Expert on Burn Injuries and How to Care for Them

Even with firecrackers being banned across the country this year, burn injuries remain one of the commonest forms of domestic injuries. Each one of us has suffered from some type of burn in our lifetime, be it while cooking, ironing, or simply while preparing a cup of tea. Most of the injuries that occur are minor burns, which is why we tend to ignore them and stick to applying over-the-counter ointments. However, burns can be serious and even fatal if not treated at the right time. 

Elaborating upon the impact of burns, Consultant Plastic and Reconstructive Surgeon at Wockhardt Hospital, Dr. Shraddha Deshpande explained, “Burns can be classified as first degree, second degree, and third degree. The treatment of burn injuries may vary from person-to-person depending upon how severe the injury is. First degree burns include sunburn as well. The second degree can be serious and may cause pain, redness, swelling, and blistering and third-degree burns are life-threatening. Children and the elderly are especially prone to complications following burn injury.”

Dispelling the myths of burn treatment and seeking specialized wound care can decrease the burden of burn related morbidity to a great extent. Below, she answers a few pertinent questions on the identification of serious burns, importance of treatment, apt first aid response, and preventing infections.

How do we identify serious burns?  Which are the ones requiring medical attention?

• Any type of burn in a child less than five-years-old or elderly more than 70-years-old must be taken seriously. 
• The presence of co-morbidities like diabetes, immunocompromised state due to chemotherapy, pregnancy, thyroid disorders, obesity, or kidney issues can quickly escalate a simple-looking burn injury into a serious infection.
• The presence of other injuries like lacerations, crush injury, or bruising also warrants attention.
• The surface area involved in a burn injury is to be paid close attention to. As a thumb rule, any burn wound of size more than five percent of body area should be immediately shown in the emergency room. 
• Burns occurring in enclosed spaces associated with a lot of smoke require immediate attention as they maybe having associated inhalational injury which can be fatal if not identified in time. 
• 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. 

What is the adequate first aid response to burns?

Adequate cooling
As burn injuries are common, several anecdotal treatments exist for its cure. These include the application of toothpaste, potato peels, wheat flour, rice water, ink, turmeric, and so on. Such' treatments' 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 five percent then it is best to approach a doctor who will assess the depth of the burn and treat it accordingly. 

How can we prevent infections?

Skin is the protective covering that prevents various micro-organisms from entering our bodies. Burns cause breakage in this protective mechanism. A fresh burn is sterile and if controlled with an advanced protective dressing immediately does not require the 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 specialised dressings. For minor burns use any antiseptic ointments, which work as both emollients and for the prevention of infections.

Modern medicine has allowed the 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. 

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