Lecture Notes on Burn Injuries

Introduction to Burns

• Causes of Burns:

  • Extreme heat (fire, hot water, steam, hot objects)
  • Extreme cold
  • Electricity
  • Chemicals (strong acids)
  • Radiation (sun, medical treatments)

• Effects of Burns:

  • Damage and inflammation of the skin
  • Impairs the skin's role as a protective barrier

Structure of Skin

• Layers of the Skin:
  • Epidermis:
    • Outermost layer, made of keratinocytes
    • Secretes glycolipids to prevent water loss
  • Dermis:
    • Thicker layer with nerves and blood vessels
    • Divided into:
      • Papillary Layer:
        • Contains fibroblasts, blood vessels, nerve endings
        • Senses pain and fine touch
      • Reticular Layer:
        • Contains tightly packed collagen and elastin for skin flexibility
        • Houses skin’s accessory structures (sweat & oil glands, hair follicles)
  • Hypodermis:
    • Made of fat and connective tissue
    • Provides insulation and padding

Degrees of Burns

• First Degree (Superficial):

  • Affects only the epidermis
  • Symptoms: Red, dry, painful, blanching with compression

• Second Degree (Partial Thickness):

  • Affects epidermis and dermis
  • Superficial Partial Thickness:
    • Affects papillary layer
    • Symptoms: Red, blisters, wet, very painful, blanching
  • Deep Partial Thickness:
    • Extends into reticular layer
    • Symptoms: Varying colors, blisters, wet/dry, less blanching, pressure pain

• Third Degree (Full Thickness):

  • Affects entire epidermis and dermis
  • Symptoms: Waxy, white/leathery appearance, dry, minor pain due to nerve damage

• Fourth Degree:

  • Extends into hypodermis
  • Symptoms: Charred black, dry, may be painless, deep pressure pain, dead skin patches

Complications and Healing

• Complications:

  • Infections (especially pseudomonas aeruginosa)
  • Water loss

• Healing Process:

  • Macrophages remove dead cells
  • Fibroblasts create new collagen, leading to potential scarring

Diagnosis and Severity

• Diagnosis:

  • Based on appearance and pain
  • Possible tissue biopsies to determine affected layers

• Severity (Rule of Nines):

  • Evaluates body’s surface areas in sections, each 9% (head, arms, etc.), and 1% for the groin

Treatment and Management

• General Treatments:

  • Immediate cooling with water
  • Pain management with medication

• Minor Burns:

  • Heal on their own, keep clean, bandaged, moisturized

• Severe Burns:

  • Hospitalization in specialized centers
  • Fluid and electrolyte replenishment
  • Prevent infections with antibiotics
  • Surgical procedures (skin grafting, excision, amputation) for severe cases

Recap

• Summary:
  • Burns cause protein denaturation and cellular damage.
  • Degree and treatment depend on the skin layers affected, cause, and location.
  • Treatments focus on minimizing damage and managing pain; severe cases require more intensive interventions.