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Burn

This article is about the injury. For other uses, see Burn (disambiguation).

Burn
Second-degree burn of the hand
SpecialtyDermatology, critical care medicine, plastic surgery[1]
SymptomsFirst degree: Red without blisters[2]
Second degree: Blisters and pain[2]
Third degree: Area stiff and not painful[2]
Fourth degree: Bone and tendon loss[3]
ComplicationsInfection[4]
DurationDays to weeks[2]
TypesFirst degree, second degree, third degree,[2] fourth degree[3]
CausesHeat, cold, electricity, chemicals, friction, radiation[5]
Risk factorsOpen cooking fires, unsafe cooking stoves, smoking, alcoholism, dangerous work environment[6]
TreatmentDepends on the severity[2]
MedicationPain medication, intravenous fluids, tetanus toxoid[2]
Frequency67 million (2015)[7]
Deaths176,000 (2015)[8]

A burn is an injury to skin, or other tissues, caused by heat, cold, electricity, chemicals, friction, or ionizing radiation (such as sunburn, caused by ultraviolet radiation).[5][9] Most burns are due to heat from hot liquids (called scalding), solids, or fire.[10] Burns occur mainly in the home or the workplace. In the home, risks are associated with domestic kitchens, including stoves, flames, and hot liquids.[6] In the workplace, risks are associated with fire and chemical and electric burns.[6] Alcoholism and smoking are other risk factors.[6] Burns can also occur as a result of self-harm or violence between people (assault).[6]

Burns that affect only the superficial skin layers are known as superficial or first-degree burns.[2][11] They appear red without blisters, and pain typically lasts around three days.[2][11] When the injury extends into some of the underlying skin layer, it is a partial-thickness or second-degree burn.[2] Blisters are frequently present and they are often very painful.[2] Healing can require up to eight weeks and scarring may occur.[2] In a full-thickness or third-degree burn, the injury extends to all layers of the skin.[2] Often there is no pain and the burnt area is stiff.[2] Healing typically does not occur on its own.[2] A fourth-degree burn additionally involves injury to deeper tissues, such as muscle, tendons, or bone.[2] The burn is often black and frequently leads to loss of the burned part.[2][12]

Burns are generally preventable.[6] Treatment depends on the severity of the burn.[2] Superficial burns may be managed with little more than simple pain medication, while major burns may require prolonged treatment in specialized burn centers.[2] Cooling with tap water may help pain and decrease damage; however, prolonged cooling may result in low body temperature.[2][11] Partial-thickness burns may require cleaning with soap and water, followed by dressings.[2] It is not clear how to manage blisters, but it is probably reasonable to leave them intact if small and drain them if large.[2] Full-thickness burns usually require surgical treatments, such as skin grafting.[2] Extensive burns often require large amounts of intravenous fluid, due to capillary fluid leakage and tissue swelling.[11] The most common complications of burns involve infection.[4] Tetanus toxoid should be given if not up to date.[2]

In 2015, fire and heat resulted in 67 million injuries.[7] This resulted in about 2.9 million hospitalizations and 176,000 deaths.[8][13] Among women in much of the world, burns are most commonly related to the use of open cooking fires or unsafe cook stoves.[6] Among men, they are more likely a result of unsafe workplace conditions.[6] Most deaths due to burns occur in the developing world, particularly in Southeast Asia.[6] While large burns can be fatal, treatments developed since 1960 have improved outcomes, especially in children and young adults.[14] In the United States, approximately 96% of those admitted to a burn center survive their injuries.[15] The long-term outcome is related to the size of burn and the age of the person affected.[2]

  1. ^ "Burns - British Association of Plastic Reconstructive and Aesthetic Surgeons". BAPRAS.
  2. ^ a b c d e f g h i j k l m n o p q r s t u v w x y Tintinalli, Judith E. (2010). Emergency Medicine: A Comprehensive Study Guide (Emergency Medicine (Tintinalli)). New York: McGraw-Hill Companies. pp. 1374–1386. ISBN 978-0-07-148480-0.
  3. ^ a b Singer A (June 2007). "Management of local burn wounds in the ED". The American Journal of Emergency Medicine. 25 (6): 666–671. doi:10.1016/j.ajem.2006.12.008. PMID 17606093.
  4. ^ a b Herndon D, ed. (2012). "Chapter 3: Epidemiological, Demographic, and Outcome Characteristics of Burn Injury". Total burn care (4th ed.). Edinburgh: Saunders. p. 23. ISBN 978-1-4377-2786-9.
  5. ^ a b Herndon D, ed. (2012). "Chapter 4: Prevention of Burn Injuries". Total burn care (4th ed.). Edinburgh: Saunders. p. 46. ISBN 978-1-4377-2786-9.
  6. ^ a b c d e f g h i "Burns". World Health Organization. September 2016. Archived from the original on 21 July 2017. Retrieved 1 August 2017.
  7. ^ a b Vos T, Allen C, Arora M, Barber RM, Bhutta ZA, Brown A, et al. (October 2016). "Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015". The Lancet. 388 (10053): 1545–1602. doi:10.1016/S0140-6736(16)31678-6. PMC 5055577. PMID 27733282.
  8. ^ a b Wang H, Naghavi M, Allen C, Barber R, Bhutta Z, Carter A, et al. (October 2016). "Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015". The Lancet. 388 (10053): 1459–1544. doi:10.1016/S0140-6736(16)31012-1. PMC 5388903. PMID 27733281.
  9. ^ Moore K (2014). Clinically Oriented Anatomy (7th ed.). Lippincott Williams & Wilkins. p. 45. ISBN 9781451119459.
  10. ^ "Burns Fact sheet N°365". WHO. April 2014. Archived from the original on 10 November 2015. Retrieved 3 March 2016.
  11. ^ a b c d Granger J (January 2009). "An Evidence-Based Approach to Pediatric Burns". Pediatric Emergency Medicine Practice. 6 (1). Archived from the original on 17 October 2013.
  12. ^ Ferri FF (2012). Ferri's netter patient advisor (2nd ed.). Philadelphia, PA: Saunders. p. 235. ISBN 978-1-4557-2826-8. Archived from the original on 21 December 2016.
  13. ^ Haagsma JA, Graetz N, Bolliger I, Naghavi M, Higashi H, Mullany EC, et al. (February 2016). "The global burden of injury: incidence, mortality, disability-adjusted life years and time trends from the Global Burden of Disease study 2013". Injury Prevention. 22 (1): 3–18. doi:10.1136/injuryprev-2015-041616. PMC 4752630. PMID 26635210.
  14. ^ Herndon D, ed. (2012). "Chapter 1: A Brief History of Acute Burn Care Management". Total burn care (4th ed.). Edinburgh: Saunders. p. 1. ISBN 978-1-4377-2786-9.[permanent dead link‍]
  15. ^ "Burn Incidence and Treatment in the United States: 2012 Fact Sheet". American Burn Association. 2012. Archived from the original on 21 February 2013. Retrieved 20 April 2013.

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