Leg burn 3rd degree treatment. What is the best way to treat a burn. Antiseptic dressings and treatments

Third-degree burns are divided into two subgroups - third-degree "A" burns and third-degree "B" burns. Moreover, a burn of the third "A" degree is still referred to as superficial burns, and the third "B" degree is already a deep burn, the difference seems to be quite small, only a few millimeters, but it is, in fact, very significant - it's all about the germ skin layer. If the germ layer is damaged, the burn becomes deep by definition, which means that such a burn wound will not heal itself - skin restoration will be required here surgical methods is a complex and lengthy process. A 2nd degree burn can also be compared and understand the fundamental differences.

Symptoms when examining a 3rd degree burn

On examination, a third-degree burn can be identified by the bursting of the blisters. Superficial burns from the first to the third "A" degree are usually caused by hot liquids - this is water, tea, broths. With the third "A", pain sensitivity is still preserved in the burn area, because not all nerve endings die and this is also a certain diagnostic sign. If pain is not felt when touching the wound, then there is a loss pain sensitivity- this is a sign of a deep burn - that is, the third "B" or already the fourth degree. Deep burns are caused by exposure to flames, hot metals, so when the clothes on the victim ignite, 95% of the burns can be deep. Chemical burns can also become deep, especially when high concentration acids or alkalis.

Deep burns, as a rule, are accompanied by the development of burn shock, the victims are excited, rush about in pain, poorly oriented in place and situation, try to escape, blood pressure first rises slightly, and with the development of shock, it begins to progressively decrease. In this case, excitation is replaced by prostration. For burn shock, thickening of the blood is especially characteristic, due to massive plasma loss.

If the fact of a burn is not difficult to establish, then it can be quite difficult to determine the depth and even the area of ​​the burn. The determination of the area is carried out according to the well-known rule of "nines" or according to the rule of "palms". When the blisters on the skin burst, against the background of fragments of the epidermis, the skin is pale with a clear relief (“pigskin”), hair on such skin is usually absent.

Third degree burn treatment

Emergency care for third-degree burns begins, as with other degrees, with the elimination of the damaging agent. That is, you need to bring down the flame and tear off the burning clothes, then proceed to adequate anesthesia. If compared with a 1st degree burn, then it immediately becomes clear that there are serious intentions in the treatment of this degree. This is very important point, since in the third degree of a burn, pain often serves as a triggering moment of burn shock. It is possible to perform anesthesia with narcotic analgesics and for these purposes use a 1% solution of morphine, a 2% solution of promedol or pantopon, if it is impossible to enter narcotic analgesics you can use any available, but their effect is certainly inferior. At the same time, it is necessary to administer antihistamines (diphenhydramine, suprastin, tavegil), locally the burn can be treated with 33% alcohol and sterile dressings can be applied. The burn surface can be sprayed with a 0.5% solution of novocaine through a syringe needle for 5-19 minutes until the pain subsides. With extensive burns, as well as with the risk of developing burn shock, even at the prehospital stage, it is necessary to start antishock therapy, which primarily consists in compensating for the lost liquid part of the blood, that is, the volume of circulating blood is corrected. The volume of fluid injected can be determined by adding two zeros to the burn area figure. To do this, you can use solutions of glucose, polyglucin, as well as solutions with anti-shock action - venofundin, gelofusin. In the presence of excitation - appoint sedatives- seduxen, relanium. With prolonged transportation, the administration of painkillers can be repeated as the effect decreases.

The skin consists of the following layers:

• epidermis ( outer part skin);
• dermis ( connective tissue of the skin);
• hypodermis ( subcutaneous tissue).

Epidermis

The epidermis consists of the following layers:

• basal layer ( provides the process of reproduction of skin cells);
• spiny layer ( provides mechanical protection against damage);
• granular layer (protects underlying layers from water penetration);
• shiny layer ( participates in the process of keratinization of cells);
• stratum corneum ( Protects the skin from invasion of pathogenic microorganisms).

Dermis

The dermis is made up of the following layers:

• papillary layer ( includes loops of capillaries and nerve endings);
• mesh layer ( contains blood vessels, muscles, sweat and sebaceous glands and hair follicles).

Hypodermis

With burns, the following damage to the layers of the skin occurs:

• superficial or complete lesion of the epidermis ( first and second degree);
• superficial or complete lesion of the dermis ( third A and third B degrees);
• damage to all three layers of the skin ( fourth degree).

It should also be noted that in burn injuries protective function skin is significantly reduced, which can lead to the penetration of microbes and the development of infectious inflammatory process.

The circulatory system of the skin is very well developed. The vessels, passing through the subcutaneous fat, reach the dermis, forming a deep cutaneous vascular network at the border. From this network, blood and lymphatic vessels go up into the dermis, nourishing the nerve endings, sweat and sebaceous glands, as well as hair follicles. Between the papillary and reticular layers, a second superficial cutaneous vascular network is formed.

Burns cause disruption of microcirculation, which can lead to dehydration of the body due to the massive movement of fluid from the intravascular space to the extravascular space. Also, due to tissue damage, small vessels liquid begins to flow out, which subsequently leads to the formation of edema. With extensive burn wounds, destruction blood vessels can lead to the development of burn shock.

Causes of burns

• thermal impact;
• chemical impact;
• electrical impact;
• radiation exposure.

thermal effect

• Fire. When exposed to fire, the face and upper respiratory tract are most often affected. With burns of other parts of the body, it is difficult to remove burnt clothing, which can cause the development of an infectious process.
• Boiling water. AT this case the burn area may be small, but deep enough.
• Steam. When exposed to steam, in most cases, shallow tissue damage occurs ( often affects the upper respiratory tract).
• hot items. When the skin is damaged by hot objects, clear boundaries of the object remain at the site of exposure. These burns are quite deep and are characterized by the second - fourth degrees of damage.

• influence temperature ( the higher the temperature, the stronger the damage);
• duration of exposure to the skin how longer time contact, the more severe the degree of burn);
• thermal conductivity ( the higher it is, the stronger the degree of damage);
• the condition of the skin and health of the victim.

Chemical exposure

Burns due to chemical exposure can occur due to exposure of the skin to the following substances:

• Acids. The effect of acids on the surface of the skin causes shallow lesions. After exposure to the affected area in short term a burn crust is formed, which prevents further penetration of acids deep into the skin.
• Caustic alkalis. Due to the influence of caustic alkali on the surface of the skin, its deep damage occurs.
• Salts of some heavy metals (e.g. silver nitrate, zinc chloride). Damage to the skin with these substances in most cases causes superficial burns.

electrical impact

Electrical injuries are divided into:

• low voltage;
• high voltage;
• supervoltage.

Radiation exposure

• Ultraviolet radiation. Ultraviolet skin lesions predominantly occur in summer period. The burns in this case are shallow, but are characterized by a large area of ​​damage. Exposure to ultraviolet often causes superficial first or second degree burns.
• Ionizing radiation. This effect leads to damage not only to the skin, but also to nearby organs and tissues. Burns in such a case are characterized by a shallow form of damage.
• infrared radiation. May cause damage to the eyes, mainly the retina and cornea, but also to the skin. The degree of damage in this case will depend on the intensity of the radiation, as well as on the duration of exposure.

Degrees of burns

• I degree;
• II degree;
• III-A and III-B degree;
• IV degree.

The depth of damage in case of burns depends on the following factors:

• the nature of the thermal agent;
• temperature of the active agent;
• duration of exposure;
• the degree of warming of the deep layers of the skin.

• Superficial burns. These include first, second, and third-A degree burns. These lesions are characterized by the fact that they are able to heal fully on their own, without surgery, that is, without scarring.
• Deep burns. These include burns of the third-B and fourth degree, which are not capable of full self-healing ( leaves a rough scar).

Burn symptoms

• faces ( in most cases leads to eye damage);
• scalp;
• top respiratory tract (pain, loss of voice, shortness of breath, and cough with a small amount sputum or streaked with soot);
• upper and lower limbs ( with burns in the joints, there is a risk of dysfunction of the limb);
• torso;
• crotch ( can lead to disruption of the excretory organs).

Burn degree	Symptoms	A photo
I degree	With this degree of burn, redness, swelling and pain are observed. The skin at the site of the lesion is bright pink in color, sensitive to touch and slightly protrudes above the healthy area of ​​​​the skin. Due to the fact that with this degree of burn only superficial damage to the epithelium occurs, the skin after a few days, drying and wrinkling, forms only a small pigmentation, which disappears on its own after a while ( an average of three to four days).
II degree	In the second degree of burns, as well as in the first, hyperemia, swelling, and burning pain are noted at the site of the lesion. However, in this case, due to the detachment of the epidermis, small and loose blisters appear on the surface of the skin, filled with a light yellow, transparent liquid. If the blisters break open, reddish erosion is observed in their place. The healing of this kind of burns occurs independently on the tenth - twelfth day without scarring.
III-A degree	With burns of this degree, the epidermis and partly the dermis are damaged ( hair follicles, sebaceous and sweat glands persist). Tissue necrosis is noted, and also, due to pronounced vascular changes, there is a spread of edema over the entire thickness of the skin. At third-A degree a dry light brown or soft white-gray burn crust is formed. Tactile-pain sensitivity of the skin is preserved or reduced. Bubbles form on the affected surface of the skin, the sizes of which vary from two centimeters and above, with a dense wall, filled with a thick jelly-like liquid. yellow color. Epithelialization of the skin lasts an average of four to six weeks, but when an inflammatory process appears, healing can last for three months.
III-B degree	With burns of the third-B degree, necrosis affects the entire thickness of the epidermis and dermis with partial capture of subcutaneous fat. At this degree, the formation of blisters filled with hemorrhagic fluid is observed ( streaked with blood). The resulting burn crust is dry or wet, yellow, gray or dark brown. There is a sharp decrease or absence pain. Self-healing of wounds at this degree does not occur.
IV degree	With fourth-degree burns, not only all layers of the skin are affected, but also muscles, fascia and tendons up to the bones. A dark brown or black burn crust forms on the affected surface, through which the venous network is visible. Due to the destruction of nerve endings, there is no pain at this stage. At this stage, marked intoxication is noted, there is also high risk development of purulent complications.

Burns are divided into extensive ( lesion of 10 - 15% of the skin or more) and not extensive. With extensive and deep burns at superficial lesions skin more than 15 - 25% and more than 10% with deep lesions burns may occur.

Burn disease is a group clinical symptoms with thermal lesions of the skin, as well as nearby tissues. Occurs with massive destruction of tissues with the release of a large amount of biologically active substances.

The severity and course of a burn disease depends on the following factors:

• the age of the victim;
• the location of the burn;
• burn degree;
• area of ​​damage.

• burn shock;
• burn toxemia;
• burn septicotoxemia ( burn infection );
• convalescence ( recovery).

burn shock

Degrees of burn shock

Burn toxemia

For intoxication syndrome the following features are characteristic:

• increase in body temperature ( up to 38 - 41 degrees with deep lesions);
• nausea;
• thirst.

Burn septicotoxemia

For burn septicotoxemia, the following symptoms are characteristic:

• weakness;
• increase in body temperature;
• chills;
• irritability;
• jaundice skin and sclera ( with liver damage);
• increased heart rate ( tachycardia).

convalescence

Determining the area of ​​burns

There are the following methods for determining the area of ​​the burn:

• the rule of nines;
• palm rule;
• Postnikov's method.

Rule of nines

Rule of nines	A photo
head and neck 9%
upper limbs (each hand) by 9%
anterior torso18% (chest and abdomen 9% each)
back of the body18% (top part back and lower back 9% each)
lower limbs (each leg) by 18% (thigh 9%, lower leg and foot 9%)
Perineum 1%

palm rule

Postnikov method

First aid for burns

• elimination of the source of the acting factor;
• cooling of burned areas;
• the imposition of an aseptic bandage;
• anesthesia;
• call an ambulance.

Elimination of the source of the acting factor

Cooling of burned areas

Note: for third and fourth degree burns, this first aid measure is not performed.

Applying an aseptic dressing

Dry and clean handkerchiefs, towels, sheets can be used as an aseptic dressing. An aseptic bandage must be applied to the burn wound without pre-treatment. If the fingers or toes have been affected, it is necessary to lay additional tissue between them in order to prevent the parts of the skin from sticking together. To do this, you can use a bandage or a clean handkerchief, which must be wetted before application. cool water and then squeeze out.

Anesthesia

Call an ambulance

• with burns of the third and fourth degree;
• in the event that a second-degree burn in area exceeds the size of the palm of the victim;
• with first-degree burns, when the affected area is more than ten percent of the body surface ( for example, the entire abdomen or the entire upper limb);
• with the defeat of such parts of the body as the face, neck, joints, hands, feet, or perineum;
• in the event that after a burn there is nausea or vomiting;
• when after a burn there is a long ( more than 12 hours) increase in body temperature;
• when the condition worsens on the second day after the burn ( increased pain or more pronounced redness);
• with numbness of the affected area.

Burn treatment

• conservative;
• operational.

• the area of ​​the lesion;
• the depth of the lesion;
• localization of the lesion;
• the cause of the burn;
• the development of a burn disease in the victim;
• the age of the victim.

Conservative treatment

Conservative burn treatment includes:

• closed way;
• open way.

• applied dressings prevent infection of the burn wound;
• the bandage protects the damaged surface from damage;
• used medicines kill microbes and promote rapid healing burn wound.

• dressing change provokes pain;
• the dissolution of necrotic tissue under the bandage leads to an increase in intoxication.

open way
This method of treatment is characterized by the use of special techniques ( e.g. ultraviolet irradiation, air cleaner, bacterial filters), which is available only in specialized departments of burn hospitals.

The open method of treatment is aimed at the accelerated formation of a dry burn crust, since a soft and moist scab is a favorable environment for the reproduction of microbes. In this case, two to three times a day, various antiseptic solutions (e.g. brilliant green ( brilliant green) 1%, potassium permanganate ( potassium permanganate) 5% ), after which the burn wound remains open. In the ward where the victim is located, the air is continuously cleaned of bacteria. These actions contribute to the formation of a dry scab within one to two days.

In this way, in most cases, burns of the face, neck and perineum are treated.

There are the following advantages of the open method of treatment:

• contributes to the rapid formation of a dry scab;
• allows you to observe the dynamics of tissue healing.

• loss of moisture and plasma from a burn wound;
• high price the treatment method used.

Surgical treatment

• necrotomy;
• necrectomy;
• staged necrectomy;
• limb amputation;
• skin transplant.

necrectomy
Necrectomy is performed for third-degree burns in order to remove non-viable tissues with deep and limited lesions. This type The operation allows you to thoroughly clean the burn wound and prevent suppuration processes, which subsequently contributes to the rapid healing of tissues.

Staged necrectomy
This surgical intervention is performed with deep and extensive skin lesions. However, staged necrectomy is a more gentle method of intervention, since the removal of non-viable tissues is performed in several stages.

Amputation of a limb
Amputation of the limb is performed with severe burns, when treatment by other methods has not brought positive results or necrosis has developed, irreversible tissue changes with the need for subsequent amputation.

These methods of surgical intervention allow:

• clean the burn wound;
• reduce intoxication;
• reduce the risk of complications;
• reduce the duration of treatment;
• improve the healing process of damaged tissues.

Skin transplantation
Skin grafting is performed to close large burn wounds. In most cases, autoplasty is performed, that is, the patient's own skin is transplanted from other parts of the body.

Currently, the following methods of closing burn wounds are most widely used:

• Plastic surgery with local tissues. This method is used for deep burn lesions of small size. In this case, there is a borrowing of neighboring healthy tissues to the affected area.
• Free skin plastic. It is one of the most common methods of skin transplantation. This method consists in the fact that using a special tool ( dermatome) in the victim from a healthy part of the body ( e.g. thigh, buttock, abdomen) the necessary skin flap is excised, which is subsequently superimposed on the affected area.

Physiotherapy

• inhibition of the vital activity of microbes;
• stimulation of blood flow in the area of ​​​​impact;
• acceleration of the regeneration process ( recovery) damaged area of ​​the skin;
• prevention of the formation of post-burn scars;
• stimulation of the body's defenses ( immunity).

Burn Prevention

Prevention of sunburn

• Avoid direct contact with the sun between ten and sixteen hours.
• On particularly hot days, it is preferable to wear dark clothing, as it protects the skin from the sun better than white clothes.
• Before going out, it is recommended to apply on exposed skin. sun protection.
• During the reception sunbathing the use of sunscreen is a mandatory procedure that must be repeated after each bath.
• Since sunscreens have different protection factors, they must be selected for a specific skin phototype.

• Scandinavian ( first phototype);
• light-skinned European ( second phototype);
• dark-skinned Central European ( third phototype);
• Mediterranean ( fourth phototype);
• Indonesian or Middle Eastern ( fifth phototype);
• African American ( sixth phototype).

Prevention of household burns

To avoid burns at home, the following recommendations must be followed:

• Do not use electrical appliances with damaged insulation.
• When unplugging the appliance from the socket, do not pull the cord, it is necessary to hold the plug base directly.
• If you are not a professional electrician, do not repair electrical appliances and wiring yourself.
• Do not use electrical appliances in a damp room.
• Children should not be left unattended.
• Make sure there are no hot objects in the children's reach ( for example, hot food or liquids, sockets, included iron, etc.).
• Items that can cause burns ( e.g. matches, hot objects, chemicals and other) should be kept away from children.
• It is necessary to conduct awareness-raising activities with older children regarding their safety.
• You should stop smoking in bed, as this is one of the common causes fires.
• It is recommended to install fire alarms throughout the house or at least in places where the likelihood of a fire is higher ( e.g. in a kitchen, a room with a fireplace).
• It is recommended to have a fire extinguisher in the house.

From the first lines, it is necessary to warn our readers that the treatment of 3rd degree burns modern medicine definitely recommends to stationary conditions under close medical supervision. This follows from the fact that the severity of the lesion here is quite serious and already poses a direct threat to the health of the victim and is even fraught with death if the patient's body is damaged significantly.

But, alas, there are situations when, quite unexpectedly, we can find ourselves in conditions where, apart from folk methods, there is no other way to cope with the problem that has arisen. It is here that it is worth recalling these very folk methods in order to quickly and with maximum efficiency not only stop pain syndromes, but also take measures aimed at healing burns and maximizing the restoration of the health of the victim.

Below we offer a selection of recommendations drawn from a variety of folk sources. They are all acceptable at home or as close as possible to such conditions and have occurred in the practice of treating third-degree burns without special medical intervention.

It should be noted that folk wisdom a very long time ago, she adopted the properties of vitamins from groups A, C, B, E, which positively affect the acceleration of the wound healing process. Observation and experience made it possible to collect many prescriptions for the treatment of 3rd degree burns in conditions where, apart from healing properties some products we have nothing else to use, and apart from home methods, we cannot use anything else, as well as find ourselves in other conditions. It remains to be hoped that you will never need our selection of recipes.

1. From a well-washed clean water Remove the thorns and skin from an aloe leaf. We put the resulting pulp on a cotton cloth and apply it to the wound.
2. We will need chicken eggs, pre-cooked hard-boiled. Separating the yolks, fry them in a hot dry frying pan and on an ordinary sheet of iron, if you can only make an open fire. You fry the prepared raw materials well, and you can directly on the flame, if there is no device at all (the eggs themselves can also be held in coals for 15-20 minutes, instead of boiling them). Then you take a clean cloth, preferably gauze or nylon, put the yolks into it and squeeze firmly so that the oil begins to stand out. The resulting material ideal remedy for the treatment of skin areas affected by burns of the 3rd degree. Egg yolk butter is very easy to make at home.
3. For this recipe we will need:

• about 100 grams of grated peeled potatoes,
• Bee Honey.

Mix the resulting mixture with a teaspoon of non-thickened honey. It is used as a compress on burned areas of the skin. Important! Apply chilled. As soon as the mixture has warmed up, it should be replaced with a fresh one. Therefore, we advise you to prepare the composition in the quantity you need. But at the same time, keep in mind that the peeled potato mass has the properties of darkening, and this should not be allowed.

And a few words at the end

According to some experts, the treatment of a 3rd degree burn means traditional medicine may well replace modern drugs. We must fully agree with this, especially while we are in a situation where there is no possibility of qualified medical intervention.

Nevertheless, these methods have been tested by many generations, are relatively easily accessible and effective. In conclusion, it remains to wish our readers, as far as possible, to avoid such injuries and never face the problem of treating a third degree burn in real life. Watch yourself.

Burns are some types of injuries resulting from external influence. They are thermal, chemical, radiation, electrical. Also allocate various degrees burns, depending on the severity of the injury.

Burn classification

There are two generally accepted classifications. The division is carried out depending on the impact that caused the lesion. Also, burns are divided into degrees of burns, depending on the severity and depth of damage to the skin and soft tissues.

Thermal

This type is the most common among such injuries. Exposure to high temperatures from solids, liquids or steam accounts for approximately 94% of all such damage.

Most often, people get such injuries at home. Approximately half of the cases occur as a result of contact with open flames.

Rest- due to the interaction of body surfaces with hot liquids, steam, hot solid objects. A thermal burn of 2 or 3 degrees, occupying one third of the body area can lead to death.

When thermal burns occur, the severity of such burns depends on several factors. The exposure temperature matters.

Temperatures above 45 degrees are traumatic. With an increase in this indicator, the damage is aggravated. The thermal conductivity of the substance that has an effect also plays an important role. For example, while in the bath, some people like to make the air temperature from 90 degrees and above, and no injuries occur.

Gaseous substances have much lower thermal conductivity than liquids and solid bodies. Exposure to water at a temperature of 90 degrees will certainly lead to a burn. In addition, the duration of exposure to the traumatic factor plays an important role.

Electric

Such injuries are called electrical injuries. They can occur at home, at work due to equipment malfunction or neglect of safety regulations. They are characterized by several features. The current penetrates into the body, damaging not only the surface layers of the skin.

In addition, electricity can burn you at a distance, without contact with the source. With such injuries, the severity of damage depends on the thickness of the skin and its moisture content. Do not touch electrical appliances with wet hands, even if they are in good condition.

Electrical shock is often painless due to the destruction of nerve endings. In the event of a clothing fire, electrical injury can be combined with a thermal burn. Also, people often get mechanical damage as a result of falling after an electric shock.

These include fractures, TBI, abrasions and scratches. Such lesions are rarely mild.

Chemical

These types of injuries occur as a result of exposure to some chemical compounds. These include acids, alkalis, salts of heavy metals.

Most often, such injuries are received by workers in laboratories or specific industries, but this can also happen in domestic conditions.

The most severe are burns resulting from exposure to alkali. Such injuries have characteristic signs: they heal for a long time, penetrate deeply, sometimes affecting internal organs.

Ray

These types of injuries occur under the influence of radiation. Their features and stages depend on the dosage, as well as the type of radiation beam.

This most rare view burns can occur in the event of an accident at a specific production facility associated with radiation, during x-rays and radiotherapy.

The severity of the damage. Degrees of burns

There are several degrees of burns depending on the severity of the lesion, there are four in total. Classification by degrees allows physicians to predict the development of the situation. It also matters what percentage of the total area human body damaged.

The classification is based on the determination of the required volume of therapeutic measures, as well as the possibility of tissue regeneration without surgical intervention.

First degree

Each of us received a first-degree burn, more than once throughout our lives.

First-degree thermal burns are characterized by slight redness, sensation unpleasant burning sensation, mild swelling. The injury goes away after a couple of days. If you get burned at home, you can simply act on the damaged area of ​​\u200b\u200bthe skin with running cool water. This will relieve inflammation and pain.

When there is a 1 degree thermal burn, skin damage is minimal, only the upper layers of the epidermis are affected. They are also in normal conditions constantly die off, this is the most common physiological process.

First-degree burns do not require special treatment, they pass quickly, moreover, completely without a trace. In most cases, they have a small area of ​​damage.

Large-scale superficial lesions are extremely rare. If this happens, then most often a 1st degree burn is combined with deeper lesions.

Second degree

Second-degree burns show more significant damage to the skin. Traumatic impact leads to the formation of blisters filled with fluid. Sometimes they appear after a while. Such lesions have a very favorable prognosis, pass without leaving traces, noticeable scars on the skin.

The second stage is characterized by the destruction of the epidermis and the uppermost layer of the dermis. At the same time, symptoms such as severe pain, hyperemia, and edema are noted.

Burning pains, aggravated by touch, quite long. Redness around the blisters may or may not be present.

Blisters are formed by dead cells of the epidermis, and are filled with the liquid fraction of blood - plasma, penetrating into them from the damaged smallest vessels.

These types of injuries do not require medical care and special therapeutic measures. The regeneration process can take up to two weeks. To speed it up and make it easier pain syndrome you can use special pharmaceutical ointments or gels.

Never treat damaged areas with oil. This method interferes with cellular respiration, significantly slows down healing.

The danger of such damage is that opening blisters are open gates for infections. If the affected area is large, it is better to consult a doctor. He will advise medicines to prevent infection.

Differentiation between the second and third degree is carried out with the help of pain identification. Both of these stages are characterized by the formation of blisters, but in the second there is pain, and in the third they are not, since the nerve endings are damaged.

Third degree

Degree three burns are usually divided into two subspecies. 3A - this is a violation of the dermis to the deep layers, the lowest of which remain intact.

With such a depth of penetration, independent regeneration is still possible, without surgical intervention.

This applies only to fairly minor wounds. They can be delayed due to the growth of the epithelium from the marginal zones. Grade 3B is characterized by deep damage that captures all layers of the dermis, reaching the layer of subcutaneous fat.

This layer of skin does not structural elements, which are necessary for the regeneration of cells of the epidermis and dermis. Therefore, self-restoration and growth of tissue with this degree of burns does not occur.

The main signs are blistering different size filled with bloody contents, as well as the absence of pain when touched. Exudes from the wound a large number of mucous fluid with blood impurities. Around the wound defects, severe swelling, redness, increased local temperature. The damaged area is inflamed.

With such deep lesions, a number of common symptoms are noted. Clinic includes growth general temperature, the fall blood pressure, interruptions in the work of the heart, tachycardia, shortness of breath.

The third stage of the burn requires immediate hospitalization of the victim. Patients need surgical intervention and drug therapy.

The prognosis depends on how many percent of the body area is occupied by the lesion. It has an important prognostic value, how quickly medical care is provided.

In addition, the prognosis also depends on the general condition of the victim. For example, with thermal burns received during a fire, the degree of carbon monoxide intoxication plays a role.

4th

The most rare type of this type of injury. This is the most severe type of injury, differing poor prognosis even when small area wounds.

With damage of this depth, even within a small area, there is a high probability lethal outcome or alienation of the injured limb.

The deep layers of the human body are affected: the skin burns, the muscle tissues, tendons and even bones. A 4th degree burn involves the destruction of most of the nerve endings and blood vessels in the affected area.

The fourth degree can occur as a result of prolonged high-temperature exposure, acid or alkali damage, as well as electricity.

Wounds of such severity are immediately visible, they cannot be confused with anything. 4 degree of burn is characterized by charring, that is, a prolonged combustion reaction, leading to a change chemical structure tissue cells. The burn site becomes dark, sometimes black. The condition of the victims is extremely serious.

As a rule, people are in a state of shock or coma. If the wound defect has a significant area, medical care should be provided urgently, the count goes on for minutes. But still, the likelihood of death is very high.

In cases where such injuries occur, determination of their severity and classification is necessary only for medical professionals. When you are burned or someone has received a defeat in front of your eyes, it is necessary not to assess the damage, but to provide first aid.

If the victim is in serious condition carried out in a timely manner therapeutic measures can save his life.

There are 2 types thermal burns 3 degrees - burns 3a and 3b degrees.

For 3rd degree burns the entire epidermis with the surface layers of the dermis is affected, the death of most of the germ layer occurs. Clinical manifestations such injuries may be different. In some cases, thick-walled blisters appear, the wall of which consists of the entire thickness of the exfoliated epidermis, in others - a thin light brown scab, resembling parchment in appearance.

The formation of a leukocyte wall at the border of necrosis and living tissue begins on the 2nd day and reaches a maximum by the end of the 2nd week. At the same time, the scab is rejected. Complete sequestration occurs on average after 2 weeks. Under the necrosis, granulations form. AT hair follicles and sweat glands proliferation of the epithelium is noted. Burn wounds heal on average in 4-6 weeks.

The diagnosis of 3a degree burns in the early stages is based on the signs listed above, as well as the determination of sensitivity in the wound area. Tactile and pain sensitivity is usually reduced, but in some areas they are preserved. Accurate Diagnosis can be set only in the process of dynamic monitoring of wound regeneration. The appearance of islands of epithelialization against the background of granulations indicates the presence of a 3a degree burn.

Burns of the 1st, 2nd, 3a degrees are superficial, and 3b and 4th are deep. Superficial ones heal on their own, deep ones can only be cured by surgery.

For 3rd degree burns there is necrosis of the entire thickness of the skin. Possible partial or complete damage subcutaneous tissue. Initially, a grayish-white eschar develops, usually with long-term exposure hot liquids. When burned by a flame or hot metal, it is dense, dry, dark brown or black. A moderate edema and a narrow strip of hyperemia appear around the scab. The vascular pattern found in it, due to vein thrombosis, indicates a deep lesion.

Sometimes with burns of the 3b degree, blisters filled with hemorrhagic contents can be observed; their bottom is a deathly pale dermis, on the surface of which petechial hemorrhages. Bubbles are usually found when exposed to hot liquids. Developing in these cases, wet (colliquation) necrosis contributes to the transition of the inflammatory process to intact tissues. In parallel with the development of the suppurative process, proliferation is also noted.

Due to more pronounced than with dry necrosis, inflammatory response scab rejection occurs on average 2 weeks earlier.

In areas of 3b degree burns, there is complete absence tactile and pain sensitivity. The skin temperature in such areas is 1.5-2.5°C lower than in 3a degree burns, which is associated with impaired blood circulation and changes in metabolic processes. In the absence of an electrothermometer, this difference can be felt by touch.

As a result of such injuries, the manifestation of a burn disease is possible!