A burn is a tissue injury from thermal heat or cold application or from the absorption of physical energy or chemical contact.
Burns are classified as follows:
- Scalds: Result from partial-thickness or deep dermal skin loss.
- Fat burns: Usual full-thickness skin loss.
- Flame burn: Patches of partial and full thickness.
- Electrical burns: Full thickness with deep extensions.
- Cold injury: Ice formation, tissue freezing, vasospasm.
- Friction burns: Heat plus abrasion.
- Ionising radiation: Early tissue necrosis, late or tissue dysplastic change.
- Chemical burn: Inflammation, tissue necrosis, systemic effects.
Burn depth depends, in thermal injury upon:
- The temperature of the burning agent.
- The mode of transmission of heat.
- The duration of the contact.
Superficial burns
The have the ability to heal themselves by epithelisation above. Epidermal burns look red, are painful, blisters are not present, and they heal rapidly without sequel. Superficial dermal burns are, blistered and painful they should by epithelisation within 14 days without scarring, but sometimes leave long-term pigmentation changes.
Deep burns
These have lost all adnexal structures and if left can only heal by second intention with scarring they may be blistered and have a blotchy red appearance with no capillary return on pressure and absent sensation on pinprick.
Effect of burn injury
Local effects
- Tissue damage: cell necrosis or direct cell rupture.
- Inflammation: cellulitis.
- Infection: by Beta haemolytic streptococci, Septicemia, Bacteremia.
Regional problems in burns
- Circulation: Damage to limb vessel in high tension electrical burn causing oedema and leads to venous obstruction.
Systemic Effects
- Fluid loss.
- Multiple organ failure of renal or hepatic function or heart failure.
- Inhalation injury: inhalation of products of combustion or a hot gas causes thermal burn to various part of upper respiratory track and chemical burn to the bronchial tree and lungs.
- Systemic complications: occurs in association with burns such as Curling’s (gastric or duodenal) ulcer that may result in acute haematemesis, urinary tract infection, deep vein thrombosis, pulmonary embolism, septic complications.
Clinical Features of Burn Injury
- Pain: immediate, acute and intense in superficial burns. Little pain in deep burns.
- Acute anxiety: severe at the time of injury.
- Fluid loss and dehydration: tachycardia from fluid loss
- Local tissue oedema: superficial burns with blisters and deeper burns develops oedema in subcutaneous spaces.
- Special sites: Eyes may be involved in explosion injury or chemical burns and nasal airway, mouth and upper airway in inhalation injury.
- coma
Management
General Management
First aid:
- Stop the burning process.
- Cool the burned surface immediately for 20 minutes.
- Emergency examination performs the order of priorities in the management of a major burn injuries.
A – airway maintenance
B – breathing and ventilation
C – circulation
D – disability, neurological status
E – exposure and environment control – keep warm
F – fluid resuscitation
Homeopathic management
Homeopathy is very good for stimulating and speeding up the body’s healing process in cases of acute trauma and wounds. This is partly because the right remedy can help to remove the shock from the person and therefore the body’s energy forces are freed up to just get on with the physical stages of repair. Therefore, the quicker the homeopathy is administered, the better the response will be over the long-term. There are remedies for both the initial and long-term stages of healing that alleviate the pain and help the tissues to repair. They will also help prevent infections as the burns heal. Unless specifically mentioned, these remedies should be taken internally rather than in a cream form.
Homeopathic remedies
Cantharis
If used early it will prevent the formation of blisters. This is the most used remedy for scalds, burn and sunburns with vesicular character, blisters and superficial ulceration. Small blisters coalesce to form large blisters. Burns and scald with rawness and burning > by cold applications, followed by undue inflammation. Tetanic or epileptiform convulsions followed by coma. Extensive burns cause a renal complication. Patient is < by touch, approach and > rest. Use internally and externally in lotion.
Urtica Urens
It is mostly used in first degree burns confined to superficial skin. The redline symptom for using Homeopathic remedy Urtica Urens is burning and stinging pains in burnt skin. The skin is intensely red, swollen with burning and stinging pains. Urtica Urens helps in providing relief from the burning-stinging pains very promptly and helps in quick recovery. Urtica Urens is considered one of the top Homeopathic medicines for the treatment of first-degree burns.
Calendula
This remedy is useful for minor superficial burns caused by fire or the sun. Calendula also prevents gangrene and promotes granulation as well as prevents disfiguring scars. Prevents loss of blood and excessive pain. It is a good remedy to use to promote healing after specific acute remedies have removed the shock, pain and immediate symptoms. Use this remedy internally in potency and externally as a lotion.
Causticum
The ideal Homeopathic remedy for burns that are very slow to heal. Causticum is of great help in hastening the healing process in burns cases. Persons who can greatly benefit from natural Homeopathic medicine Causticum have a major complaint of rawness, excessive soreness and pain in the burnt area. Causticum also helps to speed up the recovery of burns and soothes the soreness and pain in the affected area. Another important field for using Causticum in burns is reopening of burns that had occurred long ago. Causticum is also the best Homeopathic medicine for all those cases where the person complains of soreness and pain in old healed burns. Causticum thus can be used in two fields of burns cases: when the burns are slow to recover and when old burns surprisingly freshen up, leading to pain and soreness.
Arnica
This is the key to the locked-up healing process in case of shock from burn and also in alleviating the pains. It may lead the healing leaving no requirement for any other medicines. In case of burns its best used internally rather in external forms.
Arsenic album
Deep burns with vesicles and infected flesh that turn black showing tendency towards gangrene, Inflammatory swelling, with burning, lancinating pains. Infection from dead tissue remaining in the wound great anguish and restlessness, changes place constantly. Fents death and being left above. Thinks it is useless to take medicine. Prostration which may seem out of proportion with the situation colic after severe burn.