Burns – first aid, treatment, types of burns

Burn — first aid, treatment. What not to do with a burn

A burn is damage to body tissues caused by the action of high temperature, chemicals (salts, acids, heavy metals) or ionizing radiation.

Causes of burns

Burns can occur for various reasons. Here are some of the most common causes of burns:

• Thermal. This is the most common type caused by exposure to heat, such as flames, hot liquids, steam, or contact with hot objects.
• Electric. They are caused by an electric current passing through the body and can lead to tissue damage, internal damage and even cardiac arrest.
• Chemical. Occur when the skin or eyes come into contact with aggressive chemicals such as acids, alkalis or solvents.
• Radiation — occurs as a result of exposure to high levels of ionizing radiation, for example, during radiation therapy for cancer treatment or in nuclear accidents.
• Sunny. They appear due to excessive exposure to ultraviolet (UV) radiation from the sun and can cause redness, pain and peeling of the skin.
• Friction burns rarely occur as a result of skin rubbing against a rough surface, for example, with a road rash as a result of a motorcycle accident or carpet burns.

Types of burns

There are four main types, classified according to the severity of the injury:

• The first degree is the mildest form of burns, affecting only the upper layer of the skin (epidermis). Symptoms include redness, pain, and slight swelling. These burns usually heal within a few days without scarring.
• The second degree. These burns penetrate through the epidermis and reach the second layer of the skin (dermis). Symptoms include blistering, severe pain, and swelling. The healing time varies depending on the severity of the burn, scars may remain.
• The third degree is a severe lesion that penetrates through all layers of the skin and often affects the underlying tissues, such as muscles and bones. The skin may turn black or burn, and the pain may be minor or absent due to nerve damage. Third-degree burns require immediate medical attention and may require skin grafts or other reconstructive surgeries.
• The fourth degree is characterized by necrosis (charring) of all layers of the skin.

Complications of burns

Burns can cause a wide range of complications, depending on the severity of the burn and the degree of damage. Some of the most common complications include:

• Infection of the damaged area. Burns can make the skin more vulnerable to infection, which can lead to serious complications.
• Scarring — Burns can lead to scarring, especially in the case of severe burns. Scarring can restrict mobility and cause significant cosmetic defects.
• Contractures: Burns affecting deeper layers of the skin can lead to the formation of scar tissue, which can tighten the skin and other tissues, limiting mobility and significantly changing the appearance of the damaged area.
• Respiratory problems. Burns to the face or throat can cause swelling, which can block the airway and lead to difficulty breathing.
• Shock. Severe burns can cause shock, a life-threatening condition in which the activity of the cardiovascular and respiratory systems is disrupted, as well as the coordination of all organ systems with the help of the nervous system. This condition requires immediate inpatient medical care. Psychological problems. Burns can cause emotional and psychological trauma, such as depression, anxiety, and post-traumatic stress disorder
  (PTSD).

Diagnosis of burns

The diagnosis of «burn» usually includes a physical examination and an assessment of the severity and extent of the injury. In addition, some diagnostic tests and procedures are used to assess the patient`s condition and
choose the best treatment strategy.

• Physical examination. A medical professional examines the burn and assesses its severity, degree and localization. If the patient`s condition requires it, the patient`s vital signs are also evaluated, such as heart rate, blood pressure and respiratory rate. A doctor`;s examination is enough to make a diagnosis. During the
  examination, the doctor classifies the burn. Burns are classified according to their severity, which can help determine the appropriate treatment plan. The most commonly used classification system is the «rule of nines» which divides the body into areas of 9% or multiples of 9%.
• Visualizing studies. Imaging studies, such as X-rays, computed tomography or MRI, can be used to assess the extent of the burn and assess any damage to the underlying tissues or organs. They are used when it is assumed that not only the skin is affected, but also deeper tissues. Blood tests. Blood tests may be prescribed to detect signs of infection, dehydration, or electrolyte imbalance that may occur with severe burns.
• Assessment of the depth of the burn. There are various methods for assessing the depth of the burn, including visual assessment, assessment by touch or pressure, as well as specialized equipment such as a laser Doppler scanner or infrared thermography.
• Bacterial seeding. In the case of infected burns, you can take an analysis that will allow you to identify specific bacteria or fungi present in the damaged area and prescribe treatment with the right antibiotics.
• Specific diagnostic tests and procedures will depend on the severity and localization of the burn, as well as on the general health of the patient. In addition to those listed, additional examinations may be prescribed.

Treatment of burns

Treatment of burns primarily depends on the degree of burn and to a lesser extent on the patient`s condition.

Treatment of first degree burns

These minor burns can usually be treated with over-the-counter painkillers and topical ointments to soothe the skin. Cool compresses or soaking the affected area in cool water can also alleviate the condition.

Treatment of second degree burns

These burns may require more extensive treatment, such as the use of painkillers, creams or ointments to prevent infection and accelerate healing. In some cases, drainage of blisters or sanitation (wound treatment and removal of damaged tissue) may be required. Bandages and wound care may also be required to prevent infection and speed up healing. This requires outpatient medical care.

Third degree and fourth degree burns

These are severe burns that require immediate medical attention and always require hospitalization. Treatment may include pain relief, wound care, skin grafting, or other reconstructive surgery to repair the damage. In some cases, amputation may be required if irreparable damage has been done. In this clinical situation, in addition to the direct surgical treatment of burns, emergency measures aimed at saving the patient`s life are also required. Such measures include the following actions. It may be necessary to compensate for the loss of fluid and electrolytes, intravenous injection of fluid through the skin may be required. Anesthesia – painkillers may be required.

After treatment of burns of the third and fourth, but sometimes second degree, patients usually need rehabilitation. Physical therapy and psychological counseling may be required to help patients recover and restore the mobility and functions of an organ or part of the body.
The specific treatment plan will depend on the severity and degree of the burn and the general health of the patient. With any burn, it is important to seek medical help, as even minor burns can lead to serious complications if they are not treated properly.

Treatment of nail plate burns

Nail plate burns can be painful and require immediate treatment to prevent infection and further damage to the nail. Here are a few steps that you need to take in this case:

• Remove all jewelry or tight clothing from the affected area to prevent further
  injury.
• Rinse the burn site with cool water for 10-15 minutes to reduce pain and swelling.
• Do not use ice or very cold water, as this can further damage the skin.
• Gently dry the affected area with a clean soft towel. (We are not talking about
  third- to fourth-degree burns or acid burns.)
• Apply a sterile bandage to protect it from further damage and reduce the risk of
  infection.
• Avoid pressure on the affected area, as this can cause additional pain and damage.
  Take over-the-counter painkillers to ease the pain.
• If the burn is severe, covers a large area, or the medications taken do not give the necessary analgesic effect, you should immediately seek medical help.

In addition to these steps, it is important to keep the affected area clean and dry,
and to avoid touching the injury site. If any signs of infection appear in this area,
such as redness, swelling or pus, you should immediately consult a doctor.

Modern methods of treatment of burns

Stem cell therapy is a new treatment option for burns. The essence of this therapy is that stem cells can help regenerate damaged tissue and promote healing.
There are several types of stem cells that can be used to treat burns, including embryonic stem cells, induced pluripotent stem cells, and mesenchymal stem cells.
Mesenchymal stem cells (MSCs) are often used in the treatment of burns because they have the ability to differentiate into different types of cells, including skin cells, and can also modulate the immune response to reduce inflammation.
Treatment of burns with stem cells occurs in several stages:

• Collection of stem cells from a patient or donor. Stem cells can be withdrawn from
  bone marrow, adipose tissue or umbilical cord blood.
• After that, stem cells multiply in the laboratory under the action of special
  solutions to produce enough cells for treatment.
• Applying stem cells to the burn site, either directly injecting them into the wound,
  or using a scaffold to support the cells as they grow.
• Monitoring for the presence of any signs of adverse reactions in the patient, such as
  inflammation or infection.
• Studies have shown that stem cell therapy can help improve wound healing and reduce scarring. In order to determine the optimal type of stem cells to use, the best method of delivering cells to the wound site, as well as the potential risks and benefits of this treatment, it is necessary to consult with an experienced and
  qualified doctor in this field.

Recovery after burns

Recovery after burns may depend on the severity of the burn and the degree of damage to the skin and underlying tissues. In general, recovery from burns can be a lengthy and complex process that requires an interdisciplinary approach involving medical professionals, rehabilitation specialists and mental health
professionals.
Recovery consists of several stages:

• Direct treatment. Treatment of a burn can include various measures from cleaning the wound and applying a bandage or ointment to hospitalization, surgical interventions and reconstructive operations.
• Wound Care — Proper wound care is necessary to prevent infection and accelerate healing. This may include regular cleaning of the wound, application of ointments and bandages for topical application, as well as the use of specialized wound care products.
• Rehabilitation. Burns can lead to significant physical limitations, such as loss of mobility, strength, and range of motion. Rehabilitation may include physical therapy, massages, and other forms of rehabilitation to help patients regain function.
• Scar treatment: Post-burn scars can be painful and restrict mobility. Scar treatment includes the use of silicone wipes, compression clothing and other treatments that help reduce scarring and improve the appearance of the skin.
• Psychological support. Burns can also have serious psychological consequences, including depression, anxiety and post-traumatic stress disorder. Psychological support may include counseling, support groups, and other forms of therapy to help patients cope with the emotional impact of trauma.

For patients with burns, it is important to follow the recommendations of their attending physician on care and rehabilitation and seek help if they experience any complications or difficulties in the recovery process. With proper care and support, many patients achieve significant improvements in quality of life and functionality.

Ointments for the treatment of burns

Patients are often interested in the question of which ointments are suitable for the treatment of burns. There are several types of ointments that can be used in such a clinical situation. Some ointments are suitable for the treatment of mild burns, while others, on the contrary, are needed only in cases of more severe injuries. The
stage of the healing process is also of great importance.
Here are some commonly used ointments for the treatment of burns:

• Silver sulfadiazine is a cream with an antibiotic for topical use, which is usually used to treat second-degree burns. It helps prevent infection and promotes healing.
• Bacitracin is another topical ointment with an antibiotic that can be used to prevent infection. It is used for first and second degree burns.
• Vaseline. This is a simple over-the-counter ointment that helps soothe and moisturize the skin after a burn. It can also help protect the skin from further damage. It is used only for burns of the first stage.
• Aloe vera. Aloe vera is a natural plant extract with anti—inflammatory and wound healing properties. It can be applied topically to reduce pain and speed up healing. Also suitable for mild burns.
• Lidocaine is a local anesthetic that can help reduce pain and discomfort. It is often used in combination with other ointments or dressings.

In any case, when using ointments of each type and with any type of burn, it is important not to self-medicate, but to consult with a doctor of the appropriate specialty before starting treatment.

Where to turn for burns

If a mild burn occurs, it is necessary to contact your doctor (most often it is a family doctor). If you suspect a second-degree burn (a large area of damage, severe pain, blistering, skin damage by unknown substances or chemicals), you should contact the emergency room on the same day. In even more serious situations, it is necessary to call emergency medical care as soon as possible.

Our specialist doctors

The MedTour team, having extensive experience in the treatment of the most complex pathologies using stem cells, can recommend as experienced doctors showing good treatment results two specialists working with the treatment of burns using stem cells — Dr. Kovalchuk and Dr. Badyin. Dr. Kovalchuk works in Ukraine, and Dr. Badyin accepts in Serbia.

F.A.Q.

1. How can burns be prevented?

They can be prevented by taking precautions such as wearing protective clothing or equipment, being careful when handling hot liquids or objects, and properly storing and handling chemicals and other hazardous materials. It is also important to observe fire safety and have serviceable smoke detectors in the house.

2. What types of stem cells are used to treat burns?

Various types of stem cells can be used for this purpose, including mesenchymal stem cells, adipose tissue stem cells and embryonic stem cells.

3. What are the potential benefits of using stem cells to treat burns?

Benefits include improved wound healing, reduced scarring, increased mobility and functionality.

If you have any questions about the possibilities that stem cell therapy can provide for burns, please contact the MedTour coordinating doctor for a free consultation.