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Burns: Quick guide

Posted by Erum Ilyas on
Burns: Quick guide

The most common reasons for a kitchen burn would be direct contact with a heated surface such as a pot or the inside of an oven, hot fluids, and steam. These are by far and away inadvertent in that there is accidental contact in addition to potential spills.

 

Examples:
-Contact with a hot surface such as a pot or the inside of an oven: lifting the top off a pan and realizing its way too hot or taking cookies out of the oven and accidentally touching the side of the oven 
-contact with hot fluids: pouring out spaghetti into a strainer and accidentally having boiling water splash
- contact with steam: opening the lid while food is cooking and having the steam burst up too quickly.
 
1st degree:
Bright red changes to surface of skin, exquisites sensitive. No skin breakdown
2nd degree:
Redness and swelling of the skin, blistering and pain 
3rd degree:
Key distinguishing feature is numbness not pain- these have gone so deep as to affect the nerve endings. The skin can be charred and even whiten in some areas

 

Management:
1st degree:
These are superficial. As soon as the burn occurs the very first step is to cool the skin quickly. Cool compresses or immersing in cold water quickly will help stop the burn from worsening. After this immediate period of time applying petroleum jelly a few times a day will help the skin heal quickly. This cannot be applied immediately after a burn- only after it has cooled . (  https://www.aad.org/public/skin-hair-nails/injured-skin/burns since I know there is conflicting info in the public about this). And,    taking acetaminophen for pain is helpful
2nd degree
Same as for first degree, however these will require bandaging as well. Applying petroleum jelly or antibiotic ointments with a non stick dressing such as telfa and paper tape to hold in place will help. It is worth seeing a doctor to make sure antibiotics are not necessary as these burns are deeper and at higher risk for infection
3rd degree
All of the above as for second but this will require the attention of your doctor. Given the full thickness burn, healing may require debridement (removal of dead tissue) and potentially a skin graft
Healing time:

First degree: 1-3 weeks
Second degree: 2-4 weeks
Third degree : these will heal along the edges in a few weeks but there will definitely be scarring. 
Scarring? 
For first and second degree burns: if managed  appropriately as outlined above these do not usually scar. There may some changes in pigmentation afterwards for second degree burns but this can be avoided by keeping them moist and covered while healing
Third degree burns will always leave a scar as they are full thickness and even if grafted the skin will not appear the same after 
Following the above steps and avoiding scabbing or crusting in the wound as it heals as this impairs healing. So much so that if a scab forms, often these have to be removed (escharectomy) to promote wound healing. I remind my patients that our skin heals like a purse string from the outside in and requires a moist environment to promote wound healing with minimal scarring.
**only other note is to keep in mind extent of burn as this will impact healing and need for medical attention 

 

 

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