Management of third-degree burns

Thousands of individuals die of severe burns every year. Electricity, heat, chemicals and radiation can cause third-degree burns. When it comes to third-degree burns, it is considered as the most severe type of burn. The elderly and young children are highly susceptible to severe burns and the treatment typically takes several months. If the treatment was delayed, it can lead to a number of complications.

Close look on burns

Burns are categorized as first, second and third degree. When it comes to third-degree burns, it involves destruction of the upper skin layer or epidermis and the dermis. Muscle, bone, fat and the nerve endings are damaged or destroyed. The burned skin appears white or charred and the individual does not feel pain since the nerve endings are destroyed.

Third-degree burns

Third-degree burns put an individual at high risk for infection due to the dead tissue and lack of blood flow to the burned area.

Initial treatment

Individuals who sustained third-degree burns with airway involvement require immediate intubation with placement of a tube that provides oxygen to the lungs. On the other hand, if severe swelling is present, the placement of a tube is difficult or impossible.

Third-degree burns that occur on the hands, feet, face or genitals or cover more than 5% of the total bodily surface area must be treated in a healthcare facility. Many cases usually end up with dehydration due to fluid loss and require large amounts of intravenous fluids in order to prevent shock.

Infection control

Third-degree burns put an individual at high risk for infection due to the dead tissue and lack of blood flow to the burned area. In most cases, antibiotics are administered intravenously along with the application of creams to prevent the development of infection.

Healing of the skin

It is vital to keep the skin clean and free from any infection. This requires the application of medications that contain silver or components that help the skin heal properly. Take note that burns require the use of dressings along with sterile bandages that should be changed a number of times in a day.

The dead skin should be removed under a procedure known as debridement. The healing skin often forms a dense scabbed area called as eschar that limits the flow of blood to the damaged skin, thus should be trimmed away.

The use of transitory skin grafts using donor skin or animal skin or even permanent skin grafting using unburned skin from a different part of the body can protect the burned area during the healing process. In some cases, skin substitutes can be used to cover up the healing wound.

Prevention of scarring

It is important to note that minimal scarring unavoidably occurs after sustaining a third-degree burn. Hypertrophic scarring which is described as dense, itchy, reddened and sore scarring occurs in some individuals.

Scarring can result to contractures which are tightening of the skin around the joints that makes them rigid and difficult to move. The use of pressure garments, early wound closure and medications such as antihistamines, corticosteroids and interferons can help minimize scar formation.

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