Minor, or first degree burns, may be caused by intense heat, fire, friction, radiation, chemicals or any process which heats the skin to the point of damage. While a first degree burn, such as mild sunburn, requires little treatmant, a burn which destroys the top layer or layers of skin may be serious.
If the burn is painful, the first treatment should be to cool the area. When I was an inpatient doc, a patient knocked over the hot coffee, soaking herself. I rushed her to the shower, and we both emerged wet but unburned. Cooling prevents further heat damage and relieves pain.
If the burn is deeper, redness of the area and visible damage to the skin occur. This requires covering the burn with a sterile dressing, preferably gauze to avoid fibres in the area, which may be infectious. If available, cover the burn with an antibiotic ointment such as Polysporin or Bacitracin which will soothe and may prevent secondary infection.
Remember, once the body’s Maginot Line, the skin, is broken, infection is likely. Our bodies swarm with bacteria, skin, throat, intestines, most harmless, some useful, some infectious.
Third degree burns have penetrated the epidermis, dermis, under-lying muscle, even charring bone. Napalm and flame-throwers, prolonged exposure to fire, car crashes, cause damage which often requires surgical intervention to remove burned, dead tissue, suture the cleansed, healthy tissue and/or patch the area with skin taken from, say, abdomen.
Inoculation eschar on popliteal area.
Black eschars are most commonly attributed to anthrax, which may be contracted through herd animal exposure. Eschar is sometimes called a black wound because the wound is covered with dry, black necrotic tissue.
Note that deep burns are painless due to destruction of nerves.
Remember, first cool, not ice, the burn area, cleanse with hydrogen peroxide or similar antiseptic, cover with STERILE gauze and an antibiotic cream or ointment, then leave it alone for 2-3 days. If pain persists, or surrounding area is warm, may need an antibiotic such as Keflex, but that’s up to your all-wise doctor or (shudder) nurse-practitioner.
(All photos and graphics taken from Wikipedia.)
William Goldsmith, M.D.
27 Oct, 2014