Burns and scalds are one of the common diseases that endanger human health and life safety. Skin wound damage will cause cell death, tissue necrosis and decreased immune function; A large amount of necrotic tissue fluid is easy to cause bacterial infection, and secondary inflammation will lead to new cell death and deepen the wound. When the skin loses its natural barrier, it will cause a series of reactions such as dehydration and pain. Antibiotics are commonly used in clinic to prevent and treat wound infection, but long-term use of antibiotics is easy to produce drug-resistant strains.

I. Definition of burns and scalds

External injuries such as skin or muscle burns, scalds, burns, electric injuries and chemical burns caused by fire, hot water, hot oil, hot gas, electric shock or irritating chemicals are called burns and scalds.

Second, the classification and degree of burns

The severity of burn is related to the cause, location, area, depth, whether there is poisoning, compound injury or inhalation burn, the age of the patient, the health status before the injury, and whether the post-injury treatment is timely and correct. Among them, the burn area and depth are the basic indicators to judge the severity of burns.

Estimation of burn area: burn area refers to the percentage of skin area to the total body surface area. The commonly used estimation methods are nine-point method and palm method. According to the anatomical position, the nine-point method divides the human body into nine parts, namely, the surface area of the head, face and neck accounts for 9%, the upper limb accounts for 65,438+08%, the trunk accounts for 27%, and the lower limb accounts for 46%. Palm method means that the area of the injured person's palm is about 1% of the body surface area. It is generally used to estimate the burn area of a small area, especially the scattered burn area.

There are two criteria to judge whether the burn is serious: first, the size of the burn area; The second is the degree of burn depth.

The estimation of burn depth mainly depends on the change of injured skin surface.

The first degree burn is (epidermal injury): the skin at the wound is red and accompanied by pain.

Shallow second-degree burns (including deep damage to epidermis and dermis): large blisters appear on the skin and the pain is severe.

Deep second-degree burn (the burn has reached the deep dermis): small blisters appear on the skin. After the blister bursts, you can see that the wound is reddish or reddish in white, or there are many red spots.

Third-degree burns are full-thickness skin burns, also known as eschar burns, and even muscles, blood vessels, nerves and bone tissues are burned, and the wound skin is white or burnt yellow or black.

However, there is still no unified standard for judging the severity of burns in the world, and the grading method discussed and adopted by 1970 National Burn Conference is often used in clinic.

(1) adult burn severity classification

① Mild burn: second degree burn with a total area less than 10%.

② Moderate burn: burns with total area 1 1% ~ 30% or third degree burn area 10% or less.

③ Severe burns: the total area is between 365,438+0% and 50%, or the area of third-degree burns is between 65,438+065,438+0% and 20%, or the total area is not more than 365,438+0%, but under any of the following circumstances: the whole body is in serious condition or in shock, with compound or compound injuries (such as )

④ Extremely severe burn: the total area is above 565,438+0% or the third degree burn area is above 265,438+0%.

(2) The severity of burns in children is different from that in adults, and the classification is as follows.

① Mild burns: Second degree burns with a total area less than 5%.

② Moderate burns: second-degree burns with a total area of 5% ~ 15% or third-degree burns with an area below 5%.

③ Severe burns: burns with a total area of 15% ~ 25% or a third degree burn area of 5% ~ 10%.

④ Extremely severe burn: the total area is more than 25% or the third-degree burn area is more than 10%.

(3) Because the above-mentioned grading standards can neither reflect the level of treating large-area burns in China, nor reflect the true severity of burns, at present, "small area", "medium area", "large area" and "super large area" are often used in clinic to indicate the severity of burns.

① Small-area burns: those with second-degree burns within 10% or third-degree burns within 1% are equivalent to mild burns.

② Moderate burn: The total area is 65,438+065, 438+0% ~ 30% is second degree burn or 65,438+00% ~ 20% is third degree burn, which is equivalent to moderate and severe burn.

③ extensive burn: the total area is 3 1% ~ 79% or the third degree burn area is 2 1% ~ 49%.

(4) Extra-large area burns: more than% of the country's total area or more than 50% of third-degree burns.

Third, the wrong understanding of burns.

1, some people think that burns are skin diseases, which is irrelevant, thus delaying the rescue time. In fact, large-area burns are prone to shock, sepsis and multiple organ dysfunction, and even small-area burns have been reported to cause death due to improper treatment.

Generally speaking, the bigger the blister, the redder and more painful the wound, and the more serious the burn. On the contrary, the bigger the blister, the redder the wound, the more painful it is, and the lighter the burn is, while the third-degree burn has neither blister nor pain.

Many patients feel that the medical conditions in big hospitals are good. In fact, for patients with severe burns, it is difficult for hospitals with good medical technology to successfully treat them. Even if it is successful, there will often be many complications, many scars and serious dysfunction during the treatment. In this way, together with the medical expenses for treating complications and later plastic surgery, the total medical expenses actually far exceed the cost of hospital treatment.

4. Many people think that cold water can be contacted after burn, but they don't know that cold therapy in time after thermal burn will make heat continue to act on the wound to deepen it, which will not only relieve the pain, but also reduce exudation and edema.