Radiation burns of the auricle and external auditory canal
Last reviewed: 23.04.2024
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Radiation burns are caused by the energy of UV and radioactive radiation (intense infrared radiation causes a thermal burn). UV-burn occurs with individual intolerance to this type of radiation, or with its long exposure (UV-therapy - erythema therapeutic dose, insolation - beach burn). In the latter case, the majority of victims develop a second degree of lesion (hyperemia). However, with increased individual sensitivity to UV rays, small vesicles surrounded by bright hyperemic skin can form on the affected areas.
Severe burns are caused by radioactive radiation. Such burns can occur with a local single exposure at doses of 800-1000 rem and more. The nature and degree of tissue damage in radiation burns, their clinical course and outcome depend on the amount of energy absorbed by the tissues, the type of ionizing radiation, exposure, size and localization of the lesion.
[Symptoms
Radiation burns of the auricle, as a rule, are accompanied by a corresponding lesion of the face, which manifests itself several minutes after irradiation with hyperemia caused by the expansion of the capillaries of the skin and subcutaneous tissue. After a few hours or days, the irradiated tissues remain unchanged.
Then they gradually begin to manifest necrobiotic and dystrophic processes. First of all, pathological and morphological changes develop in the nerve tissues: the myelin sheaths of the skin nerves swell, the extremities of the sensory and trophic nerves break up.
Simultaneously, pathological changes occur in all tissues of the dermis: hair follicles, sebaceous and sweat glands, etc., are dying. There is an expansion of capillaries and stasis in them, which causes a second wave of hyperemia of the affected skin area. In severe radiation burns, the arterial wall changes and tissue necrosis occurs. Due to the death of the trophic nerve endings, the regeneration process proceeds very sluggishly and for a long time, the formation of the leukocyte shaft does not occur, but the border of the necrosis does not occur, and the restored dermis and scars often undergo repeated ulceration.
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Treatment
UV-burns of the 1st degree do not require treatment and pass spontaneously, as well as second-degree burns. In the latter case, when an unpleasant subjective reaction occurs in the form of burning and tingling, a hyperemic skin area can be irrigated occasionally with 70% ethyl alcohol or cologne, which has a dehydrating property and reduces perineural edema, compression of nerve endings and a painful sensation.
Limited areas of burns can be lubricated with ointments containing corticosteroids, as well as corn oil or baby cream. With third-degree burns, the treatment is carried out as in a thermal III A burn. In all cases, UV burns of these degrees pass without leaving a trace for several days.
Treatment of radiation burns is much more complicated. Treatment begins immediately after irradiation. General treatment is aimed at combating shock, spend it in specialized therapeutic departments.
To prevent the sensitization of the body by the products of protein breakdown and the harmful effect of histamine-like substances accumulating in the body, dimedrol, intravenous infusions of a solution of calcium chloride, glucose, vitamin mixtures, enterally - a large amount of fluid in different types.
A great therapeutic value in the period of the onset of edema and hyperemia development are novocain blockades (locally or in the regional artery) of affected tissues.
When bubbles are formed, antitetanus serum is administered and antibiotics of a wide spectrum of action are administered. With the observance of aseptic, the blisters are removed, and the same ointments are applied to the surface of exposed erosion as in the case of thermal burns. Bandages are changed no more often than once or twice a week.
At the first signs of regeneration, the closure of the defect with the help of autoplastic skin material is shown. With deep burns and extensive necrosis, enlarged necroctomy is shown, but the possibilities are within the limits of healthy or regenerative tissues.
However, this measure does not prevent further development of various complications in the form of trophic ulcers and skin cancer in the place of the former burn.