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Tbilisi State Medical Univers

Experimental and Preclinical Anatomy

Kakabadze Ann

DEFINITION
A burn is a type of injury of skin or other tissues caused
by heat, electricity, chemicals, friction or radiation.

Reminder of Anatomy

Electrical burns
Electrical burns may cause serious injury that is not readily
apparent. Often the entry and exit points for the electrical shock
may not be easily found.
Electricity flows more easily through tissues in the body that are
designed to deal with electricity. Nerves and muscles are
"wired" for this task and often are damaged. If significant
muscle damage occurs, muscle fibers and chemicals can be
released into the bloodstream causing electrolyte disturbances
and kidney failure.

Electrical burn

Chemical burns
Burns can also occur when chemicals are spilled onto
the body and generate a reaction that creates heat.
Chemical burns may be classified by their pH or acidity.

Acids are those with pH less than 7 and include


common household compounds like acetic acid,
hydrochloric acid, or sulfuric acid.

Bases or alkali compounds have a pH greater than 7.


Ammonia is a common alkali found in the home.

Chemical burn

Radiation burns
Radiation burns may be caused by protracted
exposure to ultraviolet light (such as from the sun,
tanning booths or arc welding) or from ionizing
radiation (such as from radiation therapy, X-rays
or radioactive fallout). Sun exposure is the most
common cause of radiation burns and the most
common cause of superficial burns overall.
There is significant variation in how easily people
sunburn based on their skin type.

Radiation burn from cancer treatment

CLASSIFICATION
Based upon their depth, burns are classified as follows:
First degree burn: superficial, causes local inflammation of
the skin (can be caused by sunburns)
Signs:

Pain

Redness

Mild swelling

Painful erythema and edema recover spontaneously without


special treatment, and most of these burns do not scar.

CLASSIFICATION
Second degree burn: deeper, affecting epidermis and part of
the dermis.
Signs:

Pain

Redness

Swelling

Blistering of the skin


Second degree burns have been subdivided into burn
categories:
Superficial
Deep

CLASSIFICATION
Superficial second degree burns affect the entire epidermis
and upper third of the dermis, including papillary layer of the
dermis. It may leave slightly rough and weak scars.

Deep dermal burn affects most reticular layer of dermis and


extends down to about of the dermis. It leaves severe scars
with high possibilities of developing into hypertrophic scars.

Superficial second degree burn

Deep dermal burn

CLASSIFICATION
Third degree burn: causes most damage, extending through
every layer of skin. The damage can even reach the
bloodstream, major organs, and bones, which can lead to
death
Signs:

Difficulty breathing

Carbon monoxide poisoning

Other toxic effects, if smoke inhalation also occured


There is also technically a fourth-degree burn. In this type,
the damage of third-degree burns extends beyond the skin
into tendons and bones

In addition to the depth of the burn, the total area of the burn is
significant. Burns are measured as a percentage of total body area
affected.
The "rule of nines" is often used. This calculation is based upon the
fact that the surface area of the following parts of an adult body
each correspond to approximately 9% of total (and the total body
area of 100% is achieved):

Head = 9%

Chest = 18%

Abdomen =18%

Each hand = 9% total (18%)

Groin = 1%

Each leg = 18% total (36%)

If more than 15%-20% of the body is involved in a burn, significant fluid may be
lost. Shock may occur if inadequate fluid is not provided intravenously. As the
percentage of burn surface area increases, the risk of death increases as well.
Patients with burns involving less than 20% of their body should do well, but those
with burns involving greater than 50% have a significant mortality risk, depending
upon a variety of factors, including underlying medical conditions and age.

FIRST AID FOR BURNS


For minor burns (first degree burns or second degree burns involving a small area of
the body)
Gently clean the wound with lukewarm water.
Though butter has been used as a home remedy, it should NOT be used on any burn.
Rings, bracelets, and other potentially constricting articles should be removed
(edema, or swelling from inflammation may occur and the item may cut into the
skin).
The burn may be dressed with a topical antibiotic ointment like Bacitracin or
Neosporin.
If there is concern that the burn is deeper and may be second or third degree in
nature, medical care should be accessed.
Tetanus immunization should be updated if needed.
For major burns (second and third degree burns)
1.Remove the victim from the burning area, remembering not to put the rescuer in
danger.
2.Remove any burning material from the patient.
3.Call 112 if needed.
4.Once the victim is in a safe place, keep them warm and still. Try to wrap the
injured areas in a clean sheet if available. DO NOT use cold water on the victim; this
may drop the body temperature and cause hypothermia.

FIRST AID FOR BURNS


Heat burns (thermal burns): Smother any flames by covering them with
a blanket or water. If your clothing catches fire, do not run: stop, drop,
and roll on the ground to smother the flames.
Cold temperature burns: Try first aid measures to warm the areas.
Small areas of your body (ears, face, nose, fingers, toes) that are really
cold or frozen can be warmed by blowing warm air on them, tucking
them inside your clothing or putting them in warm water.
Liquid scald burns (thermal burns): Run cool tap water over the burn
for 10 to 20 minutes. Do not use ice.
Electrical burns: After the person has been separated from the electrical
source, check for breathing and a heartbeat. If the person is not
breathing or does not have a heartbeat, call 112.

Chemical burns: Natural foods such as chili peppers, which contain a


substance irritating to the skin, can cause a burning sensation. When a
chemical burn occurs, find out what chemical caused the burn.
Tar or hot plastic burns: Immediately run cold water over the hot tar or
hot plastic to cool the tar or plastic.

Any questions?