Immediate Treatment Of Burns Leads To Better Outcomes

Health Minute     Fall 2017

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A critical countdown begins the minute a person sustains a burn to their skin because the next 72 hours will ultimately decide its outcome.

Burn specialist Travis Perry, MD, says people often underestimate a burn’s ability to harm their body. He explains that it’s common think that the injury you see immediately after being burned is the extent of your injury long-term. Science proves this thinking wrong. A burn can actually morph and deepen up to 72 hours after your initial incident.

“Individuals need to understand that immediate medical evaluation of a burn is critical because once a patient sustains a burn injury we are on a timeline,” Dr. Perry says. “How soon the burn process is stopped and how quickly a person gets specialized medical care determines the physiological, functional, and cosmetic outcomes of the injury.”

Dr. Perry explains why it’s important to seek medical attention for a burn. 

Click play to watch the video or read video transcript.

Degree Of Burns

The degree of a burn is diagnosed through a clinical exam conducted by a specialist, and is often determined by the level of skin that is involved. First-degree burns are superficial burns that involve only the top layer of skin, the epidermis. Second-degree burns involve the dermis – the thick layer of living tissue below the epidermis that forms the true skin, and in which lies blood capillaries, nerve endings, sweat glands, and other structures.

Third-degree burns involve the fatty tissue underneath the epidermis, and fourth-degree burns involve the deeper structures including tendons, muscle, and bone. Fourth-degree burns are most common in patients who have electrical injuries, Dr. Perry explains. Diagnosis of a burn is a process that involves observation up to 72 hours after the incident.

Dr. Perry explains the various degrees of burns. 

Click play to watch the video or read video transcript.

“Patients may come in with what appears to be a superficial, second-degree burn, but because of the natural progression of a burn injury, microscopically it could end up being a third-degree burn with a 72-hour timeframe,” says Dr. Perry.

Flame burns and scald burns are the two most commonly seen. Flame burns are common in young adults, especially young males who tend to be engaged in risky activity. Scald burns are common among young children and older adults. Children’s burns are caused by immature judgment, while older adults may experience burns from accidents as a result of medical issues such as a cardiac event, Dr. Perry explains.

Dr. Perry says knowledge is critical in properly treating a burn:

  • Know the look. There are specific characteristics of burns that should always be evaluated by a specialist. Any burn that is larger than a quarter, forms blisters, is dry or tender to the touch, is firm, or is surrounded by a large ring of redness needs medical attention. Such characteristics signal the burn is equal to a second-degree burn.
  • Seek advice when in doubt. Those who think they are in the clear because their burn has not penetrated the first layer of skin shouldn’t be so quick to relax. It is possible for some first-degree burns – such as a bad sunburn – to convert to second-degree burns. 
  • It’s a race against time. Seeking medical attention for burns as fast as possible is extremely important. Burns that convert to the second-degree stage or beyond are more susceptible to infection. You have 72 hours to seek medical attention for a burn in order to obtain the best outcomes of care.
  • Wives’ tales are harmful. There are misconceptions about how to treat burns that can actually do significant harm. Applying grease and butter to a burn, for instance, can expose the skin to bacteria and infection. And the idea that placing your burn in cold or freezing water will stop the pain and progression of the burn actually do the exact opposite.

“Submerging a burn into ice water actually causes the burn to go much deeper into the skin while causing the small blood vessels that supply that skin to clot off,” Dr. Perry says. “The skin no longer receives the nutrients, oxygen and blood supply that it needs and ultimately dies off. I can still remember when I was a kid one of the beliefs was that it was good to let a burn ‘air out.’ However, a burn needs the right amount of moisture and humidification to heal. Drying it out impedes the healing process.”

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Travis L.

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