BURNS

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Last Updated : 2/15/2011
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Ira Shah
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Treatment of burns
First degree or superficial burns heat naturally. Deep second degree and full thickness burns require skin grafting for rapid healing and minimum scarring and generally require hospital care. In addition supportive therapy like fluids, blood infusion and pain medication is required. In some patients, the burn may lead to intolerable and excruciating pain for which even lV morphine may be required. For first degree burns and open wounds, topical creams like silver sulfadiazine and bacitracin may be applied. Often dressings may be applied.

Treatment of skin discoloration that occurs with healing
UV protection is required for 12-18 months post burn and these patients should apply sunscreen lotion when going out in the sun. Camouflage cosmetics to cover the burns can be used. Hair coloring products can be used 6 weeks after healing is completed. Permanent products can be used 3 months after healing.

Skin Grafting
Skin grafting consists of excision or removal of burnt devitalised tissue, removal of healthy skin from a donor site to cover the cleaned burnt area. An instrument (dermatome) gently shaves a piece of skin about 1/100 of an inch thick from the healthy skin and that skin is grafted over the burnt area. Skin can also be used from dead people (cadavers).To help the graft become secure, the area of the graft is immobilized for at least 5 days and later normal daily activity is started. Skin grafting is usually done under anesthesia.

There are other types of artificial skin grafts available which can temporarily cover the wounds:
- Xenograft or Heterograft: Skin is taken from animals
- Collagen
Meshing is a process by which the donor skin is enlarged to cover a large burnt area when there is not enough healthy skin available. The disadvantage is that it is a less durable graft and leads to more scarring. However, it helps by allowing the blood and body fluids to drain under the graft and thus preventing graft loss and it allows the donor skin to cover a great burnt area.

Grafts are held in place with surgical staples or stitches. Once the graft usually becomes stable within 4-5 days, the staple/stitches are removed.

What happens to the donor site from where the skin is removed?
Although the skin taken from the donor site is very thin, it can cause scarring and pigmentary changes at the donor site.

How does exercise help a burn patient?
Exercise helps the body heal better. It helps a burn patient to regain independence.



Contributor Information and Disclosures Ira Shah
Consultant Pediatrician, B.J.Wadia Hospital for Children, Mumbai, India


First Created : 2/28/2001
References
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