Burn Wound: Causes, Symptoms & Treatment

Almost everyone is injured by burns one or more times during their lifetime. These burns can then lead to minor or severe burns. Most often, these are minor injuries to the fingers or arms that happen while preparing food in the kitchen or handling an open fire. Even the smallest burns can be very painful and should be treated.

What is a burn wound?

Open wounds usually bleed a lot at first. However, if there is no bleeding disorder or if anticoagulant medications are not taken, a wound usually closes with scabs within 12 hours. Burn wounds can injure and damage the skin, muscles, tendons or even organs. Depending on the type of injury, its extent and its depth, burn injuries are divided into specific degrees of severity and treated accordingly. Breathing in humans does not take place exclusively through the lungs, but also through what is known as skin respiration. Therefore, extensive burns can be life-threatening and require the fastest possible specialist treatment. A severe burn is always an emergency and can be associated with danger to life and limb. The time factor plays a very important role in the initial treatment of burn victims.

Causes

Direct physical contact with fire, explosions, abrasions, or burning with liquids can cause burns to any part of a person’s body. This involves charring or burning of the skin or affected tissue, and in severe cases, organs such as the nose, mouth, or ears. The eyes can also be affected by a burn injury. In any case, the treatment of major burns belongs in the hands of medical professionals. Only they can determine whether hospitalization is necessary or conventional methods such as a burn ointment are sufficient for treatment.

Symptoms, complaints and signs

Depending on the degree of burn, a burn manifests itself with different symptoms and signs. A first-degree burn involves a superficial injury to the skin that may be associated with pain, redness and itching. Occasionally, moisture leaks from the wound. A blister usually forms and heals after a few days. In grade 2a burns, there is severe pain associated with redness, itching, and peeling of the skin. In addition, the wound weeps and a blister forms. If not treated properly, scars are occasionally left behind. Second-degree burns are manifested by open blisters, slightly rough wound edges, and a moist wound surface. The wound is usually very painful, but usually heals without scarring. In third-degree burns, the skin is dry and thickened like leather. Touching it is not painful and usually no more fluid leaks out. Externally, a grade 3b burn is indicated by a whitish to brownish discoloration of the skin. In a fourth-degree burn, the muscles, tendons, bones and joints are damaged. Movement disorders, paralysis and sensory disturbances may occur. The skin is charred and discolored black.

Diagnosis and course

A simple burn blister from brief contact with a burning lighter, stove, or pot can usually be treated by the patient. However, if there is an extensive burn, the patient is taken to a doctor or hospital as soon as possible. Many larger cities also have trauma clinics and special burn centers where the correct diagnoses can be made quickly and safely. The attending physician first diagnoses burns by visual examination. Highly red, detached, torn or even black skin shows him the degree of injury. If burns are visible on the face and head, an ophthalmologist is consulted immediately. This is accompanied by an examination by an ear, nose and throat specialist, who will diagnose scorching of the ears, nose and throat. If internal injuries are feared, an MRI or magnetic resonance imaging of the body may also be ordered.

Complications

A burn wound that does not receive prompt professional medical attention can lead to a variety of complications. First and foremost is wound infection, because the damaged layers of skin are much more susceptible to bacterial attack.The increased risk of sepsis (blood poisoning) should also be mentioned in this context. Sepsis, if it spreads through the bloodstream in the body, can damage the entire organism and, in the worst case, develop into a life-threatening condition. Septic shock and (multiple) organ failure can follow and almost always have a fatal course. The extent of the scarring depends on how extensive and deep the burn injury is. If thick and bulging scars develop, pain due to shortening of skin, tendons and muscles cannot be ruled out. Very deep burns can even lead to bone and joint problems. The larger the burn wound, the more likely it is to require a skin graft to cover the area. This will prevent further infection and may stimulate the formation of new skin cells. Extensive burns can damage blood vessels and lead to massive fluid loss. As a result, there is a risk that not enough blood can be pumped through the body by the heart. There is also a risk of hypothermia because the body temperature drops dangerously.

When should you see a doctor?

A burn is usually associated with considerable pain, so medication and medical treatment are highly advisable. In many cases, a burn wound also forms burn blisters that fill with water. Affected individuals should seek medical attention as soon as possible when burn blisters appear. Only medical treatment can prevent serious complications or secondary diseases. Those who forego such treatment at this point expose themselves to great danger. Burst blisters are extremely susceptible to infections, since bacteria and viruses can settle in them ideally. There is a risk of dangerous inflammation, which can even lead to the formation of pus. If an inflammation is present, including the formation of pus, then a visit to the doctor is unavoidable. Only with an appropriate treatment can the present inflammation be effectively and quickly combated. If this is not done, the amount of pus will increase considerably. In the worst case, there is even a threat of blood poisoning if bacteria and viruses should enter the human bloodstream. Thus, the following applies: Burn wounds should always be treated by an appropriate physician. Serious complications or even permanent consequential damage can only be avoided by medical and medicinal treatment. Therefore, in the case of a burn wound, a visit to the doctor should not be put on the back burner.

Treatment and therapy

Severely burned patients need fluids urgently, and they are given glucose infusions while first aid is still being administered. They are wrapped in special burn sheets to keep their body temperature stable and protect the injured skin from bacteria. Burn patients cool easily, and the drop in body temperature can impair organ function or even cause the patient’s death. Blood pressure and cardiac activity are seamlessly monitored. Burn patients are often unconscious or even in a coma. Only a physician can take the necessary action. A first responder who is a layman is left only with the transfer to burn foil and the stable side position. Burn victims who are conscious are in great pain and are given painkillers immediately by medical personnel. In the hospital, burn victims must be cut out of clothing remnants or operated on. Treatment of burn injuries is lengthy and may require multiple surgeries. Skin grafts may be performed and muscles and tendons restored to function. If parts of the body are too badly burned, amputation may also be needed.

Outlook and prognosis

The healing process of burn wounds depends greatly on various factors such as the extent and degree of the burn. Healing takes at least a few days, but can take several months in severe cases. A moderately severe burn (second-degree burn) heals in about four weeks. After that, however, scars often remain. Mild burns, such as typical sunburns, are manifested by skin redness and irritation associated with moderate pain. They can be easily treated with home remedies such as creams and bandages and leave at most slight scars.Mild burns can be completely healed after only a few days. More severe burns are manifested by noticeable wounds and severe pain. In addition to bleeding, layers of skin may also detach. Severe burns absolutely require medical treatment. This may be carried out in special centers. In some cases, skin transplantation becomes necessary, which can lead to distinct scars and different coloration of the skin. In particularly severe cases, burns can even be fatal – especially if the patient is of very advanced age or has pre-existing conditions, or if a large part of the body surface is damaged by the burn. The survival of patients with very severe burns can be assessed using the Abbreviated Burn Severity Index (ABSI).

Prevention

Proper use of open flames, electrical appliances, and hot kitchenware helps prevent burns whenever possible. Young children should never play unsupervised where hot bath water is running, cooking is going on, or lighters and chemicals are present. The housewife only touches hot appliances with caution and suitable gloves. But also in the case of occupational safety, all necessary measures to prevent burn accidents must always be observed. Electrical apparatus and machinery must be handled and maintained as directed. Flammable liquids must be kept away from open flames.

Aftercare

The aftercare required for a burn depends on its extent and depth. For a superficial and small burn wound, no aftercare is usually necessary once it has healed. However, it is important to protect the newly formed skin from sunburn. The larger and deeper the burn, the more complex the aftercare must be. From a second-degree burn, aftercare is inevitable. A problem with larger tape wounds is scarring. Here, aftercare is required to prevent movement restrictions. Scarring-related disfigurement is also possible. It can take months or even years for the burn scar to become paler and softer. Cosmetic treatments can help conceal discoloration on the burn scar. Psychological aftercare may be indicated, as well as pain relief or prescribing protective and nourishing creams. In addition, aftercare may include fitting compression garments. Addressing functional impairments is an important topic of follow-up care. If there is a grade 2 or 3 burn, bulge scars can cause functional impairments in joints. The burned skin contracts over the joint. It restricts its mobility. In addition to surgical solutions at the plastic surgeon, aftercare may include pysiotherapeuitic treatments. In addition, scar massages and occupational therapy or physiotherapy are available during aftercare.

What you can do yourself

Smaller burns should first be cooled. The affected area is best cooled under cold running water and then wrapped with damp cloths. Ice cubes, cold packs and the like should be avoided to prevent hypothermia or tissue damage. Pain-relieving ointments or burn gel can then be applied to the burn. Alternatively, preparations containing aloe vera, Bach flowers or Schuessler salts can be used. Vinegar or apple cider vinegar can be used to protect against infection. Onion, garlic or plantain – applied directly to the burn – relieve itching and reduce blister formation. If a burn blister has already formed, the rule is: do not open it and instead put a protective plaster over it, which should be renewed daily. Large burns should be treated immediately by a doctor. Until a doctor is seen, the wound must be covered loosely and as germ-free as possible. In the case of scalds, soaked clothing must be removed immediately. Regardless of the degree and extent, a burn wound should also always be examined by a doctor. Only good infection control and aftercare can reliably prevent scarring. In the case of extensive burns, psychological counseling may be advisable.