What are the Different Degrees of Burns?

Generally refers to heat, including thermal fluid (water, soup, oil, etc.), steam, high temperature gases, flames, hot metal liquids or solids (such as molten steel, steel ingots), etc., tissue damage caused mainly by the skin and / or mucosa, serious It can also damage subcutaneous or / and submucosal tissues, such as muscles, bones, joints and even internal organs. Scald is tissue damage caused by hydrothermal fluid, steam, etc., and is a type of thermal burn. China's Nine Cents: Proposed by the Third Military Medical University of the Chinese People's Liberation Army, the body surface area of adults is divided into 11 equal parts, of which 9% is head, face and neck, 2 9% is upper and lower limbs, front and back of the trunk (13% each) and perineum (1%) were 3 9%, and both lower limbs including hips were 5 9% + 1% (46%).

Basic Information

English name

burn

Visiting department

Burns, Plastic Surgery

Common locations

Skin and / or mucous membranes

Common causes

Caused by high temperature, current, strong radiation or corrosive substances

Common symptoms

Local pain, skin swelling, blisters, breakage, etc.

Burn clinical manifestations and classification

1. First degree burns

Also known as erythematous burn, only part of the epidermis is injured, but the germinal layer is alive, so the proliferation and regeneration ability is active, and it usually heals within 3 to 5 days without leaving scars.

2. Superficial second degree burns

Damage to the entire epidermis and part of the nipple layer. Because the germinal layer is partially damaged, the regeneration of the epithelium depends on the residual germinal layer and skin attachments, such as the epithelial proliferation of sweat glands and hair follicles. If there is no secondary infection, it usually heals in about 1 to 2 weeks without leaving scars.

3. Deep second degree burns

The burn is deep below the papillary layer of the dermis, but some dermis and skin attachments remain. Healing depends on the proliferation of skin attachment epithelium, especially epidermal progenitor cells in the hair follicle protrusion. If there is no infection, it usually takes 3 to 4 weeks to heal by itself, and scars often remain. There are many clinical variations, shallow is close to shallow degree, deep is critical degree.

4. degree burns

Also known as coke burn. Generally refers to the entire skin burn, the epidermis, dermis and skin accessories are all damaged. Wound repair depends on surgical skin graft or flap repair.

5. degree burns

Burns deep into muscles, bones, and even internal organs. Wound repair depends on surgical skin grafting or flap repair. In severe cases, amputation is required.

6. Mild burns

The wounds healed by themselves within 21 days after the injury included first degree burns and shallow second degree burns and some shallower deep second degree burns.

7. Deep burns

It takes more than 21 days for the wound to heal on its own. Includes deeper or deeper second-degree burns, third-degree burns, and fourth-degree burns with infection, usually requiring surgery. The surface of deep degree burns is whitish or brownish yellow. After removing the necrotic skin, the wound surface is slightly wet or red and white, and it feels dull. Small red dots of millet size can be seen. It usually takes 3 to 4 weeks to heal. Pale, yellow-brown, scorched, severe cases are burnt or charred, the skin loses its elasticity, touches hard into the leather, is dry and free of exudate, feels poor, requires surgical skin grafting, and scars after healing.

8. Moderate burns

Adult burns ranged from 11% to 30% (5% to 15% in children) or third-degree burns ranged to 10% or less (5% in children) and there were no inhalation injuries or serious complications.

9. Severe burns

Adult burn area is between 31% and 50% (16% to 25% in children) or third-degree burn area is between 10% and 20% (under 10% in children), or adult burn area is less than 31% (children) (Less than 16%), but one of the following conditions: severe general condition or shock; compound injuries (severe trauma, impact injury, radiation injury, chemical poisoning, etc.); moderate and severe inhalation injury; baby head Facial burns exceed 5%.

Burn burn first aid

Principles of first aid for burns-quickly detach from the source of injury, immediate cold treatment, nearest emergency and transfer.

Thermal burn

Including flames, vapors, high-temperature liquids, metals, etc., the common methods are as follows: Take off clothing that is soaked by fire or boiling liquid, especially chemical fiber clothing, as soon as possible to prevent the fire or hot liquid on clothing from continuing to deepen the wound. Use water to extinguish the fire, or jump into nearby pools and ditch. Burning and extinguishing flames on site, prohibit standing or running calls to prevent burns or inhalation of the head and face. Immediately leave the closed and poorly ventilated site to avoid inhalation injury and suffocation. Extinguish with non-combustible materials. Cold therapy.

2. For chemical burns

Burn severity is related to the nature, concentration and contact time of acid and alkali. Therefore, no matter what kind of acid or alkali burn is, immediately flush with plenty of clean water for at least 30 minutes. On the one hand, it can dilute and remove residual acid and alkali. A method of cold treatment can reduce pain. Pay attention to the amount of boiling water should be sufficient, quickly flush the residual alkali from the wound, head and face burns hard first pay attention to the eyes, especially the cornea with burns, and priority flushing.

3. Electric burns

In the case of first aid, the power should be cut off immediately. Do not touch the patient when the power is not cut off to avoid being injured by electric shock. At the same time, perform artificial respiration, extracardiac compression and other treatments, and transfer to the nearest hospital for further treatment.

Burn treatment

Early burn management

Early burn treatment includes pre-hospital emergency (on-site first aid and transfer) and initial treatment after admission. Under normal circumstances, correct early treatment can reduce the degree of burns, reduce the incidence and mortality of complications. It is the basis for subsequent treatment of burn patients and has a close relationship with the outcome of burn patients. Pre-burn first aid includes on-site first aid and transfer On-site first aid is the earliest link in the treatment of burns. Improper treatment often causes burns to be aggravated or delays the timing of rescue, which brings a lot of inconvenience to the treatment after admission. A wide range of burns will result in a large burn area, and a long duration will cause deep burns. The basic requirements of first aid are to promptly terminate heat source injury and emergency treatment, and to take corresponding first aid measures for different burn causes. First check some conditions that can endanger the life of the wounded, such as major bleeding, asphyxia, open pneumothorax, poisoning, etc., should be promptly dealt with and rescued, regardless of any cause of heartbeat, respiratory arrest, chest compressions and artificial breathing should be performed immediately, Evacuate the patient for recovery after resuscitation or transfer to the nearest medical unit for treatment. Leave the scene. Judging the injury, estimating the area and depth, judging the injury, and paying attention to whether there is inhalation injury, compound injury or poisoning. sedation pain. Keep the airway open. Wound treatment. treatment of compound injuries. Rehydration treatment. Application of antibiotics. In principle, the principle of in-situ treatment is the principle of transport. The need for in-situ treatment: high incidence of shock in patients with severe burns and early onset. On the issue of transferring patients with severe burns, burn professionals have reached a basic consensus and emphasized in-situ treatment. Treatment experience also needs to be transferred to hospital after anti-shock.