Burns

Burns refer to injuries caused by something that has reached high temperatures. When this happens, it will cause varying degrees of burns on the surface of our skin, which should be taken seriously. More serious burns require some form of treatment to resolve. Burns are also divided into different degrees, and they have a certain range. So what are the degrees of burns?

Generally refers to tissue damage caused by heat, including hot liquids (water, soup, oil, etc.), steam, high-temperature gases, flames, hot metal liquids or solids (such as molten steel, steel ingots), etc., mainly referring to the skin and/or mucous membranes. In severe cases, subcutaneous and/or submucosal tissues such as muscles, bones, joints and even internal organs may also be injured. Scald is tissue damage caused by hot liquid, steam, etc., and is a type of thermal burn. China's nine-point method: proposed by the Third Military Medical University of the Chinese People's Liberation Army, it divides the adult body surface into 11 equal parts, of which the head, face and neck account for 9%, the upper limbs account for 2 9%, the front and back of the trunk (each 13%) and the perineum (1%) account for 3 9%, and the lower limbs including the buttocks account for 5 9% + 1% (46%).

Clinical manifestations and classification 1. First-degree burns: also known as erythematous burns, only part of the epidermis is damaged, but the germinal layer is intact, so the proliferation and regeneration ability is active, and it usually heals within 3 to 5 days without leaving scars.

2. Superficial second-degree burns: damage the entire epidermis and part of the papillary layer. Since the germinal layer is partially damaged, the regeneration of the epithelium depends on the epithelial proliferation of the remaining germinal layer and skin appendages, such as sweat glands and hair follicles. If there is no secondary infection, it usually heals in about 1 to 2 weeks without leaving any scars.

3. Deep II degree burns: The burns are deep below the papillary layer of the dermis, but some dermis and skin appendages remain. Healing depends on the proliferation of epidermal progenitor cells in the skin appendage epithelium, especially in the protrusion of hair follicles. If there is no infection, it usually takes 3 to 4 weeks to heal on its own, often leaving scars. There are many clinical variations, with shallow cases close to superficial grade II and deep cases being borderline grade III.

4. Third degree burns: also known as eschar burns. Generally refers to burns of the entire skin, with the epidermis, dermis and skin appendages completely destroyed. Wound repair depends on surgical skin grafting or skin flap repair.

5. IV degree burns: Burns extend deep into muscles, bones and even internal organs. Wound repair depends on surgical skin grafting or skin flap repair. Severe cases require amputation.

6. Superficial burns: burns that heal on their own within 21 days after injury, including first-degree burns, superficial second-degree burns, and some shallow deep second-degree burns.

7. Deep burns: Burns that take more than 21 days for the wound to heal on its own. These include deep second-degree burns, third-degree burns, and fourth-degree burns that are deeper or infected and usually require surgical treatment. The epidermis of deep second-degree burns is whitish or brownish-yellow. After removing the necrotic skin, the wound surface is slightly moist or red and white, and the sensation is dull. Small red spots the size of millet grains can be seen. It usually takes 3 to 4 weeks to heal. The local manifestations of third-degree burns may be pale, yellowish-brown, or burnt yellow. In severe cases, it may appear scorched or carbonized. The skin loses elasticity and feels as hard as leather. It is dry and has no exudate, and the sensation is poor. Surgical skin grafting is required, and scars will be left after healing.

8. Moderate burns: Burns with an area between 11% and 30% in adults (5% to 15% in children) or third-degree burns with an area less than 10% (less than 5% in children), without inhalation injuries or serious complications.

9. Severe burns: The burn area of ​​an adult is between 31% and 50% (16% to 25% for a child), or the burn area of ​​a third-degree burn is between 10% and 20% (less than 10% for a child), or the burn area of ​​an adult is less than 31% (less than 16% for a child), but one of the following conditions exists: ① Severe systemic condition or shock; ② Complex injuries (severe trauma, impact injury, radiation injury, chemical poisoning, etc.); ③ Moderate to severe inhalation injury; ④ Infants with burns on the head and face exceeding 15%.