烧伤的不同类型及治疗

A matter of depth

How serious a burn is relates to how many layers of the skin are damaged.

Superficial burns affect the top layer of skin, and the burned area often appears bright pink or red and can blister. These burns will heal by themselves. Examples of these burns are sunburn or a minor scald.

Partial thickness burns affect the entire top skin layer as well as a portion of the dermis - the structure just under the skin. How deep the damage goes down into the dermis determines whether the burn is a “superficial’’ or ‘’deep” partial thickness wound, but it can take a week or 10 days to become apparent which type of burn it is. Superficial partial thickness burns - such as a scald - will heal themselves. If left untreated, a deep partial thickness burn - such as a serious scald or minor contact with open flame - will create scar tissue.

Full thickness burns affect the entire thickness of the skin’s outer layer as well as tissue and structures underneath it and it is not possible for these burns to heal by themselves. If left untreated, the burned area will be seriously damaged.

Full thickness burns often look white and leathery, but they can also be brown, cherry red or black. These burns are caused by such things as serious contact with open flame or severe scalds. One important thing to remember is that a person with a full thickness burn may not feel any pain, even though it’s obvious the skin has been injured. These burns require immediate expert, medical help. See below for first aid advice.

You may also have heard of burns labelled as first, second and third degree injuries:

First degree - where only the outer layer of skin is burned

Second degree - where the first and second layers of skin are burned

Third degree - where all layers of the skin are burned, and the burn may also affect fat, muscle and bone.

First things first

If a person’s clothes are on fire, make sure they do not run or move. This will help avoid fanning the flames. Get them to drop to the ground and roll to put out the clothing flames. Also help them smother the flames with something nearby such as a blanket, your jacket or you can use water, if it’s to hand. Move away from the source of the heat. Only remove their burned clothes and jewellery if these things are not sticking to the skin. If they are stuck, do not force them off. Jewellery can transmit heat if it is burned or hot, and rings and bracelets can cut off blood supply if fingers or arms swell.

If the burn is the result of scalding from hot liquid, help them take off the wet clothing – but again, only if the skin is not blistered or stuck to the clothing.

Hold the burned area under gently running, cool – not freezing cold - water for at least 20 minutes. Don’t apply ice to any burn, and don’t use butter, ointments or creams, as they can cause infection.

While cooling the burned area, it’s important to keep the rest of the person warm, so drape a blanket around their shoulders or help them into a warm jumper if necessary – just make sure this won’t cover or aggravate the wound site.

You can help pain at the area by applying a wet compress and changing this frequently to make sure the compress stays cool.

Covering the burn

After the area has been cooled, cover the burn with a dressing that won’t stick to the wound or a purpose-specific burns dressing. If you don’t have these handy you can use aluminium foil, plastic wrap or a clean, wet homemade dressing, such as a torn cotton sheet. You can use a whole wet sheet for large burned areas. Pain relief can be given if needed by running cool water over the dressing. Don’t apply dressings that will stick to the wound, such as towels, blankets or cotton wool.

When to get expert help

Get urgent medical help (for example, by heading to the nearest hospital emergency department) if:

• The burn is deep, even if the patient says they can’t feel any pain. A lack of pain coupled with a deep burn indicates a severe partial or full thickness burn.
• A superficial burn is bigger than a three centimetre square.
• The burn is to the airway – including smoke inhalation – the face, hands or genitals.
• You aren’t sure just how severe the burn is.
• 
  

Remember

In the case of chemical or eye burns flush the area with as much water as you can for at least 20 minutes.

Blisters actually serve to protect the burned area and can reduce pain if they are left intact, so it’s best to leave them alone. If blisters are very large, or if they are situated on or near a joint or make it difficult to apply a dressing, seek advice from your doctor.

FIRST AID 哈