Mr. Qureshi, a 30 year old gentleman suffered with Burns to his abdomen due to spillage of hot tea. Since he suffered with this injury during the lockdown, he refrained from approaching a doctor and applied creams and ointments as advised by his relatives. Unfortunately after 10 days, his wound got infected and he suffered with severe pain at that site. He then approached a plastic surgeon, where after treating with multiple specialized dressings his wound was healed eventually without any surgery.
On the other hand, another 10 month old baby also suffered with chest burns due to spillage of hot water from a steamer. Her parents were vigilant enough to get her immediately to the hospital. Here she was treated with an advanced dressing which allowed her to heal painlessly within 7 days.
Burns are one of the commonest form of domestic accidents. Each one of us must have suffered from some type of burn in our lifetime. Most of the injuries which occur are minor burns. However sometimes burns can be serious and even fatal if not treated in appropriate time. Children and elderly are especially prone to complications following burn injury.
How do we identify serious burns? Which are the ones requiring medical attention?
1. Any type of burn in a child less than 5 years old or elderly more than 70 year old must be taken seriously.
2. Presence of co-morbidities like Diabetes, immunocompromised state due to chemotherapy, pregnancy, thyroid disorders, obesity, kidney issues can quickly escalate a simple looking burn injury into a serious infection.
3. Presence of other injuries like lacerations, crush injury or bruising also warrants attention.
4. The surface area involved in a burn injury. As a thumb rule, any burn wound of size more than five percent of body area should be immediately shown in the emergency room.
5. Burns occurring in enclosed spaces associated with lot of smoke requires immediate attention as it may be having associated inhalational injury which can be fatal if not identified in time.
6. Contact burns occurring due to contact with very hot objects like silencer burns may look simple on presentation but are known to be quite deep and usually require surgery.
First Aid response to Burns.(ABCs)
Adequate Cooling-
As burns is a very common injury, several anecdotal treatments exist for its cure. These include application of toothpastes, potato peels, wheat flour, rice water, ink, turmeric and so on. Such treaments are known to cause more harm than good. What a burn injury needs primarily is adequate cooling. This can be done by holding the burnt area under running room temperature water for at least 20 minutes.
Burn area assessment-
Next thing to be done is to assess the burn area. If more than 5 percent it is best to approach a doctor who will assess the depth of the burn and treat it accordingly.
Control of Infections.
Skin is the protective covering which prevents various micro-organisms from entering our body. Burns cause breakage in this protective mechanism. A fresh burn is sterile and if controlled with an advanced protective dressing immediately does not require ingestion of antibiotics. However most patients approach a doctor in a later stage when the burn is colonized by micro-organisms. Then it needs to be controlled with appropriate oral medications and specialized dressings. For minor burns use of any antiseptic ointments like soframycin or mupirocin work as both emollients and for prevention of infections.
Modern medicine has allowed use of artificial skin in various forms to treat medium depth burns in a painless and scarless manner. Deep burns too if treated appropriately can heal with minimal scars and deformity.
In any type of burns, following the ABCs and using a mindful approach while seeking treatment for burns is advisable. Dispelling the myths of burn treatment and early advanced wound care can decrease the burden of burn related morbidity to a great extent.
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