Any doctor will say that combustiology is a branch of medicine aimed at treating severe forms of burns, as well as pathologies that arise in the human body against the background of this process or are its direct consequence. As an independent clinical branch appeared relatively recently. Today in Russia there are very few specialized therapeutic departments of this type and professional combustiologists. But gradually the problem of their absence is being solved: in the territories of state and private medical institutions, burn medicine centers or offices are beginning to appear.
Combustiology - what is it? Meaning of the word
The medical term is derived from the Latin word “combustion” - “burn” and the Greek “logos” - “teaching”. In other words, it is a science studying burns. In addition, combustiology studies various pathological conditions that have arisen in the body due to trauma. The most striking example is a burn shock. Clinical, radiological and laboratory studies are being conducted, new therapeutic and preventive measures are being developed aimed not only at treating pathologies, but also at preventing their occurrence.
What does combustiology study?
This section of medicine deals with the treatment of severe burns. Injury is classified according to the degree of damage, which depends on the depth and type of pathology. A burn is the most common trauma in the world, therefore it is given special attention throughout the world. The treatment process is complex and long, and the pathology itself can threaten the health and life of a person, since complex proteins are destroyed because of it, which in turn are the basis of tissues and cells.
One of the main directions in combustiology is reconstructive surgery. It is carried out after treatment. Depending on the severity of the injury, therapy can be either conservative or surgical. The complexity of the operation and the recovery period of the patient depend on the same factor.
Reconstructive surgery in combustiology - what is it? The purpose of this surgical intervention is to restore the integrity of the skin after a burn. It is equally important in this matter to leave as few scars and scars as possible. Special attention should be paid to the lost functions of the injured part of the body. If this happened, then reconstructive surgery, as far as possible, is engaged in restoring the normal functioning of these organs.
A severe burn is often accompanied by a complete loss of the skin area. In this case, a transplant of a whole flap is required. As a rule, the patient becomes a donor for himself. A tissue stretching procedure is performed, which allows you to get a skin flap of the right size.
What is a burn? Classifications by Depth and Type of Damage
Knowing that combustiology is a science that studies severe burns, it remains to become more familiar with the classification of injury. It can be obtained not only due to exposure to high temperature, but also after contact with chemicals, such as acids. Regardless of this, the burn is classified by depth and type of damage.
Classification by depth of lesion:
- The first, easiest degree, is characterized by damage to the upper layer of the keratinizing epithelium.
- The second degree is characterized by damage to the keratinizing epithelium to the germ layer, as a result of which vesicles with serous contents form.
- The third degree is characterized by the defeat of all layers of the epidermis and the dermis itself, and is divided into degrees "A" and "B":
A) the dermis is partially affected, characterized by the presence of the remainder of the epithelium at the "bottom" of the wound. Self-healing tissue is possible;
B) the complete death of the dermis and epidermis to subcutaneous fat.
- The fourth degree is characterized by complete tissue death, carbonization of muscles, bones and subcutaneous fat.
Classification of burns by type of damage:
- thermal (open flame, steam, boiling liquid, hot objects);
- chemical (acid, alkali, heavy metals);
- electric;
- ray.
Also, when studying what combustiology is, it is important to know about the systemic effects of burn injury. There are only 3 of them:
- burn disease - the body's response to injury (burn shock, toxemia, septicotoxemia);
- endogenous intoxication syndrome - a complex of symptoms indicating the presence in the body of a large number of catabolism products, which is due to insufficient liver function;
- burn infection with sepsis - the depletion of the immune system due to the aggressive effects of bacteria through damaged skin.
Combustiologists, in addition to treating the burn itself, also carry out a number of measures aimed at eliminating systemic effects.
The history of combustiology as a separate section of medicine
Burns have always been treated, even in ancient times, but then all therapy was based on the use of folk recipes. Doctors made lotions and special creams that relieve pain and promote wound healing. This was the end of the therapy. Now it is worth saying that combustiology is a section that was discovered by Paul Amman. It was he who in 1658 engaged in a detailed study of burns. After conducting a series of studies, he made several statements regarding injury care. Paul Amman found that, firstly, alternative drugs should be used as soon as possible in order to minimize the negative consequences. Secondly, you can not supercool the burn site. Thirdly, if there is a scab, it must be opened to remove the accumulated liquid.
It took about 140 years to collect the results of research burns. And in 1869, the first reconstructive operation was already carried out: the Swiss surgeon Reverden transplanted healthy skin onto the injured area.
The development of combustiology in the world: treatment methods
Burn medicine (combustiology) is a section that is constantly evolving. Since 1658, various studies have been carried out, drugs and therapeutic methods are being developed that allow you to relatively quickly and with maximum quality cure the injury, as well as eliminate the possibility of the manifestation of negative consequences. In 1939, an instrument called dermatitis was invented. He gave combustiologists the opportunity to remove a very thin, but large area of skin for subsequent transplantation. Thanks to this method, the healing of the donor site was faster.
Next, scientists decided to reduce the healing time of the wound. In the course of the research, it was found out that in order to achieve this goal it is necessary to remove dead tissue as soon as possible. Practice has shown that this really works. This procedure is called necroectomy.
Some time later, in the 1990s, combustiologists began to deal with the problem of growing new skin and its cells in order to refuse the donation of strangers. Now widely used method of balloon tissue extension, which allows the patient to be a donor for himself.
The importance of combustiology in medicine
Injuries of this kind are among the most common, so the role of burn surgery in medicine should not be underestimated. In the modern world, specialized centers and departments of combustiology are opened everywhere, equipped with the necessary equipment and furniture, in which qualified specialists are able to provide emergency assistance to patients. Combustiology as a science continues to develop, which is facilitated by ongoing research and observations of professionals.
The most famous centers of combustiology in Russia
In Russia, there are few specialized combustiological clinics, but, what is good, this number is gradually increasing. The most famous is the burn center. Inozemtseva in Moscow, and he is considered the largest. There is also the Burn Center of the Institute of Surgery. A.V. Vishnevsky, who deals with even the most complex forms of injury.