The healing process of a 3rd degree burn. Prevention of household burns. How healing happens

The burn itself has its own division into 2 subgroups 3A - superficial burn, and 3B - deep burn. The difference between these varieties lies in the depth of penetration of the traumatic factor, which consists of only a few millimeters. But even such a seemingly insignificant difference can be extremely important.

Grade 3A symptoms

Burn 3A causes destruction of the cells of the epidermal layer and superficial dermal balls. With incomplete damage to the germ layer, the victim has some chances for successful skin restoration. The symptom complex of a burn wound of the 3rd degree is diverse: in some people, large blisters appear at the site of exposure to high temperature, the walls of which are lined with exfoliated epidermis, with a capacity of a yellow liquid or a thick homogeneous mass (blood plasma). In others, a thin ball of white, yellowish or brown scab protrudes in the area of injury.

3A degree burns proceed with a significant preservation of the threshold of pain sensitivity. The burnt epidermal ball exfoliates along with the clothing adjacent to it, thus exposing deeper tissues. Instead of the usual pale pink hue, they are colored dark red and have great amount whitish and burgundy blotches (consequences of thrombosis and minor ruptures of capillaries). Near the burn, soft tissues swell a little. Immediately after the injury, the victim feels a slight soreness, which disappears over time (depending on the rate of death). nerve endings in the upper layers of the skin).

Therapeutic measures and the entire period of skin healing after receiving burns of the 3rd degree, as a rule, take from 1 to 1.5 months. The first 2 weeks in the wound dead tissue is torn off and granulation is formed. After that, the process of proliferation of epithelial tissues located along the edges of the wound comes into action, sebaceous glands, excretory ducts and hair follicles.

The growing epithelium begins to merge with the whole skin, and after a couple of months, the tightened skin after a burn is almost no different from healthy skin. Only if you look more closely at the affected area, slightly expanded sebaceous glands and small scars.

Symptoms of 3B degree burns

They proceed a little harder than the above, since the lesion affects the deep balls of the skin. They undergo necrotic changes concerning and subcutaneous tissue. This type of thermal injury is possible with prolonged exposure to high temperature, as well as certain chemical substances.

3B degree burns occur with the appearance of a characteristic scab on the surface of the wound, which can be white, gray or even black. On the crust, you can see a vascular pattern that appeared due to vein thrombosis, soft tissue edema and a narrow area of local temperature increase.

From the influence of boiling water, multiple bubbles filled with small hemorrhages. In this situation we are talking not about dry, but wet tissue necrosis, which is dangerous with a high probability of suppuration spreading to neighboring soft tissues.

chief diagnostic criterion burns 3 degrees is the lack of pain sensitivity. Pathological changes that affect metabolism and blood circulation lead to a decrease local temperature in the burn area by 3-4 degrees. You can even notice the difference by touch, without the use of measuring instruments.

With a deep thermal injury, there is a possibility of developing a burn disease, which aggravates the general condition of the patient and the treatment itself. Being in a state of burn shock, the patient will suffer from pain, have poor orientation in space and situations that occur to him, and constantly try to escape from the hospital. Over time, arousal changes into a state of prostration, and previously elevated blood pressure indicators begin to fall sharply. A large volume of burn leads to plasma loss, due to which the blood becomes thicker.

First aid for the injured

It should be noted right away that injuries of this kind are not treated at home, but if the victim is given timely, and most importantly, correct first aid, further therapy can be greatly facilitated and accelerated, and the likelihood of complications can be reduced. How can you help a person who has received a 3rd degree burn:

First of all, it is necessary to stop the influence of the traumatic factor, and move the person to a safe place.
You can ask others around, or call an ambulance on your own.
If possible, it is better to raise the burned part of the body a little to reduce blood flow and prevent discrepancy. toxic substances throughout the body.
It is advisable to cover the burn area with a clean, and even better with a sterile cloth, in order to prevent infection and the development of a purulent process.

The desire to help a victim with third-degree burns can sometimes only lead to complications, so while doing help, you need to remember some points:

The use of anesthetics will not provide the desired relief, but will only complicate the diagnosis carried out by specialists.
No need to treat the burn yourself medicinal substances, apply an ice pack or rinse it with running water.
You do not need to take off your clothes, as they can pull stuck particles along with them. skin which will harm the person even more.

If the person who received the burn has lost consciousness, he needs to ensure the maximum flow fresh air, protection against aspiration by laying the head on its side and monitoring the pulse rate and the presence of breathing until the paramedics arrive. Timely assistance can help not only alleviate the condition, but also save lives.

Treatment

Treatment of any burns of the 3rd degree is carried out only in a hospital, under the supervision of qualified doctors. Self-treatment at home is absolutely unacceptable, because it is fraught with the development of dangerous complications: the formation of rough scars, incomplete joint mobility, incomplete restoration of the functionality of the body, the development of sepsis and many other undesirable and dangerous consequences, the cause of which lies behind improper therapy.

Burns of severe stages can affect the functioning of the respiratory, cardiovascular, immune, and even endocrine systems cause dysfunction of many internal organs. It is important to remember that particularly difficult cases require surgical intervention, so hospitalization and medical recommendations must be carried out impeccably.

Medical therapy

Therapeutic measures begin with anesthesia. In many cases, the use of analgesics will not improve the general condition of the patient, and the pain does not stop, so doctors decide to prescribe narcotic drugs like morphine. But, using these tools, you can cause a dangerous allergic reaction(anaphylactic shock), and to prevent this from happening, their use is paired with Suprastin or any other antiallergic drug. For fast elimination inflammation and accelerate the recovery of the skin, use hormonal drugs.

3rd degree burns often occur with increased excitability, so the victim should drink regularly sedatives. With a pronounced intoxication of the body, and to prevent dehydration, are connected intravenous systems with the necessary solutions. Sometimes, in addition to all drugs, antibiotics are prescribed. a wide range. Wounds are regularly treated with specific anti-burn drugs, they are cleaned of exudate and dead skin particles.

Surgical treatment

If a person has received a large-scale burn or the wound is too deep, and the body’s strength is not able to restore the skin on its own, even against the background of ongoing treatment, then the only way out can be only a skin transplant, or other types of surgical intervention. During heavy thermal lesions skin, several types of operations are possible:

Decompression surgery for deep lesions that can cause subfascial edema.
Necrectomy, which is aimed at cleansing the wound from dead particles. To this species operations can be attributed to the amputation of a burned limb.
In order for the wound to have an aesthetic appearance after treatment, to eliminate coarse scars and cosmetic defects, Dermatoplasty is performed.

Rehabilitation

Burns of the 3rd degree can harm not only physical health, but also significantly undermine the psyche of the victim. Psychologically, traumas that are associated with amputation of limbs, disfigurement of the face or other parts of the body, depression and other serious conditions require psychotherapeutic rehabilitation. The scheme of such events is developed by doctors, taking into account the characteristics of each individual case.

Emergency care and treatment for 3rd degree burns

The concept of a burn implies exposure to human skin of high temperatures, chemically acting liquids and environments, electric current and radiation that can cause damage to the skin and muscle layer.

There are 4 degrees of burns, having various levels skin lesions. Grade 1-2 is characterized by a slight injury to the skin, as well as a fairly rapid healing of wounds. The most dangerous are the 3rd and 4th stages of the lesion.

3rd degree burn causes severe and deep damage to the skin, necrosis of the connective tissue membranes and surface layers of the skin.

At this stage, the blisters become hemorrhagic, that is, containing, in addition to serous fluid and blood clots.

Classification and symptoms of burn injury of the 3rd degree of severity

Burns of the 3rd degree of severity are divided into 2 types, which determine the level of skin lesions affected by high temperatures and the area of injury:

3rd degree burn

It is characterized by damage to all layers of the epidermis, as well as the surface layers of the dermis. This level of burn completely kills the cells responsible for reproduction and growth, wound healing. Bubbles at this stage are a fairly thick tubercle, inside which is a serous and hemorrhagic fluid. Some areas of the body are covered with a thick brown crust that prevents the movement of the limb or damaged areas, cracking and causing severe pain. The 3rd stage of injury is caused practically total absence sensitivity on the affected areas of the body.

3-b degree of burn injury

At this stage, necrosis of all layers of the epidermis and dermis, as well as some layers of subcutaneous fat, develops. At this stage of damage, the surface acquires a gray-white or dark brown tint. The lesion site is completely covered with thick and big bubbles, mainly with hemorrhagic contents and elements of hemorrhages.

What signs indicate a 3rd degree burn?

This stage is characterized by complete or partial tissue necrosis. The first hours after injury are due to the strongest painful sensations patient in contact with affected areas of the body.

After a few hours, the pain is slightly reduced. The surface on the affected area acquires a dark brown hue with partially or completely covered blisters.

A sufficiently large tissue edema is formed around the damaged part of the body, which is due to the protective reaction of the body to injury. Together with edema, inflammation of the tissues quickly develops, which prevents the reduction of swelling of the tissues.

With the onset of pain or burn shock, the pressure of the victim drops sharply, tachycardia occurs, the patient loses consciousness.

This condition requires immediate first aid measures.

Emergency care for a patient with a 3rd degree burn

If you happen to be near a person who has received a 3rd degree burn, first aid will help save the victim's life and should be provided immediately.

Remove the cause of the injury immediately or move the victim away from the area of injury.
Remove all clothing from the victim - this is necessary due to the fact that the fabric quickly gets wet and sticks to the affected part of the body.
Lay the victim, if possible, with the elevated position of the affected area on the human body.
Cover the wound site with a dry clean cloth or napkins to prevent the ingress of germs and the occurrence of septic complications in the patient.

Important! Urgently call an ambulance and stay with the patient until the arrival of doctors.

Before the ambulance arrives, give the patient more to drink - this will avoid dehydration and can reduce the risk of falling blood pressure

Attention! Do not independently transport and move the victim if he is in a safe place, and also try to cool the affected area.

Treatment of 3rd degree burns - only in a hospital

Any touch to the damaged area brings the patient severe suffering, and can also lead to the development of a shock reaction. If the fabric of the clothing is already stuck to the skin, do not tear it off - you can further damage the already affected areas of the body. Do not give a person any medication before the arrival of medical personnel, as well as wash the wound with water or antiseptics.

Principles of treatment of 3rd degree burns

When a patient is diagnosed with 3rd degree burns, the patient is hospitalized in the burn department of the hospital, where he will stay until the wounds are completely healed. If a 3rd degree burn is detected, home treatment is not possible, due to high risk development of sepsis and other formidable complications.

Hito Pran dressings - a novelty in the treatment of 3rd degree burns

The main principles of treatment are:

Permanent anesthesia of the patient - is necessary to reduce the pain of the victim and reduce the reaction of the body;
The constant introduction of a large amount of liquid into the body is carried out using droppers. If the victim is conscious, you can give him a large number of drinking;
The imposition of aseptic dressings that contribute to the destruction of harmful bacteria inside the wound;
Appointment of glucocorticoids to reduce and eliminate inflammatory processes in the body;
Antibacterial therapy;
Therapy with sedative drugs - can reduce the risk of developing anaphylactic shock and helps to reduce the excitability of the patient.

When strong areas damage, carried out surgical removal and truncation of the edges of the wound in order to eliminate and most rapidly heal wounds.

At deep wound large areas of the body, doctors resort to transplanting it from other, healthy parts of the body, which contributes to faster healing of wounds and the most aesthetic appearance of the damaged part.

Rehabilitation measures after a 3rd degree burn are aimed at preventing the development various complications, as well as the speedy restoration of the skin after surgical and therapeutic treatment.

Cavitator treatment for 3rd degree burns

Important! In the treatment of third stage burns, A complex approach, with the application of all principles and activities.

It must be remembered that the skin heals after a 3rd degree burn. long time, so you need to be patient, and also follow all the prerequisites of the doctor. With proper and timely assistance, there is a high probability of wound healing with the least aesthetic and hygienic consequences.

It is necessary to follow all the rules of prevention. Be careful when handling hot objects, and chemical liquids and mixtures. Keep chemical and flammable items away from children. These simple methods will help keep you healthy and avoid injury and serious injury. Remember - any disease and injury is easier to prevent than to treat it later.

First aid and treatment for second degree burns

From the school lessons of life safety, everyone knows that according to the nature of severity, 4 degrees of burns are distinguished.

A burn is damage to human soft tissues as a result of exposure to high temperatures or chemical exposure. Each degree is characterized by its depth of affected tissues, from which specific measures are taken to restore health.

Physicians paid importance and reasons for the injury. But in any case, in the event of a burn, it is necessary to provide first aid to the victim, without waiting for the arrival of the ambulance team.

What is a second degree burn and how long does it take to heal?

Unlike the first degree, which affects only the epidermis, in this case there is a deeper damage to the skin, where, in addition to the epidermal layer, the upper layer of the dermis is injured and microcirculation is disturbed.

Usually burns of the 2nd degree in time heal relatively quickly - up to two weeks, and their treatment with a small area of damage is possible at home.

This is explained possible reaction of the body to an injury in the form of a burn disease or shock, which are the basis for mandatory hospitalization. Possible infection in the wound and dehydration. Special attention given to children and elderly patients.

Causes

Depending on how the burn was received, the following types are distinguished:

Thermal

Consequence of defeat by fire, boiling water, steam or touching hot objects.

Chemical

The result of exposure to soft tissues of acidic and alkaline solutions.

Electric

It is formed at the entry / exit points of the electric charge.

Ray

When exposed to ultraviolet or ionizing radiation.

Symptoms

inflammation and redness of the affected area;
soreness when touched;
puffiness;
blistering.

Blisters form instantly or after a short time. As a result of exfoliation of the upper layer of the epidermis, a cavity is formed, filled with a yellowish transparent liquid - blood plasma from broken capillaries. After a few days, the contents of the blister become cloudy.

Natural tearing may occur, followed by fluid leakage and exposure of bright red wet erosion. The gradually formed wound heals, and after two weeks it acquires a natural skin color.

A little later, many small blisters form. You can add symptoms to this picture sunstroke- Nausea and fever.

When an infection enters, the affected area acquires a purple hue and becomes hot, there is a discharge of pus.

Diagnostics

2nd degree burns are diagnosed by visual inspection. The combustiologist determines the area of the skin lesion, the degree of its swelling and the level of pain. Check for infection.

With a burn of the mucous membranes of the respiratory tract, an x-ray is taken. For large areas, a detailed blood and urine test may be prescribed.

After assessing the patient's condition, a conclusion is made and appropriate treatment and prevention of complications are prescribed.

First aid

First of all, it is necessary to eliminate contact with the cause of the burn and cause ambulance, after which the following steps are performed:

It is required to quickly cool the burnt surface with running cold water (15-17 ° C). The fact is that after receiving a burn, the skin continues to heat up and break down for some time, thereby causing severe pain. Cold water stop this process, thereby reducing the depth of skin lesions. Constriction of blood vessels and a decrease in the sensitivity of nerve endings give the effect of an anesthetic. It is recommended to treat the resulting wound with cold for 20 to 60 minutes - until the skin becomes numb. The water pressure should be low to avoid causing additional pain.
With a chemical burn, the chemical is first removed with a sterile dry cloth, after which the remnants of the substance are also washed off with running cold water for minutes.
After washing the inflamed surface, a sterile gauze bandage should be applied.
To relieve pain, you can take any painkillers. Effective pain relief with injections.
In the absence of vomiting, the victim is given lightly salted water to prevent dehydration.

What not to do when providing first aid:

tear off tissue adhering to burns;
apply ice and cotton to the burn;
use adhesive tape or tightly bandage the wound;
treat damaged skin with coloring antiseptics - iodine, brilliant green, as well as sour cream and butter;
open blisters on your own.

If the area of skin damage is small, and the resulting blisters are also small, it is permissible to treat the burn at home.

The post-burn recovery process

For second-degree burns, the recovery process takes days.

It is important during this period to properly care for the wound, avoiding exposure to traumatic events, as well as infection. Local preparations should be properly selected to accelerate cell regeneration.

If the wound becomes infected, the recovery time can be much longer.

There are three stages in the healing of wounds obtained by a 2nd degree burn:

Purulent-necrotic

It is desirable that this procedure conducted by a doctor. If this is not possible, then the opening of the blister is carried out independently in compliance with the rules of disinfection. To do this, the burn surface is treated with an antiseptic, the puncture is made with a sterile needle. Leaked pus is carefully removed with a clean napkin, and the wound is treated with anti-burn or antibacterial ointment.

After that, a sterile dressing is applied.

Granulation

Eliminates inflammation and blisters. A bandage is no longer required, moreover, the contact of the wound with clothing and other surfaces that can rub it is limited.

The surface of the burn is treated regularly wound healing ointments to prevent it from drying out and, as a result, the formation of cracks. It is important to eliminate the risk of re-infection of the wound.

epithelialization

Regenerating ointments are still used to speed up this process.

When caring for a burn wound key point is to protect against infection by following the rules of antiseptics.

It is not recommended to wet the wound with water. Dressings are changed as they get wet with the procedure for treating the injured surface. At each dressing change, the condition of the skin is assessed and a conclusion is made for further therapy.

Medical treatment

Properly selected treatment will speed up the healing process of a burn wound. For this, a number of drugs or their analogues, both general and local, are used.

Anti-inflammatory drugs

Antiseptics

Spray

homeopathic remedies

Antihistamines

It should be noted that some antihistamines cause drowsiness.

Analgesics

Injections with painkillers are effective.

vitamins

In the process of treatment, it is important for the victim to maintain a water-drinking balance in order to more quickly remove toxins from the body. It is recommended to include foods rich in proteins and carbohydrates in the diet to make up for the loss of energy that accompanies burn injuries.

What to do with bubbles?

Manipulations with them must be extremely careful and depend primarily on their size.

If the blisters are small, then with proper care of the burn, they gradually disappear on their own.
When the bubbles are inflated, piercing is required to remove the contents, as well as its shell. In this case, the help of a doctor who will perform necessary procedure in compliance with all rules.
With a natural tear, it is first necessary to treat the surface of the burn from contamination with an antiseptic, for example, 3% hydrogen peroxide. Then, using sharp sterile scissors, the bladder membrane is cut off and an antibacterial ointment is applied.

Actions for inflammation

The presence of an inflammatory process indicates the entry of harmful bacteria and viruses into the body. It is characterized by fever, chills, weakness. As a result, the recovery process is delayed, and a scar may form at the site of the burn. In such cases, you can not delay the visit to the doctor, otherwise even a fatal outcome is possible.

As a rule, with inflammation, they are first prescribed systemic antibiotics in the form of injections or pills. Moisturizing ointments are replaced by antiseptics and ointments with antibacterial action.

In the absence of purulent plaque at the recovery stage, the wound is treated with aerosols that form a protective film on the surface that prevents the penetration of harmful microbes.

In each individual case, the treatment regimen and the selection of drugs are carried out taking into account the individual characteristics of the organism.

Burn in a child

The principles of treatment of burns in children are the same as for adults, with the only difference being that the dosages of prescribed drugs are determined taking into account the age and weight of the patient, and the treatment procedures are often carried out under the influence of painkillers. Additionally, physiotherapy can also be prescribed to speed up the recovery process.

A burn is a type of wound that requires close attention and careful handling. Any self-activity in this matter is unacceptable. Timely access to a specialist contributes not only quick recovery health, but also help to avoid the risk of complications, fraught with negative consequences.

Treatment of 3rd degree burns

A burn is an injury to the skin or mucous membrane. Damage can cause various sources. Based on this, thermal, chemical, electrical and radiation burns are classified.

Violation of the integrity of the skin due to exposure to a hot surface, boiling liquid, steam or fire is called a thermal burn.

A chemical burn causes contact with aggressive reagents (acids, alkalis). Electric shock causes electrical burns.

Exposure of the skin to ultraviolet or similar rays provokes a radiation burn.

Classification of burns by degrees

Regardless of which impact factor provoked the damage, injuries are classified according to the degree of tissue damage:

If redness and swelling appear on the epidermis, and the victim experiences burning pain, a 1st degree burn is diagnosed. Such an injury usually does not require specific therapy and resolves in a few days.
Getting a 2nd degree burn is accompanied by a number of symptoms: immediately or after a few hours, blisters filled with a clear liquid form on the damaged area. Below them is the germ layer of the epidermis. Often the wound surface is affected by infectious inflammation. Healing usually takes about two weeks. Scars at the site of injury are extremely rare.

The presented classification is applied all over the world and does not change depending on the damaging factor that caused the injury.

IMPORTANT! The volume and degree of damage can be objectively assessed no earlier than a day after the injury. Only after this time it becomes possible to clearly distinguish between healthy and dead tissue.

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Clinical picture of a 3rd degree burn

A third degree burn is severe injuries. Damage affects all layers of the skin. The epidermis around the affected area becomes red. The burn site itself is covered with blisters filled with blood.

It is customary to distinguish two types of burns with a given degree of severity, they have a letter designation: A and B.

Grade 3a lesions differ in that they only partially affect the germ layer. Namely, he is responsible for the regeneration of skin cells. Deeper layers are preserved intact. During treatment, doctors constantly monitor the regenerative abilities of the skin in the damaged area. Externally, burns of this type appear in the form of numerous blisters. different sizes with bloody fluid inside. The burn surface oozes serous-hemorrhagic secretions. The ability of the burned tissue to regenerate makes it possible to classify burns of the 3rd degree as superficial.

Form 3c of the lesion implies complete necrosis of the subcutaneous tissue, therefore, restoration of the skin at the site of the burn is no longer possible. To the clinical picture is added a violation of blood flow and metabolic processes in tissues. This condition entails a local decrease in temperature on the surface of the burn. A characteristic sign of injury is loss of sensation in the affected area. The patient does not experience pain on tactile contact. healthy skin reddens around the burn, swelling appears.

IMPORTANT! Often, trauma provokes the development of burn shock. The victim is experiencing strong arousal and disorientation in space, a person cannot adequately assess how seriously injured. This state is replaced by lethargy and a sharp decrease in pressure.

Depending on what caused the burn, they differ external manifestations injury. From damage by steam or boiling water, a wet, dead scab forms on the skin. This condition provokes the spread of the suppuration process to healthy areas. The skin becomes red and blistered. Such injuries are rarely more severe than type 3a.

Contact with hot metal causes dry necrosis. A dark, thick crust covers the burnt area. The boundaries of the wound surface are clearly defined. The healing of thermal burns is accompanied by the formation of scars.

After exposure to aggressive substances, a dark hard crust appears on the epidermis, insensitive to touch. Put accurate diagnosis succeeds only after the final rejection of the dead tissues.

Electric shock causes a burn, in which the entire layer of the epidermis is peeled off. Often, the damaged area is charred. The injured area often becomes covered in ulcers and takes much longer to heal than other types of burns.

In addition to external injuries, the victims have the following symptoms: the body temperature rises sharply, the patient experiences nausea, which in some cases is accompanied by bouts of vomiting, intoxication and dehydration of the body can cause tachycardia.

First aid

It is possible to treat burns of the 3rd degree only in a medical institution. In most cases, the decision is made surgical intervention. Therefore, the victim must be taken to a medical facility as soon as possible.

While waiting for an ambulance, you need to eliminate the damaging factor. If a small area is damaged, you should try to lift the affected part of the body. The burn site is covered with a sterile dressing to prevent infection. Sometimes it is recommended to give a person an anesthetic, but it must be remembered that this can make it difficult for doctors to take an anamnesis.

IMPORTANT! When providing first aid, it is unacceptable to wash the burnt area with water or apply ice to it. Do not apply cotton wool or other materials with a fleecy structure to the damaged area. The burnt area should not be freed from clothing, as damaged skin welded to the fabric and removed with it.

Treatment of 3rd degree burns

As a rule, it is necessary to treat a burn of such severity permanently. Timely hospitalization and promptly started drug treatment significantly reduce the risk of developing a burn disease, which in severe cases may result in death.

The first task for physicians is to relieve pain, which can provoke shock. For this purpose, potent drugs of the narcotic group for intravenous administration (morphine, promedol) are used.

Along with this, local anesthesia is performed: antiseptic drug in the form of a spray, novocaine solution is usually used. To prevent anaphylactic shock from the introduction of narcotic drugs, the patient is prescribed antihistamines, such as suprastin, diphenhydramine, tavegil and others.

The decay products of dead tissue enter the bloodstream and can cause intoxication of the body. This condition is treated by infusion administration of special preparations (sorbilact and the like).

Burn injuries cause general dehydration of the body. Anti-burn drug therapy includes drip administration of solutions to restore water balance.

Burns of the 3rd degree are associated with serious blood loss, a weakened body is not able to restore volumes on its own. Often, an urgent blood transfusion is prescribed. During treatment, the procedure may be needed more than once.

A burn is a shock to the body. Trauma leads to development secondary immunodeficiency. Damaged areas of the skin are vulnerable to bacterial infection. Inflammatory processes caused by infection can seriously complicate the course of the disease. Therefore, one of the points of treatment for burns is vaccination against tetanus and antibiotics to prevent infection.

Burn wounds are regularly treated with drugs to speed up the process of skin regeneration. Also medicines applied to the damaged area, increase the outflow of fluid. During daily dressings, dead tissue, mucus and suppuration are removed.

Conservative treatment measures remain ineffective if the depth of the lesion has led to a loss of skin regenerative capacity. In such situations, resort to surgical treatment, which consists in transplanting the dermis from healthy areas. If the lesions cover a large area, several surgical interventions. Dermoplasty is necessary if the area is burned mobile joint. Otherwise, the resulting scar can significantly limit the mobility of the joint.

It usually takes several months to heal and fully restore the skin after a 3rd degree burn. Subsequently, operative plastic surgery is used to get rid of cicatricial neoplasms at the site of injury.

A 3rd degree burn refers to severe injuries that require long and complex treatment. Not only the positive dynamics of recovery, but also the life of the victim often depend on competent and timely first aid. It is necessary to seek help from specialists as soon as possible, who know exactly how to treat burns.

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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 growth layer is damaged, the burn becomes deep by definition, which means that such a burn wound will not heal itself - here it will be necessary to restore the skin by surgical methods, this 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. At the third "A" is still preserved pain sensitivity in the burn area, because not all nerve endings die and this is also certain diagnostic sign. If pain is not felt when touching the wound, that is, there is a loss of 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, have poor orientation in the 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, a 1% solution of morphine, a 2% solution of promedol or pantopon is used, if it is impossible to administer narcotic analgesics, any available ones can be used, 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. 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 for another prehospital stage it is necessary to start anti-shock therapy, which primarily consists in replacing 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, sedatives are prescribed - Seduxen, Relanium. With prolonged transportation, the administration of painkillers can be repeated as the effect decreases.

In everyday life, it is quite common to encounter burns on the skin. The degree of burns varies from minor to very serious. Everyone should know how to help with burns.

The first degree of a burn on the skin can be treated at home, since the degree of damage is small (up to 10% of the total skin cover). If you notice that the wound has become inflamed, an infection has got into it, immediately contact specialist doctor.

The second degree is a more serious skin lesion and requires professional treatment.

Serious and demanding great attention, is a third-degree burn that affects up to 90% of the human skin area. How to treat a 3rd degree burn correctly and is treatment possible with folk remedies?

The third degree burn means not only superficial wounds, but also deeper lesions: muscle fibers, nerve endings, subcutaneous layers, and the central nervous system suffer. A red spot forms at the burn sites. After a while (about three hours), blisters with a clear liquid appear at this site, which in no case can be removed or pierced on their own. This can lead to infection of the wound, making it very difficult further treatment sick.

Complications of the disease:

1. Pain shock;

2. Development of infection;

3. Internal damage;

4. Lethal outcome.

How is the treatment?

Treatment of skin affected by third-degree burns at the initial stage requires a professional approach from doctors. Surgically remove the damaged epidermis from the skin of the patient and carry out a kind of processing.

The defeat is divided into two parts: closed and open. If the illness goes away stable condition, without deep open wounds (which often get infected and complicate the treatment of the patient), such a lesion is called closed.

An open lesion requires close attention, and sometimes skin grafting to damaged areas of the body. Skin is taken for grafting, often with outer side the patient's thighs. After the skin grafting operation, a gauze bandage with an anesthetic and a wet-drying solution is applied to the transplanted areas. The first day the patient walks with such a bandage, after it is changed to oil-balsamic, which gives the effect of an antiseptic and has anti-inflammatory properties, helping the skin to take root in a new place.

Ointment or ointment dressings, which are used for complete wound healing, enable the skin to accelerate regeneration, and also soften and absorb postoperative scars and scars.

Folk methods of treatment

In practice, folk methods of treatment are often used in the rehabilitation period. Use oil-based therapies. The most common oils are sea buckthorn and olive (they relieve inflammation). Apply dressings soaked in oil quite often: about four times a day on a cleaned wound.

Often now can be found in methods of treatment and beeswax, which helps to restore the elasticity of the skin after injury and burns. It is not difficult to prepare a wax bandage: we take wax, melt it in a water bath to the desired consistency, after cooling it to a comfortable temperature, put it on a sterile bandage and apply it in the form of a bandage to the affected part we need for several hours. After removing the bandage, you need to treat the place with a weak solution of potassium permanganate. You can also prepare an ointment at home from ingredients purchased at a pharmacy in the following proportions:

1. 20 grams of liniment synthomycin 10%;

2. 5 ampoules of novocaine.

All components are thoroughly mixed, the ointment is ready. Keep the ointment in a dark, cool place. The ointment is applied independently without a bandage, in an even layer on the wound, without wiping the ointment until it is completely absorbed.

It is also important for the patient complex nutrition, taking vitamins of category E and D, which increase skin elasticity and prevent the formation of scars on wounds. Useful foods containing calcium and potassium. Their frequent use in daily diet will favorably affect the recovery of a patient suffering from the third stage of a burn.

Now you know how to treat a 3rd degree burn. We hope that such cases in your life are not expected.

A burn is a destructive damage to various tissues in the human body that occurs during contact with aggressive factors. environment. Depending on which of the factors led to the burn, they are divided into:

Chemical;
Electrical;
Radiation;
Thermal.

If a person is burned by steam, boiling water or oil, a hot iron or soldering iron, then such a burn is called thermal. They are often obtained at home or at various enterprises.

Electrical burns are those caused by contact with high voltage. This affects not only the skin, but also internal organs. You can get such a burn in a thunderstorm from lightning or when interacting with any current sources. Most often, the cause is: a faulty power tool, neglect of safety precautions, pranks of children left unattended by their parents.

Chemical burns are formed from contact of the skin with a chemical composition that melts it: acid, alkali, organic substances, and so on.

Ultraviolet and infrared radiation can also cause severe burns skin. With this type of burns, they are called radiation. You can get a radiation burn on the beach from sitting in the open sun for a long time at noon or in the office of a doctor who uses a laser or administers radiation therapy to a patient.

Degrees of burns

Depending on how badly the tissues are damaged, burns are divided into 4 degrees. This is necessary in order to choose the right treatment regimen for the patient. Whether the vessels, internal organs were damaged and what percentage of the human body occupies the burn area is valuable data for the doctor. Therefore, before starting treatment, the doctor carefully examines the victim, determining the degree of burns to his body.

1st degree burns are characterized by redness and slight swelling on the skin. In this case, the person does not experience significant discomfort and quickly recovers within 5 days.

2nd degree burns differ from 1st degree burns by the presence of numerous plasma-filled blisters. They burst, and an open wound surface of red color remains under them. Such burns heal for about 14 days, especially if an infection has joined at the same time. Scars subsequently do not occur.

3rd degree burns are much more serious and can lead to tissue necrosis, with the formation of crusts that are gray or black in color.

4th degree burns are the most severe of the options. fabrics human body subject to charring and necrosis. The process involves not only the skin, but also muscle, tendons and even bones. In the case of 4th degree burns on the body, after a long period of healing, terrible scars always remain.

Doctors can make a final diagnosis with large amounts of damage only the next day, since burn injuries are characterized by an increase in indicators over time. After 24 hours, you can accurately limit the zone of healthy and affected tissues.

1st degree burns

With 1st degree burns, only the upper layer of the epidermis is damaged. AT human body this layer can be easily regenerated and replaced. A healthy person undergoes a daily process of exfoliation of old skin cells. The cause of a 1st degree burn can be solar radiation, exposure to weak alkalis and acids, hot liquid, touching hot metal objects, and others.

A sign of a 1st degree burn is hyperemia of the affected area, accompanied by moderate pain. Touching this area causes pain. Puffiness depends on the area of the lesion and may be moderate or absent altogether. First-degree burns are considered mild and do not result in side effects such as burn disease, scarring, or extension of the lesion to deep tissue levels. Healing occurs with minimal intervention, within a week. In this case, drying and wrinkling of the damaged epidermal layer occurs. Then it is safely exfoliated and new healthy skin is formed in its place.

2nd degree burns

The second degree burn is more dangerous, because it affects not only the upper, but also the deep layers of the epidermis and dermis. The blood flow in the lesions and the surrounding tissue is disturbed. This type of burn is most common, and doctors give it a favorable prognosis for healing, even with a large area of distribution.

A 2nd degree burn can be identified by the formation of blisters, various sizes filled with a clear, straw-yellow liquid. The surface of the surrounding tissues may be edematous and inflamed or have a healthy appearance. With this type of burn, a person is worried burning pain, which persists for quite a long time. These burns heal successfully. In their place, pale pink marks may remain, which over time acquire a skin tone. The burn itself heals within 14 days. burn disease in such cases does not develop. The danger is only large foci that can become infected and lead to dehydration. In these situations, supervised treatment is indicated. medical workers. In a hospital under sterile conditions, the blisters are punctured, medical dressings are applied, and the patient is prescribed a course of antibiotics. Burns 2 and 3 degrees are similar in symptoms. To determine exactly what kind of burn you have this patient- conduct a sensitivity test in the affected area. At 3 degrees - there is no sensitivity, at 2 it is preserved.

3rd degree burns

With a 3rd degree burn, the entire thickness of the skin is affected, up to the subcutaneous fat. Restore to original form she will never be able to. In the tissues surrounding the burns, blood circulation is disturbed, which can often lead to a condition characteristic of second-degree burns. The third degree leads to burn disease in most cases. This is due to the large area affected. In this case, decay and decay of dead tissues occur, inflamed areas absorb their particles into the bloodstream, which leads to severe intoxication of the body. If this happens, then blood poisoning, called sepsis, can occur, which threatens the death of the patient. Intoxication of the body can be suspected by the following symptoms: rapid pulse, very low pressure numbers, heat body, weakness and shortness of breath. Also, third-degree burns can be accompanied by burn shock, in which patients rush about in pain and try to escape, being in a state of prostration. Along with this, due to the active loss of plasma, there is a strong thickening of the blood. Treatment of patients with burns of the 3rd degree is carried out only in a hospital. It lasts for months. Very often, skin grafting and plastic surgery is required. The consequences are scars. You can get deep burns of the 3rd degree from: hot metal, acids and alkalis, flames of fire, high voltage.

4th degree burns

The most severe burn. Regardless of what area was affected, the patient may die or lose one of the limbs of the body. Often, 4th degree burns are suffered by people under the influence of narcotic substances. In an inadequate state, they throw cigarette butts indoors, forget the pot on the stove, or drive. All this leads to ignition and self-burning. But not only the flame of fire causes such dire consequences, as well as exposure to high voltage or chemicals. The burns are very deep. The entire thickness of the skin, nerve and muscle tissue, tendons and ligaments, and blood vessels are destroyed. The lesion can embrace the surrounding intact tissues due to a violation of blood microcirculation in them. It is not difficult for a doctor to make a diagnosis, since with such burns a black or brown scab is formed. This is a thick crust formed when tissue is charred. A person, with such a scale of damage, is always in a state of shock and can fall into a coma. If a large area of the human body is affected, the chances of salvation are very small, and you need to act as quickly as possible. The treatment is very long. It lasts for months and even years. Dozens of transfers plastic surgery help return the survivor to a more fulfilling life.

Methods for determining the percentage of burnt body

In order to determine the area of the lesion, doctors use two methods. The first is called the "rule of ten". A person is conditionally divided into 11 parts, each of which is assigned 9%. Thus we have:

Damage to the head and neck - 9%;
Burn upper limbs – 9%;
Burns of the lower extremities -18% (for both or 9% alone);
The defeat of the back surface of the body -18%;
The defeat of the anterior part of the body-18%;
Crotch -1%.

The second method is called the "palm method". If the burns are local, then they are measured with the palm of your hand. If they occupy a vast area, then healthy tissues are measured with the palm of your hand. At deep defeat 15% of the body area or more than 30% of a superficial burn may develop burn disease.

Prognosis for recovery from burns

AT medical institutions use the Frank index in order to make a forecast in each individual case. It is calculated in the following way:

burned Airways while maintaining the function of breathing -15 points;
With impaired respiratory function - 30 points;
1% damage to the body -1-4 points (depending on the degree of burn).

Indicators up to 30 points promise a favorable prognosis. From 30 to 60 points - forecasts are favorable, but require heightened attention. From 61 to 90 points are doubtful. More than 91 points are related to poor prognosis with a lethal outcome. In addition to the Frank index, the “rule of hundreds” is used: the age of the patient is added to the Frank index. If the final value is more than 100, the forecast is considered unfavorable. In the case of children, things are even worse. Only 3-5% of skin lesions in babies and 5-10% in older children can cause a burn disease. For children, deep burns of more than 10% of the body are critical.

How to provide first aid for thermal burns

In order to help the victim, it is necessary to act according to the algorithm of sequential measures. In the event of burns, you should:

Eliminate the cause of the burn;
Cool the affected area of the skin. If it is 1-2 degree, then you need to use running water for 15 minutes. If the burns are 3rd and 4th degrees, then a sterile wet bandage should be applied and then the area with the bandage should be cooled with standing water;
Next, the affected area is closed with a new sterile wet bandage;
The patient should be kept calm until the doctors arrive.

What not to do in the event of a thermal burn:

Lubricate with creams, egg white, oil, apply foam to the burned area of the skin;
Tear off clothes that are stuck to the skin;
Puncture blisters that have arisen from a burn;
Pour urine over the injured area.

It is necessary to call an ambulance in such cases:

The area of damage is more than 5 palms;
A child or an elderly person has been burned;
Burn 3 or 4 degrees;
Burns in the groin;
burned oral cavity, respiratory tract, head;
Both limbs were affected at once.

The first pre-medical measures for chemical burns

To help the victim of a severe chemical burn, the following measures must be taken:

Remove all clothing and jewelry that has been in contact with chemicals;
Hold the affected area of the skin under tap water for 30-40 minutes;
Neutralize the action of the substances that led to the burn. Burns with acid preparations are washed with soap, after which they are poured over with soda dissolved in water (15 glasses of water per 3 teaspoons of soda). For alkaline burns, they should be washed with a light solution of vinegar and water, or well diluted lemon juice. To neutralize lime - use a 20% glucose solution;
Then a sterile wet bandage should be applied to help relieve pain;
At the end, wrap the burned area with a sterile bandage.

Seeking medical help is mandatory if:

There is a state of shock: shallow breathing, pale skin, fainting;
The diameter of the burn focus is more than 7.5 cm and penetrates into the deep layers of tissues;
The mucous membrane of the eye, respiratory organs, the area of the head, neck or groin has undergone damage;
The patient accidentally swallowed the chemical;
The patient is unable to endure severe pain.

Be sure to tell your doctor what caused the burn. It is advisable to bring along instructions for this tool. And remember that the most important thing is vigilant control over potentially dangerous situations. Take these precautions to prevent burns:

Keep all potentially hazardous chemicals out of the reach of children;
Close all sockets in the apartment with special covers;
Do not leave small children unattended near connected electrical appliances;
Do not smoke in the house, so that an accidental spark does not cause a fire;
Do not place heaters at night near upholstered furniture and curtains;
Do not use heaters that are defective or damaged;
Monitor the condition of the wiring in the house;
Do not neglect safety precautions when working with chemical compounds in enterprises;
Block children's access to matches and to the surface of the stove on which food is cooked;
Read the weather forecast and try to stay indoors during thunderstorms.

Protect yourself and your family from sad consequences- Adhere to safety precautions at home and at the workplace. This will help protect the most precious thing a person has - the health and people close to you.

A 3rd degree burn is tissue damage characterized by great depth and area. This trauma can happen to anyone and can lead to significant negative consequences up to death, so it is important to know what a 3rd degree burn looks like, what needs to be done in the first minutes after the injury and what are the principles of treatment.

The factors causing such damage may be thermal, chemical contacts, the effects of electrical or radiation exposure.

Such lesions affect the deep layers of the dermis, as well as the growth layers of the skin. Wounds heal very slowly, are difficult to treat, and recovery takes a long time.

The reasons

You can get a 3rd degree burn at home, at work, at production facilities:

Chemical - alkalis, acids;
Thermal - steam, boiling water, hot objects;
Radiation - UV rays, ionized radiation;
Electrical.

Symptoms

A burn of the 3rd degree is conditionally divided into injuries "A" and "B" levels, depending on this, different signs of the wound site are characterized:

A 3rd degree burn is accompanied by burning of the entire upper layer of the skin, pain sensitivity is reduced. The surface of the epidermis has a heterogeneous structure, there is a bright hyperemia. A 3rd degree burn is characterized by multiple blisters along the edges of the wound, with a clear liquid. Immediately after the injury, the site of the lesion looks like a black or brown scab;
Type "B" is characterized by damage to the nerve endings. If a 3b degree burn develops, it is completely absent pain syndrome. The blisters are covered with a dry scab, the edges of the wound are surrounded by hanging scraps of skin. Large-scale death of the dermis to subcutaneous fat.

Common symptoms of such damage include the following:

Malaise, dizziness;
Nausea, vomiting;
Lack of appetite;
Headache;
Increase in body temperature.

Based on the level of severity, the area of the lesion, the depth of the wounds, the general health of the patient, the attending specialist selects the necessary therapeutic regimen. With this symptomatology, self-medication at home is strictly prohibited, this can lead to tragic consequences.

Possible Complications

The most dangerous complication is a state of shock, accompanied by sharp rise blood pressure, and falling to a critical point.

After an injury, a 3rd degree burn is characterized by the following negative manifestations:

deep scarring;
Dysfunction of the central nervous system;
Diseases of the cardiovascular system;
Sepsis;
bacteremia;
Failure of the internal organs.

With such injuries, in most cases, suppuration appears, which aggravates the condition of the victim, there is a secondary deepening of the wound. A person suffers from insomnia, increases excitability, body temperature. Recovery is much longer and more difficult.

emergency events

At home, it is categorically unacceptable to treat a third-degree burn. Competent professional therapy will relieve pain, accelerate the recovery of the skin, and prevent infection.
With extensive injuries, many patients undergo surgical treatment on the first day of hospitalization.

If there is a chemical or thermal burn of the 3rd degree, it is necessary to call ambulance doctors, before their arrival, you need to provide the victim with first aid:

Limit contact with the irritant, while using personal protective equipment and safety;
Position the victim in horizontal position, so that the damage to the skin is the most high point. This solution will ensure the normal maintenance of the circulatory system;
Before transporting the victim to the hospital, it is necessary to cover the affected area with a sterile napkin or bandage. This will prevent infection;

Important! How long a 3rd degree burn heals depends entirely on how well and timely it is provided. health care. At this level of severity, self-medication at home is strictly prohibited.

Before the arrival of medical personnel, it is impossible to give the victim any analgesics or other drugs. In the future, this may make it difficult to diagnose the problem, complicate the treatment of a 3rd degree burn.

Basic principles of treatment

Complex burn therapy for these disorders should be carried out only in a hospital, under the strict supervision of specialists:

After collecting an anamnesis, potent drugs are used to prevent shock. medications, for example, "Morphine";
To remove such signs of a 3rd degree burn as edema and improve the general condition, antihistamine drugs Suprastin, Dimedrol, Tavegil are prescribed;
To restore water-salt balance use infusion therapy - a large amount of liquid is introduced into the body by drip. For this, "Sorbilact", "Ringer's solution" is often used to eliminate the detoxification of the body;
First aid for 3rd degree burns includes vaccination with tetanus toxoid;
As the basis of anti-shock therapy, drugs such as Venofundin, Gelofusin are used, Polyglukin, Glucose are dripped;
Sedative medications are used to reduce the victim's stress level. How to treat a 3rd degree burn at home and what drugs to use are prescribed only by a general practitioner or surgeon;
At the hospital, to prevent anaphylactic shock, to normalize the patient's condition, histamine blockers are used;
With a small size of the wound surface and moderate pain, it is enough to treat the injury with painkillers such as Lidocaine, Novocaine;
Glucocorticoids stimulate the fastest healing, eliminate inflammation and normalize the process of natural regeneration;

Treatment of a 3rd degree burn after opening the bladder includes a mandatory imposition antiseptic dressings to rule out infection
In order to prevent the reproduction of pathogenic flora, it is necessary topical application antibiotics (Levomikol, Tetracycline) or injections. How long a third-degree burn heals depends on whether the injury is complicated by an infection.

During the course of treatment, based on how quickly the skin is restored, the doctor can change the therapeutic regimen, methods and drugs.

Surgical intervention

After the course drug treatment will be over, most likely, the victim will be prescribed plastic surgery. Often, flaps of the patient's own skin are used for this. Pre-material in the process of preparation goes through the stages of perforation and stretching.

In some cases, the doctor uses donor skin or special fibroblasts that are pre-grown in biolaboratories to improve the restoration of the skin.

What can not be done?

There are a number of activities that are strictly prohibited in case of complex injuries, so as not to aggravate the condition of the victim:

Even if a third-degree chemical burn has occurred, you should not wash the area of injury with solutions without consulting a doctor. Without precise knowledge of the chemical - actions can increase the depth and area of \u200b\u200bdamage;
Treat a 3rd degree burn at home on your own without consulting a doctor;
Use any fat-containing, oily products until the burnt area has completely cooled;
Forcibly remove, tear, or pull clothing and jewelry from the injured area. This can cause severe pain syndrome;
Apply folk remedies from burns like independent way treatment without a doctor's permission. This technique is acceptable for use as part of complex therapy and only after agreement with a specialist;
Apply ice to cool the affected area. So sharp drop temperatures can cause additional damage.

How long a 3rd degree burn heals depends on the depth and area of the lesion, on how well and quickly it was medical assistance. On average 3-4 weeks, after the scarring stage begins.

A 3rd degree burn is a severe wound that requires an immediate response and assistance to the victim. Timely and quality treatment will prevent the dangerous consequences of a 3rd degree burn, even in the most difficult situations.