Combustiologist

Thermal and chemical burns are classified as injuries caused by external factors, but it is not only the human skin that suffers from burns. Severe burns result in burn shock, accompanied by a violation of hemostasis (a decrease in blood volume), oxygen starvation of tissues and failure of internal organs - the so-called systemic (multiple organ) failure syndrome. And here, immediate medical care is required to prevent complications and death. This care is provided by a combustologist - a doctor specializing in the treatment of burns (from the Latin combustio - burn).

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What does a combustion specialist treat?

A burn specialist – in a hospital burn or intensive care unit or in a specialized burn center (there are 11 burn centers in Ukraine) – treats patients who have suffered burns of any degree; for more details, see Burns: General Information.

Treatment of extensive and deep burns requires that burn specialists have deep medical knowledge and mastery of burn surface treatment techniques, modern methods of resuscitation and intensive care, which include anti-shock infusion-transfusion therapy to relieve pain and restore hemostasis. A burn specialist assesses the severity of the injury and cleanses the body of toxins (detoxification) through hemodialysis, hemosorption, plasmapheresis, etc.

The tasks of combustiology include cleansing the affected body surfaces from necrotic tissue and combating burn septic toxemia, as well as using the entire arsenal of medical means for healing burns - pharmaceutical, physiotherapeutic, surgical.

A surgeon-combustiologist has special functions, who, first of all, performs operations to excise dead tissue from the necrotic zone in order to avoid further complications.

Very often, wounds from third- and fourth-degree burns cannot heal without surgical intervention, and in order to restore the skin on the burned area, a burn surgeon performs a skin transplant (autodermoplasty), and if this is not possible, a transplant of its substitutes.

Advice from a combustion specialist

The lightest burns, causing minimal damage to the skin, are classified as first degree burns, also called superficial burns. However, the advice of a burn specialist in this case is as follows:

• cool the reddened burnt surface with cold water for 5-15 minutes;
• do not apply ice as this will make the wound worse;
• Avoid prolonged cooling with water as this will lead to hypothermia;
• Do not pop blisters until antimicrobial agents have been applied;
• Never use cotton swabs: the cotton fibers stick to the wound and increase the risk of infection.

You should see a doctor if the burn affects a large area of skin (more than 20 square centimeters) and if it is on the face or a large joint. It should be borne in mind that a superficial burn may progress to a deeper one over the next few days.

The best way to combat burns is to prevent them. In many cases, burns occur at home, especially in small children. The advice of a burn specialist also applies to parents, because 90% of burns in children can be prevented if:

• children will not be in the kitchen while food is being prepared;
• do not place pots or kettles on nearby burners;
• put away matches and lighters;
• install plugs on electrical sockets;
• replace all faulty electrical cords;
• Keep chemicals out of reach of children.

The WHO estimates that more than 260,000 burns result in death worldwide each year. Fire burn injuries are the fourth leading cause of injury death among people aged 65 and over.

To date, not all burn treatment problems have been solved, and the scientific search for more effective methods continues. Clinical specialists in burn therapy and surgery are united by the European Burns Association (EBA) with headquarters in the Netherlands. Every two years, an international congress of burn specialists is held (the last, 16th, was held in September 2015 in Hanover). To disseminate the experience of the best burn specialists, an international industry journal, Annals of Burns and Fire Disasters, is published.