Scalding
Scaldings occur relatively frequently in domestic surroundings. They usually occur during kitchen work and here above all when hot or even boiling water is poured out (e.g. spilled pasta water etc.). A distinction is made between scalding by hot water and by steam.
The latter can cause severe injuries to the skin, as steam is much hotter than heated water. Scaldings occur already from a temperature of 45 degrees Celsius. Only the upper skin layer is affected.
In addition to severe pain, redness and possibly swelling of the corresponding skin area can be observed. The first measures should always be to cool the area. First of all, clothing over the corresponding area of skin must be removed.
In the case of scalds, where there are no open areas of the skin, cooling tap water or ice bags can be placed on the area. It is important that cooling should be started within the first minutes after the scalding. After 10 minutes at the latest, cooling should be interrupted and the skin inspected.
If necessary, cooling can be started again. Depending on how large the area is or where it is located, a doctor should be consulted after or during cooling. If large areas of the skin or important organs such as the eyes are affected by the scalding, a doctor should always be consulted immediately.
Our skin is composed of many layers. Seen from the outside inwards, these are essentially the epidermis, dermis and subcutis with its fatty tissue. The dermis is also indispensable for the regeneration of the skin.
Severe damage to this skin layer usually results in scarring. This can be classified into different degrees of severity according to the skin layers involved in scald formation. A more detailed assessment of the burn is based on the burned area of the skin: even a second- or third-degree burn with an affected body surface of about 10% in adults (corresponds approximately to the area of an arm) or 5% in children (corresponds approximately to the area of half an arm) leads to a severe loss of water through unhindered evaporation.
A life-threatening hypovolemic shock can be the result. The so-called rule of nine allows an approximate estimate of the burn area in adults. The arms and head take up 9% of the body surface each.
The skin of the legs covers about 2 x 9 (18)% of the body, the skin of the trunk about 4 x 9 (36)%. In children, the rule of nine loses its validity due to the different body proportions. However, the general rule of thumb is that the patient’s palm (including the fingers) covers about 1% of the body surface.
- Grade 1: Here there is only a redness and slight swelling of the skin; only the epidermis is affected. The skin is painfully irritated, but the scald heals within days to weeks without permanent damage.
- Grade 2: Both the epidermis and the dermis are affected. A visible blistering with a red and white background takes place; the patient feels severe pain.
In grade 2a, complete healing takes place, in grade 2b, scarring takes place. A complete healing of the injury takes a few weeks.
- Grade 3: A third-degree burn or burn is characterized by black and white blisters or even necrosis (dead tissue). Nevertheless, the patient does not feel any pain, because together with dermis and subcutis, nerve endings have also been destroyed.
A scar-free healing is not possible.
- Grade 4: Very severe scalding damaged not only skin layers but also underlying muscles, tendons, bones and joints. Scalding is also painless here. A fourth degree burn usually requires a skin transplant.
The most important treatment for burns and scalds is to cool the scalded skin immediately after the heat source has been removed.
This can best be done with the help of about 20C° cool, germ-free water (preferably tap water). Ice, on the other hand, should not be used as there is a risk of frostbite to the skin. The study situation regarding the wound healing effect of cooling on scalds and burns is rather vague.However, a pain-relieving effect is assured and justification enough for cooling.
Clothing or other objects on the scalded skin should not be removed by the patient himself and should be left on the patient’s body until the arrival of qualified personnel. An exposed burn wound should be covered with sterile, non-fluffy wound dressings after cooling. These should be applied rather loosely.
Ideally, a wound dressing vaporized with aluminum is used for this purpose. Dressing sets designed specifically for burns usually contain such dressings. It is generally advisable, but especially with children in the household, to have such sets ready to hand in the medicine cabinet at all times.
The application of household remedies such as: should definitely be avoided, as infections and further damage to the skin can be the result. Also special wound ointments and gels should, if at all, only be applied after consultation with the family doctor or a pharmacist and are therefore not part of first aid measures. Depending on the severity and extent of the scalding, a doctor should be consulted for further treatment.
First-degree burns are easily treatable by the patient himself. In the case of more severe burns, it is recommended that the patient be seen by his family doctor or in the emergency room.
- Flour
- Oil
- Salt or
- Hand Creams
