White coating on the burn

Exposure to high temperatures or contact with caustic chemicals can cause serious damage to the skin, causing burns.

Such injuries often occur to children due to negligence or in domestic conditions. Everyone needs to know how to provide first aid and what medications to use to treat inflammation after a burn.

Inflammation after a burn: causes

In conditions of active industrialization, cases of burns at work and in the domestic environment have increased significantly. According to the World Health Association, burns are the third most common injury. Often the inflammatory process after burns ends in death or makes a person disabled for life.

The inflammatory process is a dangerous complication of trauma. It can be obtained as a result of the main causes of inflammation after a burn: exposure to flame, light radiation, hot liquid, steam or heated air. The development of large areas of burn blisters is a sign of a serious problem. If improper therapeutic treatment is carried out, an infection will occur that can threaten a person’s life.

Suffering a burn, as a rule, entails complications in the form of inflammation. This occurs due to the development of viruses and bacteria in the affected areas.

Under normal conditions, hundreds of different microorganisms live on the skin, so after suffering a burn, the bubble that appears can already be attributed to the source of inflammation. In addition, the infection enters the site of inflammation from the external environment and sweat glands.

Characteristics of inflammation after a burn, symptoms for different degrees of damage

Burns vary in severity. Depending on the damage received, inflammation is characterized by certain symptoms and can lead to various complications.

The main characteristics of inflammation in burns of various degrees are identified:

1) The upper layer of the epidermis is damaged, redness and minor swelling appear on it. The inflammation goes away in a few days and leaves no traces. These symptoms are typical for first degree burns.

2) Blisters form on the affected area of ​​the skin. With proper therapy, healing of the inflamed areas is possible within two weeks. This course of the inflammatory process is typical for second degree burns.

3) Inflammation on the skin is accompanied by the death of tissue cells. A dry crust appears in this area, and wound healing occurs very slowly. Such serious complications are typical for the third stage of burns.

4) The inflammatory process affects not only the upper layers of the epidermis, but also affects muscles, bones and subcutaneous tissues. Such symptoms require urgent hospitalization.

Any inflammatory process has three phases of development.

During the first phase the burn blister turns into a purulent state. As a result of the development of inflammation, a vascular network appears around the bladder and painful sensations occur.

Second phase characterized by granulation. The burn bladder is cleared of pus and the healing process begins. If the wound becomes infected at this stage, the whole process will return to the first phase.

Third phase involves the formation of new cells at the burn site. At this stage, it is important to prevent the appearance of cracks in the wound, so as not to re-infect the wound.

The location of the inflamed burn wound is of serious importance. If areas of the skin in the face or neck are damaged, there is a risk of inflammation and swelling, which can cause breathing problems. When the affected tissues in the chest area become inflamed, pain may occur during breathing movements. The result of this may be a disruption of the normal blood supply to the burned areas of the body, which will lead to the need to seek the help of medical specialists.

Providing first aid for symptoms of inflammation after burns

If symptoms of inflammation appear after a burn, first aid must be provided. It consists of performing simple manipulations:

- stop the process of skin burning by using water, a towel or any natural fabric;

- remove all hot things and objects (clothing, etc.) from the skin;

- to relieve pain, place the affected area under cold water or wrap the area with a towel soaked in water, which is changed periodically;

- remove compressive objects (rings, watches, bracelets) from the body before swelling appears;

- cover the inflamed area of ​​skin with a sterile dry gauze bandage;

— create comfortable conditions for the victim until the doctor appears and prescribes a course of treatment for inflammation after a burn.

Treatment of inflammation after a burn

There are basic measures that help reduce the threat to the epidermis with blisters after a burn:

1) Cleansing damaged skin from purulent formations and dead cells. It is produced with the utmost care so as not to injure living cells of the epidermis. In this case, the infected post-burn bladder is opened. This procedure must be performed by a doctor.

2) Applying antiseptics to the affected area to destroy the infection in the bladder.

3) Providing favorable conditions for the appearance of new epidermal cells in the area of ​​the burn bladder. To do this, a hydrophilic ointment base is applied to the inflamed areas of the skin. It protects the wound from drying out and damage by the drying dressing. In addition, the burn bladder must be sufficiently saturated with oxygen, so the therapeutic agents should not form a greasy film.

These approaches to the treatment of the inflammatory process after a burn prevent the formation of infection in the wound and ensure its healing as soon as possible. When the wound has already become infected, these measures will help to achieve rapid cleansing of the epidermis, getting rid of microbes and the formation of new cells. At the same time, the risk of scar formation after burn inflammation is minimized.

It is desirable that one product for external use on areas of inflammation after a burn meets the following requirements:

– protects wounds from dryness, cracks and injury;

- fights infectious bacteria and viruses;

— does not form a greasy film, has hydrophilic properties.

As an example, we can recommend argosulfan and dermazin - products that have all the characteristics listed above. They contain silver, which has an antiseptic effect. These drugs protect the wound from germs and viruses.

Also popular drugs for the treatment of inflammation after a burn are:

1) Ointments, which are used mainly for thermal burns of the skin. For example, procelan, which has bactericidal properties and promotes wound healing.

2) Povignon-iodine has a disinfecting property and accelerates the regeneration of skin cells.

3) Panthenol, levomekol also help in eliminating infection and accelerating the skin recovery process. Prevents the formation of scars.

4) “Rescuer” balm consists of natural ingredients and is used as a restorative agent for inflammatory formations in burn areas.

New products for the care of skin inflamed from burns include special antiseptic dressings, which are impregnated with a special medicinal composition. Similar components are included in gels such as kvotlan, no burns, and appolo. They have a disinfecting effect and heal the epidermis. Gels will help cleanse the wound of dead cells and eliminate suppuration.

Precautions during the elimination of inflammation after a burn and its treatment

If an inflammatory process develops as a result of the resulting burns, certain precautions should be taken so that the victim’s condition does not worsen. There is no need to puncture the resulting blister. Do not apply oil, cosmetic cream, or scented lotion to the affected area of ​​skin. Avoid using adhesive tapes and other sticky dressings.

By following all recommendations and precautions, you can significantly shorten the recovery process from injuries and avoid the development of unwanted complications.

In dark red skin parchment density (in place of former blisters), the upper layers of the skin itself have the appearance of compact tissue of a yellowish, greenish or brownish color, with an almost indistinguishable fibrous structure. Elastic fibers are not identified here. The papillae are mostly smoothed; accordingly, groups of deformed connective tissue nuclei and collapsed capillaries are sometimes distinguished.

IN surviving, but in sharply flattened papillae, in place of the capillaries, a homogeneous mass of yellow-orange or greenish color is visible; the endothelium is usually not detected. In the deep sections of the skin itself, collagen fibers are thickened, homogenized, many of them are straightened parallel to the surface of the skin and brought closer together, and have a basophilic appearance.

Therefore the quantity cores connective tissue cells appear reduced. Elastic fibers are thickened and fragmented. The sebaceous and sweat glands are wrinkled, the cell nuclei are deformed, in the hair sheaths the cell nuclei often take on the appearance of streaks and are intensely colored. Dilated vessels are common; in their lumen there is a red or green-brown homogeneous mass. Hemorrhages are found rarely, mainly near skin derivatives.
They look like brown spots colors, in which the contours of red blood cells are not determined.

In the subcutaneous fatty tissue Severe vascular congestion, hemorrhages and blood clots are observed. Small hemorrhages are found near the vessels, large ones - at the border with the skin itself. The spilled blood is brick-red in color. red blood cells are contoured weakly and only along the periphery of the hemorrhage.

In small vessels meet hyaline and mixed blood clots; in the wall of blood vessels one can see splitting and fragmentation of elastic and argyrophytic fibers. Uneven impregnation and flask-shaped thickenings are noted in the nerves of the subcutaneous fatty tissue. In striated muscles, changes are insignificantly expressed.

In the first hours after burn of the second degree, reactive processes develop: the plethora of blood vessels in the skin and subcutaneous fatty tissue increases, leukocytes appear and their number increases not only in the contents of the bladder, but also in the thickness of the epidermis and in the skin itself near the vessels.

By the end of the first day infiltration leukocytes of the papillary layer is clearly expressed. At the same time, edema develops, first in the subcutaneous fatty tissue, then in the reticular layer. On the 2-3rd day, demarcation inflammation is detected. The beginning of epithelization of the burn surface is noted at the edges of the bladder by the ingrowth of strands of epithelial cells under the leukocyte shaft.

Microscopic picture of a third degree burn characterized by two forms: a combination of necrobiotic and necrotic processes or a pure form of necrosis as a consequence of the fixing effect of high temperature (Naumenko V. G., 1955). The first form requires a certain period of time for its development and is observed under relatively gradual action of the temperature factor, the second form indicates a direct and, apparently, simultaneous thermal effect of significant intensity.

At the site of the first burn epidermis in areas where it is preserved, it is thinned. Under low microscope magnification, it looks like a structureless wavy brown ribbon. Under high magnification, the contours of the compact stratum corneum and the crimson or blue color of the granular layer, as well as the outlines of individual cells of the spinous layer, can sometimes be distinguished.

In some areas, cell contours spiny and basal layers are better preserved, the cytoplasm in them is cloudy, granular, the nuclei are enlarged, pale colored. Karyorrhexis and marginal hyperchromatosis are rarely observed. In the skin itself, necrotic and necrobiotic changes are similar to those observed in red parchment-dense skin at the site of burn blisters. However, the degree and depth of their distribution are more pronounced.

For first degree burns, the characteristic symptoms are diffuse redness and moderate swelling of the skin, appearing a few seconds after a burn with flame, boiling water, steam, or several hours after exposure to sunlight.

Severe burning pain is noted in the affected area. In typical cases, after a few hours, and more often within 3-5 days, these phenomena disappear, the damaged epidermis sloughs off and the skin acquires its normal structure. Sometimes a slight pigmentation remains at the burn site.

The clinical picture of second degree burns is quite typical. Their distinctive feature is the formation of bubbles. Bubbles form immediately or some time after exposure to a thermal agent. If the integrity of the exfoliated epidermis is not violated, then the size of the blisters gradually increases during the first two days. In addition, during these two days, bubbles may form in places where they were not present during the initial examination. The contents of the bubbles are initially a clear liquid, which then becomes cloudy. In typical cases, after 2-3 days the contents of the bubbles thicken and become jelly-like. After 7-10 days, the burns heal without scarring, but redness and pigmentation may persist for several weeks. Sometimes suppuration is possible in the blisters: in these cases, the liquid filling the blisters becomes yellow-green. In addition, an increase in swelling of the tissue surrounding the burn and an increase in redness are simultaneously noted. To a greater extent than with first-degree burns, with second-degree burns, redness, swelling and pain are expressed.

Third degree burns are generally characterized by the formation of a scab. With IIIa degree burns, blisters may also form.

For IIIa degree burns, two types of scab form: superficial dry light brown or soft and whitish gray. With dry necrosis, the skin is dry, dense, brown or black, insensitive to touch, with curls of sliding and burnt epidermis. With wet necrosis, which most often occurs under the influence of boiling water or steam, the skin is yellowish-gray, swollen, and sometimes covered with blisters. The loose tissue in the burn area and along its periphery is sharply swollen. Subsequently, demarcation (separation) of dead tissue occurs, accompanied, as a rule, by infection and suppuration. Rejection of the scab usually begins after 7-14 days, its melting continues for 2-3 weeks.

In typical cases, IIIa degree burns, regardless of the area of ​​damage, by the end of 1 - in the middle of the 2nd month they epithelialize due to independent islet and marginal processes.

IIIb degree burns (deep) can clinically manifest themselves in the form of dry (coagulation) necrosis, wet (colliquation) necrosis and so-called skin fixation.

Under the influence of a flame or upon contact with hot objects, coagulation (dry) necrosis develops: In appearance, the affected skin is dry, dense, brown, dark red or black. In the area of ​​large joints, the skin forms rough folds and wrinkles. A characteristic sign of dry necrosis is slight swelling and a rather narrow zone of redness around the lesion.

Dry scab does not change in appearance for quite a long time - right up to the onset of purulent inflammation. The process of recovery under the scab begins already on the 5-6th day, however, the formation of a demarcation shaft (demarcation) and the separation of necrosis zones ends only by the end of the 1st - mid-2nd month, when complete rejection of the scab is observed. Unlike superficial burns, epithelization in deep thermal lesions occurs only due to the marginal process and proceeds slowly, and independent epithelization of deep burns is possible only with very small lesions (no more than 2 cm in diameter).

When scalded (less often when clothes smolder on the body), wet necrosis develops. Dead skin with wet necrosis is pasty, swollen, and the swelling extends beyond the burn surface. Skin color varies from white-pink, mottled to dark red, ashy or yellowish. The epidermis usually hangs down in patches, but occasionally blisters may form. Unlike dry necrosis, with wet necrosis the demarcation line is not so clearly expressed, inflammation spreads beyond the burn wound; The development of granulations in the area of ​​wet necrosis is characteristic. Cleansing of a burn wound with wet necrosis occurs on average 10-12 days earlier than with dry necrosis. With distant (from the Latin distantia - distance) burns that develop from intense infrared radiation, a kind of thermal damage occurs, the so-called “fixation” of the skin. First, with this exposure, the clothing above the burn may not catch fire. Secondly, the burned skin in the first 2-3 days is paler and colder than the surrounding undamaged areas. A narrow zone of redness and swelling forms around the circumference of the lesion. The formation of a dry scab with this type of lesion is observed after 3-4 days.

As the scab is rejected, regardless of the type of necrosis, granulation tissue becomes visible. With positive dynamics of the burn process and adequate therapy, the granulations are bright pink, protrude above the skin level, coarse-grained, the purulent discharge is scanty, and the process of epithelization is noticeable along the edges of the burn wound.

The following signs indicate a negative course of the burn process:

1. granulations are gray, flabby, flat, dry;
2. the surface of the wound is covered with purulent-fibrinous plaque;
3. marginal epithelization slows down or stops.

The most severe burns - IV degree burns - develop most often in anatomical areas that do not have a pronounced subcutaneous fat layer under the influence of a sufficiently long-term thermal effect. In this case, muscles and tendons are successively involved in the pathological process, and then bones, joints, nervous and cartilage tissue.

Visually, IV degree burns can appear:

1. the formation of a dense scab of dark brown or black color;
2. charring and subsequent cracking of a dense and thick scab, through the breaks of which the affected muscles or even tendons and bones are visible;
3. the formation of a whitish scab of relatively soft consistency, formed as a result of prolonged exposure to low-intensity - up to 50 ° C - thermal radiation.

It is typical for IV degree burns that it is almost impossible to accurately determine the future boundaries of muscle necrosis in the first days after injury, which is due to the unevenness of their damage. The development of foci of secondary necrosis of externally unchanged muscles located at a considerable distance from the point of application of heat is possible several days after thermal injury. IV degree burns are also characterized by a slow progression of the burn process (cleansing of the wound from dead tissue, formation of granulations), frequent development of local (primarily purulent complications) - abscesses, phlegmon, arthritis.

Injuries to the respiratory system are observed, as a rule, with deep flame burns of the face, neck and chest. The thermal agent directly affects the mucous membranes of the pharynx, pharynx and larynx, and damage to the trachea, bronchi and alveoli is caused by the action of combustion products. The burned person experiences difficulty breathing, hoarseness of voice, and mechanical asphyxia rarely develops.

Upon examination, the following is revealed:

1. bluish lips;
2. singed nose hairs;
3. edema;
4. hyperemia (redness) and white spots of necrosis on the mucous membranes of the lips, tongue, hard and soft palate, and the back wall of the pharynx.

Subsequently, pneumonia often develops. Damage to the respiratory system due to thermal injuries is equated to an increase in the area of ​​a deep burn by 10-15% of the body surface.