Burns: Home Treatment, Healing Process, and Preventing Infections

Burns are a common but potentially serious injury that can cause significant discomfort and disruption to daily life. They can occur in anyone, regardless of age or gender, and are often the result of accidents in the home or workplace. Understanding the nature of burns, their treatment, and the healing process is crucial to managing these injuries effectively and preventing complications such as infections.

Burns are injuries to the skin and underlying tissues caused by heat, chemicals, electricity, sunlight or radiation. They vary in severity from minor burns, which affect only the outer layer of the skin, to more serious burns that penetrate deeper layers and can cause extensive damage.

Symptoms

The symptoms of burns can include redness, swelling, pain, blisters and peeling skin. More severe burns may cause charred or white skin, numbness and difficulty breathing if the airways are affected.

Causes

Burns are most commonly caused by exposure to heat, such as hot liquids, steam, fire or hot objects. Other causes include chemical burns from strong acids or alkalis, electrical burns from electrical appliances or power lines and radiation burns from excessive sun exposure or radiation therapy.

Impact and Complications

If left untreated, burns can lead to serious complications, including infections, scarring, and in severe cases, shock or organ failure. Burns can also cause emotional and psychological trauma.

At Risk Groups

• Children and elderly adults due to their skin's relative thinness.
• Individuals with chronic medical conditions that may compromise blood flow, such as vascular disease, heart disease and diabetes.
• People on steroids or immunosuppression medications.

Importance of Treatment

Prompt and appropriate treatment of burns is crucial to prevent complications, reduce pain and promote healing. It also minimises the risk of scarring and long-term damage.

"Any medical condition that may compromise blood flow can impact wound healing." - Amalia Cochran, Ohio State University Wexner Medical Center

Diagnosis

The diagnostic investigations for burns generally include:
1. Physical examination: This is the first step in assessing the extent and severity of the burn. The doctor will look at the size, depth, and location of the burn.
2. Medical history: The doctor will ask about general medical history, the circumstances of the burn as well as first aid given to understand the potential for complications, such as inhalation injury.
3. Bronchoscopy: This test may be performed if inhalation injury is suspected, especially in cases of smoke or chemical exposure.
4. Chest X-ray and arterial blood gasses: These tests may be used to assess lung damage in cases of suspected inhalation injury.

Treatment Options

The treatment options for burns are generally trialed in the following order:
1. Immediate care: This includes cooling the burn with cool running tap water for 20 minutes and within 3 hours of injury, and removing any jewellery or clothing near the burn area.
2. Pain management: Over-the-counter pain relievers may be used initially, with stronger prescription pain medication used for more severe burns.
3. Wound care: This includes cleaning and dressing the burn wound to prevent infection.
4. Fluid replacement: Severe burns can cause significant fluid loss, so intravenous (IV) fluids may be needed.
5. Skin grafting: For severe burns, skin grafting (replacing damaged skin with healthy skin) may be necessary.
6. Inhalation injury treatment: If inhalation injury is present, treatment may include oxygen therapy, nebulized treatments, and mechanical ventilation.

"The goal of burn treatment is to prevent infections, reduce pain and heal the skin faster." - Rockford Mutual

Doctors and Specialists Likely to Be Involved in the Patient’s Care

The doctors and specialists who may be involved in the management of a patient with suspected burns include:
- Emergency Medicine Physician: They provide initial assessment and stabilisation of the patient.
- Burn Specialist: They oversee the ongoing care and treatment of burn injuries.
- Plastic Surgeon: They may be involved in skin grafting procedures and reconstructive surgery after healing.
- Pulmonologist: They may be involved if the patient has an inhalation injury.
- Physical Therapist: They may be involved in the rehabilitation process to restore function and mobility.

Prevention

Preventing burns involves taking safety precautions such as using oven mitts when handling hot items, keeping hot liquids out of children's reach and using sunscreen. Regular checks of electrical appliances and wiring can also prevent electrical burns.

Contagiousness and Isolation Advice

Burns are not contagious and do not require isolation unless an infection develops.

Related Conditions or Complications

Infections are a common complication of burns, particularly if the burn is severe or not properly cared for. Other potential complications include scarring, contractures (tightening of the skin), and emotional and psychological trauma.

Outlook and Prognosis

The prognosis for burns depends on the severity and extent of the burn, the patient's overall health, and the quality of treatment received. With appropriate care, most minor burns heal well with minimal scarring.

Practical Tips & Coping Strategies

• Cool the burn under cool (not cold) running tap water for 20 minutes
• Cover the burn with a clean, non-fluffy dressing
• Avoid popping any blisters as this can lead to infection
• Seek medical attention for more serious burns or if there are signs of infection