compressing.
- Lift the subject upside down and cover him/her to avoid hypothermia, i.e. a drop in body temperature.
THINGS NOT TO DO
- Do not remove any clothing that has remained attached to the lesion, as there is a risk of detaching the epidermis with it, which would exacerbate the situation.
- Do not apply creams, ointments or disinfectants to the burnt area.
- Do not use home remedies, such as oil, ice, tomatoes, toothpaste, on the burnt area.
- Do not pierce the bubbles, as in contact with the air the injured part could become infected.
- Do not compress the injured area.
- Do not make the injured person drink or give him drugs.