First degree burn in a child and an adult: signs and what to do

One of the most common domestic injuries is a 1st degree burn. Consider its types, causes, pathogenesis, symptoms, as well as methods of treatment and prevention.

Thermal, radiation, chemical or electrical damage to body tissues is a burn. When combined with different substances, combined wounds can occur. The lightest form is considered the first degree. It is characterized by superficial disturbance of the epidermis. More often the pathological condition arises because of short-term contact with hot liquids, subjects or at long stay on the sun.

The severity of the wound depends on the depth and volume of the injury. Allocate 4 degrees, while the injuries of the first are the most superficial. The higher the degree of damage, the more difficult the treatment. Light injuries cause severe pain, swelling and redness. Gradually the epidermis acquires a bright scarlet or red color and stands out over healthy tissues. At the same time, watery blisters or scars do not always appear on the skin. The process of recovery is without any complications, cosmetic or functional defects. Typically, a full recovery is observed after 2-3 days. The superficial layer of the epithelium is rejected, leaving a healthy peel.

[1],

Epidemiology

According to the World Health Organization, the epidemiology of burns of mild degrees takes the leading place among other injuries. Burn injuries in America and Japan are 250-300 cases per 100 thousand of the population. In Ukraine, this is approximately 200 cases per 100 thousand population, of which up to 30% require medical care.

[2],

Causes 1st degree burn

The main causes of a 1st degree burn are thermal, chemical, radiation, electrical effects on the skin or mucous membranes. Let's consider each of the possible reasons in more detail:

1. Thermal action - a pathological condition occurs when direct contact with boiling water, steam or fire.

• Fire - most often the upper respiratory tract and face are injured. If other parts of the body are damaged, difficulties arise in removing the burnt clothing. This can cause infection.
• Hot items - on the place of defeat there is a clear trace of the incandescent object. Such wounds can be either superficial or deep enough.
• Boiling water - the wound area is small, but painful and deep.
• Steam - causes a shallow lesion of tissues, upper respiratory tract.

The degree of thermal damage depends on the temperature, thermal conductivity, duration of exposure, general health and skin of the patient.

2. Chemical trauma - are caused by the ingress of aggressive chemicals on the skin. The degree of damage depends on the concentration of the agent and the duration of contact with it. The most common damage occurs by such substances:

• Acids and alkalis - cause shallow wounds. The skin forms a crust, which prevents further penetration of the acid into the tissue. When exposed to alkali, deep wounds are formed.
• Salts of heavy metals cause superficial injuries.

3. Electrical burns - caused by interaction with a conductive material. The current spreads through the tissues, through the blood and other body fluids, bones, skin and adipose tissue. On the victim's body there is an entry and exit point of the current. For injuries of this type is characterized by a small area, but a deep defeat.
4. Radiation exposure - a pathological condition can be associated with ultraviolet, infrared or ionizing radiation. The length of the effect on the skin depends on its severity.

[3],

Risk factors

Allocate the most common risk factors that can trigger both first-degree lesions and more serious injuries:

• Boiling water and hot liquids (hot oil).
• Chemical substances (acids, technical liquids, various solvents).
• Kitchen steam.
• Contact with electricity.

The method of first aid and further treatment depends on the cause of the damage and the nature of the effect on the mucous membranes or skin.

[4], [5]

Pathogenesis

For burn injuries of the first degree, only the surface layer of the epidermis is affected. Pathogenesis consists in such changes: redness, swelling, painful sensations. The sensitivity of the burned area is significantly increased, so the area of injury causes discomfort.

A special role in the mechanism of the origin of the pathological state is played by an inflammatory reaction to trauma that passes the cellular and vascular phases. In the wound area, the permeability of the vessels increases, which facilitates rapid penetration of proteins and macromolecules of the serum. Visually this manifests as hyperemia and edema. In violation of the integrity of the skin, the nonspecific immune system is activated. It is represented by serum and cellular components. They accelerate the process of blood coagulation, involve fibrinolytic and complementary systems.

Specific immunity or the third protective reaction of the body to damage is provided by thymus-dependent and bone marrow lymphocytes. This allows to reduce the risk of sepsis and tissue necrosis with large burns of the last stages.

[6], [7]

Symptoms 1st degree burn

Burn injuries of mild degree are characterized by damage to the most functionally insignificant epidermal layer of the skin. This area is constantly updated. Thus, a healthy person within a period of 24 hours exfoliates millions of cells of the epidermis.

Such wounds are limited. There may also be common isolated surface injuries in combination with more severe injuries. In this case, they are most often found on such parts of the body: face, eyes, scalp, upper respiratory tract, limbs, trunk.

Symptoms of a burn of 1 degree are manifested as follows: redness of the skin, inflammation and swelling, painful sensations. After a couple of days, the skin dries and wrinkles, forming a small pigmentation, which descends for 3-5 days. At the same time there are no gross scars or cosmetic defects.

First signs

Most of the first degree burns are due to excessive exposure to sunlight or from domestic injuries (boiling water, steam, hot or hot liquids). The danger is extensive damage, since there is a risk of dehydration and intoxication with toxic products of tissue decay. In order to recognize pathological changes, it is necessary to pay attention to the first signs of pathology:

• Painful redness on the skin.
• Dizziness and headaches.
• Nausea and vomiting.
• Dehydration.
• Chills, feverish condition.
• Rapid breathing and pulse.

The first medical care and further treatment begin with the elimination of the factor causing injury and cooling the affected area. This will reduce discomfort and speed up the recovery process. If the injury is accompanied by a violation of the integrity of the skin, it is worthwhile to see a doctor, since even with slight damage there is a risk of infection.

Face burn of 1 degree

Particular danger and fear is caused by a burn of the face. 1 degree of this damage is considered the easiest, but still causes pain and temporary cosmetic defect. But if the area and depth of the injury are extensive, then the traces can remain for life. Damage to tissues can be due to the action of high temperatures or chemicals. This type of burns is classified according to external factors that provoked it. Further treatment and rehabilitation will depend on them.

• Thermal - the most dangerous damage, as it destroys complex proteins, that is, the basis of cells and tissues. Appears due to exposure to high temperature skin. In case of burns caused by fire, the entire face falls into sight. Hot liquids, most often boiling water provoke a local shallow lesion. In this case, the steam traumatizes not only the face, but also the upper respiratory tract.
• Chemical - wounds can be caused by various cosmetic procedures (peeling with fruit acids, acid), substandard cosmetic preparations, various medications or household chemicals. On his face appears a shallow, but hyperemic and painful burn.
• Electric - arise very rarely and entail small, but deep wounds.
• Radiation, light, ionizing - trauma caused by radiation. The defeat of the tissues is superficial, with timely and correct treatment passes without a trace.

Burning of the face of the 1st degree is accompanied by swelling, painful sensations and reddening. Restoration of the epidermis takes 3-4 days. In this case the dead cells exfoliate, leaving no traces.

[8]

Eye burn 1 degree

Light damage to the eyelids, cornea and conjunctiva when exposed to high temperatures, chemicals or rays is a burn of the eyes of the 1st degree. Under the influence of the above-described factors, the eyelids are reflexively compressed, protecting the surface of the eyeball from injury. The severity of trauma, the severity of the pain syndrome and the appearance of the eyes depend on the depth of the wound.

Symptoms:

• Persistent redness and inflammation of the conjunctiva, skin of the eyelids.
• Swelling and slight opacity of the cornea.
• Photophobia.
• Decreased visual acuity.
• Increased intraocular pressure.
• Headaches and light dizziness.

Painful burn symptoms begin to increase gradually within 5-8 hours. The victim feels intense pain and photophobia, there is increased lacrimation, spasms of the eyelids. If the retina is not damaged, then the recovery occurs within 3-4 days.

If the pathological condition is associated with the impact on the conjunctiva of UV rays with a specific wavelength, this indicates electrophotophothalmia. Burning the eyes with welding causes damage to the cell membranes, which entails an inflammatory process with pain. Even slight degrees of trauma cause severe discomfort. A powerful and long-lasting effect on the eyes can lead to damage to the retina and cell death, which will eventually cause loss of vision.

Treatment is aimed at eliminating painful sensations. Gently wash your eyes with a cotton cloth moistened with clean water. When burned with acids for washing, the soda solution is shown, and when alkali is applied it is 2% solution of boric acid. After that, you can take painkillers, bury your eyes with anesthetics and put the victim in a dark place.

[9]

Corneal burn of 1 degree

According to medical statistics, about 40% of patients with partial or total loss of vision received a corneal burn. It is the upper shell of the eye (a transparent hemisphere) about which light rays are refracted. She is very sensitive, so any injuries can impair vision or deprive him. Burning a cornea of the 1st degree does not cause such consequences, but without properly provided first aid can worsen the state of vision.

The main causes of burns:

• Ingestion of steam or splashes of swirling liquids, flames. The cornea is damaged at a temperature above 45 degrees.
• Eye contact chemicals: organic solvents, household chemicals, disinfectants, tear gas and more.
• Prolonged exposure to bright light. It can be welding, UV radiation.

The pathological condition of the superficial layers of the epithelium is accompanied by swelling of the skin of the eyelids and tarnishing of the eye. The victim may have a headache, reduced visual acuity, photophobia and lacrimation, blepharospasm and a foreign body sensation in the eye. Injury is treated out-patient (eye and bandages with antiseptic solutions), recovery takes 3-4 days, the burn passes without a trace and does not affect vision.

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Burn with boiling water of 1 degree

The most common domestic trauma is a 1 degree burned by boiling water. In order to get enough of it, spill the skin with boiled water. From such traumas very often suffer children and people of advanced age because of their care.

The main symptoms are:

• Redness of the skin.
• Slight puffiness.
• The appearance of bubbles with a clear liquid.
• Hypersensitivity.
• Painful sensations.

The first stage of injury does not require medical attention, so treatment can be done at home. First of all, it is necessary to remove clothes, which got hot water, and to cool skin with running water for 15-20 minutes. If the integrity of the skin is broken, then the wound portion is not contra-indicated. After this, it is necessary to apply ointment against burns, an antiseptic dressing or a clean flap of cotton fabric.

Categorically it is contraindicated to pierce burn blisters or rip off adherent clothing from the body, as this can cause infectious infection. Do not apply any oils to the skin or cauterize it with alcohol, iodine, or zelenka. Also, alternative methods of treatment fall under the ban: wetting of the epidermis with kefir and other sour-milk products, this can provoke an inflammatory reaction and infection.

[11], [12],

Hand burn of 1 degree

Very often in medical practice, a first-degree hand burn is found. Such injuries can occur both in everyday life and at work. An easy stage is characterized by superficial damage of the skin. On the arm a small swelling and redness is formed.

Consider the main causes of burn injuries of the hand:

• Boiling water - most often found in everyday life. On the calcined tissues, red watery blisters are formed. For treatment, it is necessary to cool the skin and apply a special ointment or antiseptic dressing.
• Steam is found both in everyday life and in production. Easy damage does not require medical intervention, and more serious wounds should be treated only in medical institutions. Wound area should be cooled for 10-15 minutes, gently washed with soap and dried. Apply on the wound anti-burn ointment, without rubbing. If there are severe pain, then it is worth taking painkillers.
• Oil - causes more serious and painful damage than boiling water or other liquids. To minimize the injury, the burned limb must be placed under a stream of water. This will cool the skin and help wash away the remnants of the hot oil. If there is redness, but without blisters, then it is possible to apply on the wound an anti-burn cream without a sterile bandage. In this case, the skin around the wound should be treated with diluted alcohol. If there are bubbles with water, then after applying the ointment, you should put a sterile bandage and change it every two hours.

The recovery period for all the above-described causes of pathology takes no more than 3-5 days. If self-treatment does not work and the inflammation lasts longer than two days, then it is worthwhile to see a doctor.

Burn of the esophagus 1 degree

The ingestion of hot food or slight damage to various substances is a burn of the esophagus of the 1st degree. It can be thermal and chemical. Thermal occurs when swallowed hot liquids and food. But more often they diagnose injuries of a chemical nature. They occur when ingestion of aggressive liquids: concentrated acids, alkalis, ammonia, solution of manganese, acetone, industrial alcohol and others.

Burn injury is accompanied by traumatization of the oral mucosa, stomach and pharynx. According to statistics, about 70% of the victims are patients under the age of ten. The remaining 30% are adults who deliberately or accidentally used caustic liquids.

• Acid damage is much more easily tolerated than alkali. This is due to the fact that when acid gets into the esophageal mucosa, it forms a scab that does not allow the reagent to penetrate into the deep layers of the organ. Since the acid contains water, it helps to reduce its concentration and release from the tissues.
• Alkaline acids cause the destruction of proteins, saponification of fats, forming a gelatinous mass from the cells. Through it easily passes alkali, causing necrosis of superficial and deep layers of the esophagus. This type of burn does not have a mild degree, since even a small amount of alkali can cause a hole in the esophagus.

An easy stage of damage to the esophagus is characterized by traumatization of the upper layer of soft epithelium. That is, the internal soft tissues are not affected. The main signs of the pathological condition are: hyperemia and swelling of the mucosa walls, painful sensations in the gastrointestinal tract.

The first aid is to wash the stomach. The victim should drink more than 1 liter of clean water and induce vomiting. Drug treatment is not required, since all the signs of the lesion pass within 10-20 days on their own. But to the doctor nevertheless it is recommended to address for carrying out of prophylaxis and specification of degree of damage. Medical assistance is also required if the burn is caused by a chemical substance and it is necessary to neutralize it.

[13], [14], [15], [16]

First degree burn in a child

Household childhood trauma is a fairly common phenomenon. The 1st degree burn in a child occurs most often and can be caused by such causes: thermal energy, UV and ionizing radiation, chemicals or electric current. According to medical statistics, more than half of the burn injuries are heat damage (hot water, steam, incandescent objects, fire). The severity of injury is divided into four stages. The first is the lightest and is a superficial lesion of the upper layer of the epidermis. Redness and swelling appear on the skin.

The first medical aid for burns of 1 degree in children depends on the cause of the injury. Consider the general recommendations aimed at improving the condition of the victim:

• If damage is received through clothing, then it must be removed. This will prevent the sticking of things to the burned skin and stop its further traumatization. But you can undress a child in the event that clothes are removed easily, ripping things is contraindicated.
• Cool the damaged surface with running water (the temperature should be about 15 ° C). This will help to remove heat from the deep layers of the skin. Cooling will reduce the severity of the inflammatory reaction, reduce swelling and stabilize the walls of blood vessels. This recommendation is acceptable for burns on the limbs. If the wound is on the trunk or head, then it is necessary to apply cool bandages. Ice is forbidden to apply, as it provokes narrowing of blood vessels and slows down the blood flow, strengthening the destruction of tissues.
• After cooling, the affected part of the body needs to be raised above the level of the heart. This will reduce swelling.
• The next step is to prevent the skin from drying out. To do this, apply an anti-burn ointment or antiseptic to the wound and close the bandage. This will prevent infection, relieve inflammation and speed up the recovery process.

Almost always children's injuries entail a burn disease. This condition is the reaction of the body to irritation of the nerve endings and the ingress of the products of their decay into the blood. Burn disease develops not only with serious injuries, but also with superficial ones. At the same time the condition of the child worsens for a long period. The first pathological symptoms make themselves felt 6-10 hours after the injury. There are sharp pains in the wound area and nervous excitement. Such a condition requires medical care, as it will not pass independently, but will only worsen, causing violations of the urinary, respiratory and other body systems.

In normal recovery takes 1-2 weeks and depends on the area and localization of the lesion. Once the pain syndrome has passed, the skin will begin to acquire a healthy color, peeling off and renewing. If the recovery is delayed, then you need to turn to the pediatrician.

Forms

The frequency of seeking medical help burns occupy a leading place. Kinds of burns determine their origin and allow you to make an optimal treatment plan and a prognosis for recovery. Consider the main burn classification (due to the occurrence):

• Thermal - occur when in contact with hot air, steam, boiling water, hot objects. Wounds can be mild, moderate and severe on any part of the body.
• Electric - most often appear when working with electrical equipment or when striking lightning. They are characterized not only by skin lesions, but also by disorders from the cardiovascular, respiratory and other body systems. Even slight injuries cause dizziness and fainting.
• Radiation - this is the defeat of ultraviolet, ionizing and other types of radiation.
• Chemical - develop by contact with aggressive substances. The degree of damage depends on the concentration of the reagent and its effect on the tissue.

There are mixed injuries, that is, a combination of several types of burns and a combination of burns and injuries of a different nature. Each species is divided into several categories. Thermal are divided into burns from fire, water, steam, hot objects. Chemical in turn for damage by acids, alkaline solutions, salts of heavy metals and other.

Pathological condition is classified not only by reason of origin, but also by severity:

• 1 degree - superficial lesion of the upper layers of the epidermis. Causes redness, swelling, painful sensations and impaired function of the affected area. Restoration is rapid, without the formation of scars.
• 2 degree - a complete defeat of the surface layers of the epidermis. The victim feels severe pain, on the skin bubbles with a liquid form.
• 3A degree - traumatization of all layers of the epidermis up to the dermis. In the wound area a dry or soft burnt crust forms - a scab of light brown color.
• 3B degree - all layers of the epidermis, dermis and partially hypodermis fall under the lesion. A dry, dense crust of dark color forms.
• 4 degree - affects all layers of the skin, muscles, tendons and bones. On the body a burnt crust of black color or charred areas is formed.

The depth of the burn injury depends on the nature and temperature of the active agent, the duration of exposure and the degree of heating of the deep words of the skin. Injuries are also divided according to the healing ability: superficial lesions (1,2, 3A degree) and deep burns (3B, 4 degree). In the first case, wounds heal independently, without scar formation. For more serious injuries, medical attention and surgery are required.

Thermal burn of 1 degree

When exposed to skin heat agents (liquid, steam), a person can get a thermal burn of 1 degree or more serious damage. According to medical statistics, this type of trauma takes 90-95% of all burns. The most dangerous are thermal damage to the respiratory tract, as they cause swelling of the larynx, complicating breathing. Also, trauma to the face and eyes is dangerous.

With a mild degree of burn, the surface covering of the epidermis suffers. Skin blushes, swelling, sometimes bubbles with fluid. The whole process of treatment consists in the correct provision of first aid.

• The affected surface must be cooled under running water or with wet dressings for 15-20 minutes.
• After that, the skin needs to be dried and applied anesthetic, anti-burn or antiseptic. More often used such drugs: Panthenol, Olazol, Amprovizol, Oleol.
• If the wound formed bubbles, it is worth preparing an ointment bandage. As an ointment is recommended to use such drugs: Levoyin, Flamazin, Dioxydinovaya and other bactericidal drugs.

The skin is restored within 3-5 days. On the site of the lesion, a dry scab forms, which quickly peels off, revealing a new layer of epidermis.

[17]

Solar burns of 1 degree

After a long stay in the sun or in a solarium, sunburns of the first degree occur. The symptomatology of the pathological condition is manifested by a gradual reddening of the skin within 12-24 hours, swelling and its soreness. In some cases, blisters with fluid may appear. Due to dehydration of the body, the burned area begins to peel off. Discomfort gradually passes, and the skin acquires a tan color.

Light sun damage heals without medical assistance and leaves no traces on the skin. The most sensitive to ultraviolet radiation are: back, abdomen and chest. In this case, people with dark skin and dark hair are less sensitive to sunlight.

To minimize discomfort, you can apply Panthenol, Rescuer or other anti-burn agent to your skin. If the first degree burns occupy a large area of the body, then it is worthwhile to seek medical help. In this case the inflammation will pass independently 3-6 days after receiving the injury.

Chemical burn of 1 degree

Light tissue damage, obtained by interaction with various acids, alkalis or salts of heavy metals - is a chemical burn of 1 degree. Most often, the injury is due to non-compliance with safety rules when working with aggressive substances, in case of domestic accidents or at work.

The depth of damage depends on the amount and degree of concentration of the chemical, its strength and mechanism of action. At the first degree of injury, only the upper layer of the epidermis is injured. Symptoms are manifested in the form of hyperemia, a small edema, burning and painful sensations.

As a treatment, the first medical aid is shown:

• First of all, you need to remove clothing from the damaged area without touching it. Rinse the skin with clean water for 10-20 minutes.
• If the trauma occurred with hydrochloric acid, then the wound can not be moistened, as during the interaction with the liquid, the acid releases heat, so it must be neutralized with a solution of soda or a soap solution.
• When burned with alkali, neutralization is also necessary, in the role of which is a weak vinegar solution, citric or boric acid.
• The burned area must dry, after which it can be applied with ointment and a sterile bandage.

Restoration of the skin takes on average 5 to 7 days.

Complications and consequences

A burn of any degree causes fears, as it can provoke various consequences and complications. The risk of developing a pathological condition is significantly increased if the lesion of even a mild form occupies more than 30% of the body area or occurs in patients of infancy or senile age. Improper provision of first aid also has a negative impact on further recovery.

There are so-called late complications of burns, which include: infectious lesions, sepsis, internal bleeding, increased metabolism and local problems.

• Many victims face burns exhaustion. This consequence is associated with a burn wound and a prolonged intoxication of the body with the products of tissue disintegration, microorganisms and products of their vital activity. There is general weakness and inhibition, irritability, sleep and appetite disorders. Also, there are possible disorders of the digestive system and the liver due to a lack of protein.
• Infection and sepsis - pose a threat to life within 36 hours after the injury. The wound is penetrated by harmful microorganisms, which cause a sharp rise in temperature and symptoms of intoxication. For treatment, regular burn treatment is carried out with antiseptic solutions and ointments. It is also possible to take antibiotics.
• Internal bleeding occurs due to the formation of acute or so-called stress ulcers. To prevent this condition, use sucralfate, antacids or histamine blockers. They maintain the pH of the gastric contents at a normal level.
• Hypermetabolism - develops in victims of burns of 2-3 degrees with a volume of damage more than 50% of the total body area. Such injuries are a great metabolic load. It takes 5-7 days to restore normal body function. In patients, the temperature rises sharply and persists for a long period of time. There may be a violation of the function of the intestines and stomach, therefore, intensive parenteral nutrition and compliance with the water balance are indicated.

The 1st degree burn does not cause serious complications. The only thing that the injured has to face is a pain shock, redness and blisters on the skin. In more serious injuries, complications such as muscular atrophy, tachycardia, anemia, hypotension, severe puffiness, neuritis, toxemia, and others may occur. In this case, the patient is waiting for a long treatment and a difficult period of rehabilitation.

How long does the 1st degree burn occur?

Many patients are interested in the question, after how much the 1st degree burn passes. To answer it, you need to determine the type of damage (thermal, chemical, radiation, electrical), its location and volume, the age of the victim and the individual characteristics of his body.

Burn injuries of mild degree are superficial, so they heal very quickly. Typically, the recovery takes from 3 to 7 days. To improve and speed up the healing process, the first medical aid and the proper care of the wound surface are very important. The wound should be treated with an antiseptic and lubricated with anti-burn ointment, so that it does not moknula and does not fester.

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Diagnostics 1st degree burn

For burn injuries of a light form, there is a sharp hyperemia, swelling and painful sensations. Diagnosis of a 1st degree burn is based on signs of superficial damage to the epidermis. When examining the wound, one can immediately see its redness and slight swelling over healthy tissues.

The fact of a burn is not difficult to establish, but it is more difficult to determine its area and depth. For this, the rule of nine is used: the head 9%, the upper limb 9%, the front surface of the trunk 18%, the lower limb 18%. The palm rule can also be applied, assuming that the palm size is 1% of the total area of the body.

In the process of diagnosis it is very important to establish the presence of shock in the victim. To do this, assess the burn area, its depth, blood pressure level, signs of cardiac or respiratory failure and other disorders. Local burn changes include: primary anatomical and functional disorders, reactive-inflammatory processes. The heavier the injury, the more morphological the expression is.

Analyzes

During the diagnosis of burns, the victim is assigned various tests that help assess his condition. First of all, the doctor collects an anamnesis, establishes the cause of the damage, its area and depth.

The patient is assigned a urine test, which can establish myo or hemoglobinuria. A blood test is necessary to determine the level of albumins (for burns it is increased), studies of the gas composition of the blood to detect respiratory disorders and leukocytosis. According to the results of laboratory tests, the doctor makes a plan of therapy or gives the patient the necessary medical recommendations.

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Instrumental diagnostics

Burn injuries to internal organs require special attention. To determine their severity and localization, instrumental diagnostics is used. So, with a burn of the esophagus or GI organs even mild, it is very important to exclude the development of pathological complications.

For this, the patient is given a fluoroscopy of the esophagus with a water-soluble contrast. It allows to diagnose perforations and esophageal-respiratory fistulas. Endoscopic examinations are also possible, but only with 1-2 degree burns. Ultrasound and an overview radiograph of the digestive and thoracic organs, is necessary for the detection of pericarditis or pleurisy.

Differential diagnosis

As a rule, light burns do not require differential diagnosis. Differentiation is necessary to determine the type of injury (thermal, chemical, etc.) if the patient can not tell about the damage on his own.

Differential diagnosis is carried out with severe burn injuries, when contact with the victim is difficult or the nature of the injury does not allow to determine its origin, and is accompanied by violations of the integrity of the skin. In this case, the burn is compared with allergic dermatitis, local acute surgical infections of soft tissues (pressure sores, erysipelas), diabetic foot, Lyell syndrome, traumatic endotoxicosis.

Differential studies are conducted with chemical burns, when the reagent is ingested. The nature of the damage is assessed by the action of corrosive substances: alkali causing deep necrosis, acid - superficial or dry coagulation necrosis. Diagnosis is carried out using radiography, esophagogastroscopy and other instrumental methods. If necessary, a biopsy can be performed to differentiate with esophageal tumors.

Treatment 1st degree burn

As a rule, treatment of a 1st degree burn does not require medical care and is conducted independently at home. Symptomatic therapy is aimed at minimizing painful sensations and eliminating the inflammatory response. For anesthesia use both local (ointments, gels, aerosols), and tablets with NSAIDs. Antibacterial agents are indicated to prevent infection. It is also necessary to ensure regular moisturizing of the skin, as this promotes rapid healing.

During treatment is strictly contraindicated:

• Treat damage with alcohol-containing substances.
• Puncture or cut the formed blisters, since there is a risk of infection.
• Rip off the burned clothing and touch the wound with your hands.
• Lubricate the skin with a solution of potassium permanganate, greens, various oils or grease.

Complete tissue repair takes from 3 to 5 days. If during this period the regeneration process does not start or the burn damage occupies an area of more than 30% of the body, then it is worthwhile to see a doctor.

Help with a 1 degree burn

The first medical aid for a 1st degree burn is aimed at eliminating the factor that caused the pathological condition. So, with the most common thermal damage, it is necessary to eliminate the action of the agent and cool the wound site. This will stop further spread of burn changes and will speed up the healing process. But this method can be used only while maintaining the integrity of the epidermis. For cooling, it is recommended to use running water for 15-20 minutes.

Such first aid is indicated for sunburn, most of which are related to mild degrees. The injured person must be taken to the shade and the skin cooled by running water or a cold compress. With severe pain, you can give an anesthetic. On the skin you need to apply any anti-burn agent, which includes substances with anesthetic and cooling effect.

The same scheme of treatment is indicated for electrical injuries of the 1st degree. In this case, special care should be taken when disposing of the victim from the action of the current. First aid for chemical burns differs from the above. This is due to the fact that when interacting with water, some agents can intensify their action, provoking even more damage.

Medications

The modern method of treating burns of mild degree prescribes the choice of a medicine depending on the phase of the wound process. Therapy of burn damage of the 1st degree consists of the following stages:

1. Cooling and wound treatment - at this stage, various antiseptic and hypertensive solutions, foam preparations in aerosols are widely used. They clean the wound of possible contaminants and effectively cool, reducing pain.

• Vokadin is an antiseptic (ointment, solution) with antiviral and bactericidal properties. The active substance is povidone-iodine. It is used for infected skin lesions, for antiseptic treatment of the wound surface, in surgical and dental practice. It is contraindicated to use for burn injuries in children younger than 6 years and with hypersensitivity to the components of the remedy. The drug can be used both in diluted and pure form, for rinsing and applying bandages. Side effects occur extremely rarely and are manifested in the form of local allergic reactions.
• Dimexide is a local anesthetic and anti-inflammatory agent. It is prescribed for inflammatory and traumatic lesions, abscesses, wounds. The solution is used for washing the wound surface or as a compress-bandage. The drug is contraindicated for patients younger than 12 years, with severe cardiovascular insufficiency, stroke, during pregnancy and lactation, coma. Dimexide is well tolerated, but in some patients it can cause the development of erythema, dermatitis, itching.
• Dioxysol-Darnitsa is a combined topical drug. It has antibacterial and local anesthetic properties. It stops wound inflammation, accelerates the repair process. The main indication for use is the treatment of wounds of soft tissues of various localization and origin. The solution is used to treat burn injuries, as bandages and compresses.
• Miramistin is an antiseptic with hydrophobic action on cytoplasmic membranes of microorganisms. Increases the permeability of cell walls and destroys them. It is active against gram-positive, gram-negative and other harmful microorganisms. It is used to treat infected wounds in the first stage of the wound process, as well as frostbite, surface burns. It is widely used in dermatology, venereology, urology, surgery and dentistry. The drug is released in the form of a solution and ointment. The main contraindication is intolerance of the active components of the drug.
• Betadine is an antimicrobial, antiseptic agent with an active substance - a complex compound of iodine with polyvinylpyrrolidone. It is used to prevent infection of wounds, in surgery, transplantology, traumatology, ophthalmology and gynecology. When burned, it is used to treat the skin and mucous membranes. The solution is used both in diluted and concentrated form. May cause allergic reactions (itching, redness, dermatitis), which pass on their own after the remedy.

2. Anesthesia - since light burns are characterized by superficial tissue damage, it is better to use topical agents, that is, ointments and aerosols, to minimize discomfort. In this case, aerosol formulations have a number of advantages over other forms. They are painlessly applied to the wound, treating a large area of damage at a time and allowing the skin to breathe, speeding up its recovery.

• Olazole is an aerosol, which includes sea buckthorn oil, levomycetin, boric acid and anesthesin. It has anesthetic and antibacterial action, reduces exudation, accelerates the restoration of damaged tissues. It is used for burns of different severity and localization, with trophic ulcers, microbial eczema, dermatitis.
• Livian - aerosol for external use. It has anti-inflammatory, antiseptic and local anesthetic properties. The main contraindication to its use is the intolerance of the components. Side effects are manifested in the form of allergic reactions. To achieve a therapeutic effect, the drug must be sprayed once a day onto damaged tissues.
• Panthenol is a drug with active substance dexpanthenol. It is used to accelerate the healing of the skin and mucous membranes. Helps with abrasions, burns of different etiology, with aseptic postoperative wounds and other injuries. Spray is applied to the skin 1-2 times a day, the duration of treatment depends on the degree of trauma and the severity of pain.

3. Prevention of wound infection - is carried out in the event that the skin appeared bubbles with a liquid. Their traumatization can lead to the development of infection. For the prevention of a pathological condition use such medicines:

• Bactosine is an antiseptic solution for external use. Its active substances: chlorhexidine gluconate and cetrimide. They combine with the skin and mucous membranes, providing low subcutaneous absorption and prolonged action. It is used to treat light burns, small wounds, abrasions, microcracks, insect bites. The main contraindication is intolerance of active components. Side effects and symptoms of overdose manifested in the form of skin allergic reactions.
• Chlorhexidine Bigluconate is a local antiseptic with bactericidal properties. Its mechanism of action is based on a change in the properties of the cell membrane of the microorganism. The medicine destroys the pathogenic bacteria and speeds up the regeneration process. With prolonged use may cause dryness, itching, photosensitivity. Used with caution in pediatrics. The main contraindication is intolerance of active substances, dermatitis, disinfection during surgical interventions.
• Levomekol is a combined agent with an antibiotic (chloramphenicol) and an immunostimulant (methyluracil). Effective against most harmful microorganisms. Ointment is used for burns, purulent-inflammatory lesions, trophic ulcers and boils. The product is applied to the damaged skin or under a sterile bandage. Side effects are manifested in the form of allergic reactions.

4. Normalization of local homeostasis - at this stage there is a rejection of necrotic skin areas, that is exfoliation of the epidermis and growth of a new healthy skin. To accelerate the regeneration process, the following tools are recommended:

• Aekol is a combined vitamin topical agent used for wound healing. It has metabolic and burns properties. Its regenerative action is based on the pharmacological properties of vitamins A and E, menadione and beta-carotene. The preparation has an oily form and is available as a solution. The main contraindication is intolerance of the vitamin complex, side effects are manifested as local allergic reactions and diarrhea.
• Kuriosin is a combined preparation containing zinc and hyaluronic acid. The latter substance supports the elasticity and turgor of the epidermis. With a decrease in its concentration, infected wounds, various pathological processes in the skin and trophic ulcers are formed. Zinc has an antiseptic effect and accelerates healing. The medicine has two forms of release: gel and solution. Before applying the remedy to the wound, it must be treated with hydrogen peroxide. The drug is used 1-2 times a day. Possible side effects - burning and a feeling of tightness of the skin. These effects pass on their own and do not require withdrawal of the drug.

Stage-by-stage medical assistance with the use of effective drugs can reduce the risk of various complications and accelerate the healing process of the wound.

Than to smear a burn of 1 degree?

Damage to the skin with high temperatures is a burn. You can get injured by a hot object, aggressive substance, boiling water, hot oil and many others. Light injuries are related to 1st degree burns. They do not require medical treatment, since the epidermis is traumatized superficially. Various preparations of topical application are used to accelerate healing. Consider how to smear a 1st degree burn, depending on its type:

• Thermal - Panthenol, Levomekol, Eplan, Actovegin, Rescuer.
• Chemical - Bepanten, the Savior, Levomekol, Solkoseril.
• Sunny - Argosulfan, Eplan, Savior, Panthenol.
• Ointments for accelerating healing - Panthenol, Rescuer, Ebermin, Actovegin.

Regardless of the cause of the burn injury and its localization, local remedies can be used for treatment: Levosin (anti-inflammatory, wound-healing, anesthetic), Luan (anesthetizes and speeds up the regeneration process), Streptocide Ointment (effective antiseptic), Titriol (anesthetic antiseptic) .

Vitamins

To restore the skin after a burn, the body needs vitamins and other trace elements that activate the regeneration processes. For these purposes, use drugs, which include various vitamins, consider them:

• Radevit - anti-burn ointment, contains substances that improve the processes of tissue regeneration. Contains vitamins A, E and D. Stimulates metabolism in tissues, accelerates the healing process. Prevents skin dryness and infection of burn wounds.
• Aekol is a combined vitamin preparation. It is used to treat burns of varying severity. The mechanism of its action is based on the pharmacological properties of vitamin A, E, beta-carotene and vitamin K. Retinol regulates cell metabolism, promotes tissue rejuvenation, improves cellular immunity. Beta-carotene increases resistance to infections, participates in regenerative processes, and menadion normalizes blood coagulability.
• Panthenol is one of the most popular anti-burn medications. Contains dexpanthenol and B vitamins. It improves tissue regeneration, has anti-inflammatory effect. Effective in the treatment of burns of any kind and stage, both in children and adults.
• Amprovisol is an aerosol with a combined composition. Contains vitamin D, propolis, menthol, anestezin. Has analgesic, antiseptic, cooling and anti-inflammatory action.

In addition to the above described preparations, to accelerate the healing of burn injuries and improve the general condition of the body, vitamins C and E can additionally be taken. Vitamin C is necessary for the formation of collagen and the healing of the burned epidermis. Vitamin E can be used both internally and externally as an ointment. This substance accelerates the restoration of tissues and prevents dry skin.

Physiotherapeutic treatment

Burns of any degree require a comprehensive approach. Physiotherapeutic treatment is used to reduce painful sensations, reduce inflammation and accelerate healing processes. With burn injuries of 1-2 degrees, physiotherapy is practically not used, since lesions are superficial. I resort to it with more serious and profound wounds. Let's consider the basic physiotherapeutic procedures used for burns:

• For anesthesia, transcranial electrostimulation is used. This is a non-invasive method that involves the effects of currents of a certain frequency on the brain.
• At the stage of formation of the scab, the injured are given procedures with exposure to the skin of blue and red light with the aid of the Gesca apparatus. The duration of the procedure is 20-30 minutes, 2-3 sessions a day. The course of treatment is 14-20 days.
• In the recovery period (the formation of granulations and epithelialization), electrostimulation, franklinization, UV therapy, magneto- and laser therapy are used.
• At the stage of formation of keloid scars, the patient is prescribed electrophoresis with the use of lidase and collalysin enzymes, paraffin applications and ultraphonophoresis on scar tissue.

The need for a physiotherapy treatment is determined by the surgeon. The physiotherapist selects the procedures necessary for the speedy recovery and determines the course of their application.

Alternative treatment

Since only a superficial layer of epithelium is affected by burn traumatism of the mild degree, the treatment of such wounds is not particularly difficult. Alternative treatment is popular in many patients. Non-traditional medicine offers such methods of treatment of skin lesions:

• Brew strong green and black tea. Cool the beverages to room temperature, mix and strain them. Prepare a compress of tea fluid and apply on the wound until it dries. If necessary, repeat the procedure.
• Mix 25 g of starch with 250 ml of warm water. The resulting solution is used for compresses or under a sterile bandage.
• Saturate the gauze napkin or bandage with sea buckthorn oil and attach to the wound. This will speed up the process of regeneration and reduce painful sensations.
• Take 1-2 tubers of raw potatoes and grate. The resulting raw materials should be applied to the burn site every 3-5 minutes. This will prevent the formation of blisters and swelling.
• 25 g of beeswax and 100 ml of sunflower oil, mix until a uniform consistency is obtained. The resulting ointment should be applied to the skin 3-4 times a day until the wound is completely healed.

All the above recipes of alternative medicine are acceptable only for minor injuries. More serious injuries require professional medical attention.

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Herbal Treatment

Another option of alternative medicine is the treatment with herbs. Properly selected plant components not only accelerate healing, but also improve local tissue immunity.

Herbal recipes against 1st degree burns:

• 25-50 g of crushed oak bark, pour 500 ml of water and cook over low heat for 20-30 minutes. Ready-made broth should be cooled and filtered. The product is used for external use, i.e. For compresses and washing of wounds.
• 25 grams of aspen bark are placed in enamel ware with a lid and pour 500 ml of boiling water. The broth should be boiled in a water bath for 30 minutes and well filtered. Take the medication by diluting 100 ml of decoction with 50 ml of warm water. Also possible external use for compresses and bandages.
• Apples are used to reduce pain and reduce the inflammatory process. The fruit is rich in tannins. Rub on a small grater apple and peel and attach to the wound for 10-15 minutes.
• Berries of fresh cowberries rub, and squeeze out juice from them. Dampen the juice with a napkin or bandage and attach to the wound. Repeat the procedure 2-3 times.
• Berries of chokeberry (mountain ash) chopped and squeezed juice from them. Take a vegetable fluid at ½ cup per day for 14 days. Juice can be used for compresses and washes.

Before using the above-described recipes, you should consult your doctor. This is associated with the risk of developing allergic reactions, which will complicate the treatment process.

Homeopathy

Alternative medicine or homeopathy also offers drugs to treat light burn injuries of different etiologies. Consider these:

• Urtica urens - suitable for sunburn. Urtica Urens is used both internally and externally. For small lesions, the drug is taken every 15 minutes 5-6 times. With strong wounds, you can make compresses from the tincture of the medicine (20 drops per ½ cup of water).
• Cantharis - effective in painful lesions with blisters. Cantaris can be used to treat children. The drug is taken every 15 minutes 5-6 times.
• Calendula is a homeopathic remedy used for burns with bursting blisters, that is, with a risk of infection. Suitable for both indoor and outdoor use. Calendula is taken 3 times a day for 3 days.
• Causticum - used for burns, which, after healing, retain their soreness. Causticum is taken 3 times a day for 2-3 days.

To relieve the painful shock and panic condition, take Aconitum, with burning pain and pronounced edema - Apis, and with strong pulsating pains the drug Belladonna is suitable. The dosage of all the above medicines is selected by the homeopath, individually for each patient.

Prevention

The prevention of burn damage is based on the elimination of factors that can cause them. Prevention of household burns (thermal, chemical, electrical) should be known to everyone. Because this is the most common traumatization. Burns occur when non-compliance with basic safety rules.

Prevention is based on these recommendations:

• Do not use faulty electrical appliances or with damaged insulation.
• Without adequate knowledge and skills, do not attempt to repair wiring or electrical appliances yourself.
• Do not leave children out of the picture, especially if there are hot objects and anything that could cause injury (matches, iron, hot kettle, corrosive liquids) in their field of vision.
• Avoid smoking in bed, as this is a very common cause of fires.
• If possible, keep the fire extinguisher at home and conduct an explanatory conversation with the children on the topic of burns safety.

Another common type of damage, especially in the hot season - is sunburn. Avoid exposure to the sun from 10-16 hours, as it is at this time that there is a risk of getting burned. On particularly hot days, try to cover the skin with light clothing of dark color. Before going outside, use sunscreen with a suitable protective factor (determined by the skin type). Compliance with such simple recommendations will reduce the risk of trauma to the skin to a minimum.

Forecast

The 1st degree burn has the most positive prognosis. Trauma causes superficial damage, which quickly passes within a few days. But do not forget about the use of first aid, which will relieve the pain, reduce the risk of all sorts of consequences and complications, and accelerate the healing process.

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