The third and fourth degrees of burns are the most dangerous for human life and health, but the latter is diagnosed much less frequently. Let us consider in detail under what conditions and from what it is possible to get a third degree burn, what it is fraught with, how to provide first aid and how long the treatment will last.
Classification of burns by degrees
As already mentioned, burns are usually classified by degrees, depending on the depth of damage to the skin.
- First degree burn. After contact with the influencing factor, the skin slightly redden and swell. The injury does not require special treatment and heals independently after 5-7 days. A burn scar does not remain.
- Second degree burn. Redness and swelling is accompanied by bloating of the upper layer of the skin and the formation of blisters filled with yellow liquid. When a bubble is pierced, a bright red layer of skin is visible, touching it causes severe pain to the victim. The probability of infection of the wound is high , so the healing period is approximately two weeks.
- Third degree burn. It is characterized by the cessation of tissue vital activity (necrosis), the wound becomes covered with a crust of gray or brown color.
- The fourth degree of burns. The most severe and deep damage to the skin. Characteristic features are the blackening or carbonization of the injured area, in certain cases involving the bones in the process. The recovery period is long, deep scars remain at the site of exposure.
If a person has suffered a cervical spine or joints with fourth-degree burns, motor activity will be noticeably disturbed during the formation of scars.
Third degree burn forms
In medicine, it is customary to separate third-degree burns.
Form 3-A
When injuring this form, the patient has a complete defeat of the epidermis. The dermis is partially and superficially affected. The main part of the basal layer ceases its activity and dies. The germ layer, which is responsible for the restoration of skin cells, is partially damaged. The remaining deep layers fully retain their functional abilities.
In the injured area, the patient practically does not feel touch. Enhanced tactile contact is accompanied by increased pain reactions of the body. An accurate diagnosis requires constant medical supervision and monitoring of the regenerative abilities of the skin.
Form 3-B
The lesion is characterized by complete necrosis of the skin in the injured area. The termination of the vital activity of the subcutaneous tissue is attached to the damage to the skin indicated in degree 3-A.
In the clinical picture, doctors note a complete absence in the patient of pain and reactions to tactile contact. The circulatory process and the metabolism of the skin are impaired.
The concept and clinic of thermal burn
Thermal burns occur when the skin comes in contact with high temperatures of various origins. With severe damage, tissue necrosis and severe redness occurs. The surface of the site of exposure is dry or wet, depending on the nature of the thermal effect. Upon contact with steam or boiling water, the patient will have wet necrosis. The skin becomes red-yellow or red-brown in color and covered with blisters filled with liquid. The nature of the damage can be compared with the process of fusion of skin tissues.
Upon contact with hot objects, for example, iron or iron, dry type necrosis occurs. The skin at the site of exposure is covered with a dense crust, has a dark color, in severe cases it may turn black. The boundaries of the wound are clearly visible. All degrees of thermal burn heal with the subsequent formation of scars on the tissues. In exceptional cases, while maintaining even the smallest sections of the epithelial layer, skin regeneration is possible.
Concept and clinic of chemical burn
In a person who has received a chemical burn, treatment should be carried out as prescribed and after examination by a doctor. Damage to the skin of this type can be obtained by contact with aggressive substances, for example, alkalis or acids. If a person received a third-degree burn of a chemical nature, all layers of the skin on the injured area undergo necrosis. The upper layer of the wound is covered with a dark, hard, immovable crust. Tactile contact is not sensitive.
A final diagnosis regarding the degree of damage is possible only after tearing away the dead areas. Most burns are diagnosed in the third degree.
For those who have received a chemical burn, the treatment and the healing process are long. Approximately three weeks are needed to completely reject the scab. As a result, deep scars form at the site of the lesion.
Characteristic burn manifestations
The main signs of the third degree of burns are a change in the surface layers of the skin from a natural color to a dark red shade. In places where the epithelium has completely ceased its vital activity, the skin color turns black, which indicates tissue necrosis. The place of contact with the acting factor is hyperpigmented.
Depending on the nature of the burn on the injured area, bubbles filled with liquid may appear, crusts of a dense structure of dark brown color, places of erosion and ulcers.
A third-degree burn of category “A” is classified as superficial; category “B” is a deep defeat.
Clinic of burns of the third degree
In most cases, patients who have received a third degree burn, in addition to the main signs of injury, express complaints about a deterioration in well-being. With a global lesion, body temperature can rise, there is a feeling of nausea with bouts of vomiting.
At the border of the injured area of the skin, a small tissue growth is formed, which forms about 2 months after the burn. This is due to the epithelization of damaged skin and the growth of a new layer. Its edges are convex, granular.
If the burn in diameter does not exceed two centimeters, it is permissible to independently heal it, however, it is necessary to create conditions to prevent infection, as well as intoxication of the body. A similar treatment with the use of antiseptic drugs is performed in a clinic.
When the germ layer is damaged, doctors note the formation of scars.
How to provide first aid to the victim
It is not possible to cure a third-degree burn yourself. Therapeutic procedures are represented by a set of measures that help relieve pain and restore the skin.
Due to such features, the injured person should be taken to the burn center as soon as possible or emergency assistance should be called. In approximately 80% of clinical cases, the patient needs surgical intervention.
The first aid complex is based on the following algorithm:
- isolation of the victim from the acting factor;
- with a small area of damage, the injured area should be raised up as far as possible;
- put a sterile napkin in place of the burn.
Then it remains to call an ambulance.
It should be noted that the patient who received a third degree burn is strictly forbidden to give painkillers. This will only aggravate the history taking process and add ambiguity to the clinical picture.
Third degree burn treatment
If the patient is taken to the burn center, this guarantees him the timely provision of proper medical care. Patients with such injuries undergo therapy in a hospital setting. Self-treatment of third-degree burns is strictly prohibited.
Doctors primarily relieve pain. For this, anesthetics of the drug group are used. The wound surface is regularly sprayed with an antiseptic, the remaining drugs are administered intravenously according to the developed scheme.
A third-degree burn is treated only in a complex manner, therefore, painkillers are prescribed:
- Means that block an attack of anaphylactic shock.
- Glucocorticosteroids that suppress the inflammatory process.
- Regular change of dressings.
- Sedative drugs.
- Medicines that eliminate post-traumatic shock.
- Droppers to remove toxins.
- Droppers, replenishing the lack of fluid.
If the lesion is large-scale, it requires surgical treatment in several stages of a third degree burn. How much injury is treated depends on the area of the lesion. After 20 days, the process of repair of the skin will be noticeable, complete healing lasts about three months. With extensive damage to the skin by chemical means or thermal exposure, the burn scar always remains and looks like a scar.
Unacceptable third-degree burn relief measures
If people were near the victim, they should know a number of actions that will not help the patient and aggravate the course of treatment.
So, with burns it is forbidden:
- rinse the place of exposure with cold water, antiseptic and other medical preparations;
- apply frozen food or ice to the affected area;
- remove clothes from the victim;
- give any drugs.
The only right action that others can take for the victim is to transport him to the clinic as soon as possible or to call an ambulance.