moderate burns
Introduction
Introduction Burns mainly refer to the damage of skin, mucous membranes and even deep tissues caused by heat, chemicals, electric energy, radiation, etc. Skin heat burns are more common. Moderate burns: burns with a total area of 11% to 30% of adults or less than 10% of burns with a III degree burn; children with a total area of 5% to 15% of burns with a second degree burn or a burn with a III degree burn of less than 5%.
Cause
Cause
1. Various heat sources such as flame, hot steam, hot liquid or solid and electric energy, various chemical substances such as sulfuric acid, hydrochloric acid, caustic potash, caustic soda can cause burns after contact with human body. Radiation, X-rays, and long-term exposure to radioactive materials can also cause burns in humans.
2. After the human body is damaged by the injury factor, its change is divided into three phases:
(1) Body fluid exudation period: early change after burn. Light edema, blisters. When the burn area is large, the amount of body fluid loss is large. If the treatment is not timely, the blood volume will be rapidly reduced and shock will occur. Exudation stopped after 36-72 hours and began to absorb and reduce swelling.
(2) Acute infection period: Infection is a serious threat to burn patients. Mainly to create homemade surface pollution, coupled with reduced body resistance after injury. Bacteria grow and spread on the wound surface, which aggravates the damage of human tissues. Bacteria can enter the bloodstream with the absorption of body fluids to cause sepsis or sepsis.
(3) Repair period: The repair of the human body begins shortly after inflammation occurs on the wound surface. Once burned for 3-5 days, no scars were left. If the second degree burn is not infected, it will heal in about half a month without leaving scars. Deep second degree burns can be cured in 3-4 weeks, leaving more scars. After the third degree burn burns, the granules are formed after the eschar has fallen off, and the skin must be grafted to heal, leaving a lot of scars. There are many obstacles in limb function after wound healing. It requires functional exercise and plastic surgery to recover.
Examine
an examination
Related inspection
Blood routine white blood cell count
Once burned - the skin is red, painful, and has a burning sensation. It can be cured after 3 to 5 days, and desquamation without leaving scars.
Second degree burns - deep into the dermis, local blisters, it can be called blister burns. It can be divided into shallow three degrees and only the shallow layer of the dermis, and some of the germinal layers are healthy. Due to more oozing, the blisters are fuller, and the effusion of the wound surface is obvious after rupture; the base is swollen and red; there is severe pain and hyperesthesia; the skin temperature is increased, and if there is no infection and other complications, it can be cured in about 2 weeks. No scars are left behind, and there may be pigmentation in the short term and good skin function. Deep second degree injury to the deep layer of the dermis, leaving skin attachments. Because the degraded surface layer is slightly thicker, the blisters are smaller or flatter, and the feeling is slightly dull, and the skin temperature can be slightly lower. After the epidermis, the wound surface is light red or red and white, or the reticular embolization of the blood vessels; the surface exudate is less, but the bottom swelling is obvious. If there are no complications such as infection, it can be cured within 3 to 4 weeks. Because there is part of the granulation tissue in the middle of the repair process, there is scar, but the skin function is basically preserved. Blisters appear in the skin in addition to redness, pain and burning.
Third-degree burns - damage the entire layer of the skin, and even deep into the skin, muscles, bones and so on. After skin necrosis and dehydration, eschar can be formed, the wound is free of bubbles, wax white or brown, touched like leather, and even carbonized. The feeling disappears; the skin temperature is low. Natural healing is very slow, it must be detached with eschar, granulation tissue grows and then forms scars, only the edge has epithelium, not only loses skin function, but also often causes deformity. Some wounds are even hard to heal.
Diagnosis
Differential diagnosis
At present, there is still no uniform standard for the determination of the severity of burns in the world. The classification method adopted in the 1970 National Burn Conference was adopted clinically.
(1) Classification of adult burn severity:
1 mild burn: a second degree burn with a total area of less than 10%.
2 moderate burns: burns with a total area of 11% to 30% or a third degree burn area of less than 10%.
3 severe burns: the total area is between 31% and 50% or the III degree burn area is between 11% and 20%, or the total area is not more than 31%, but one of the following conditions: the general condition is serious or there is shock There are compound injuries or combined injuries (such as severe trauma, chemical poisoning, etc.), and those with moderate or severe inhalation injury.
4 heavy burns: the total area is above 51% or the III degree burn area is above 21%.
(2) The severity of burns in children is different from that of adults. The classification is as follows:
1 mild burns: second degree burns with a total area of less than 5%.
2 moderate burns: burns with a total area of 5% to 15% of II degree burns or III degree burns of less than 5%.
3 severe burns: burns with a total area of 15% to 25% or a III degree burn area between 5% and 10%.
4 severe burns: the total area is more than 25% or the III degree burn area is more than 10%.
(3) Because the above classification criteria can not reflect the level of large-scale burns in China, and can not reflect the true severity of burns, the current clinical use of "small area", "medium area", "large area" and "extra large "area" to indicate the severity of the burn.
1 small area burns: 2 degree burn area within 10% or III degree burn area within 1%, equivalent to mild burns.
2 medium area burns: burns with a total area of 11% to 30% of the second degree burn or between 10% and 20% of the burn area of the third degree burn, equivalent to moderate and severe burns.
3 large area burns: the total area is 31% to 79% or the III degree burn area is 21% to 49%.
4 Extra large area burns: The total area is above 50% of the country or the burned area of the III degree is more than 50%.
