How should I treat a burned hand?
Burns and scalds
Most often occur Burns at home, for example with the iron, or at leisure, e.g. B. when grilling or any other contact with an open fire. Burns can also be caused by electric current (electrical accidents), by friction (e.g. sliding with bare skin on dry slides) and by contact with extremely cold objects (e.g. with liquid nitrogen; this is also referred to as cold burns).
The consequences of a burn or frostbite depend primarily on its severity and depth.
Georg Thieme Verlag, Stuttgart
Of Scalds one speaks when hot liquids or vapors act on the skin and damage it.
Burns are (like frostbite) in three degrees of severity or severity. Degrees of depth assigned. The extent of the burns also plays a role. You use that Rule of nine, in which the body surface (KOF) is divided into a multiple of 9: head / neck and arm each correspond to 9% of the KOF, leg, torso in front and torso back to 18% of the KOF each. The palm of the injured person corresponds to 1% of the head. If more than 20% of the body surface is burned, in children 5%, the burn wound must be treated in a hospital.
The skin has poor thermal conductivity. At high temperatures it is not able to distribute heat evenly, which is why the tissue is damaged. Burns on the body surface that exceed a certain level not only have consequences for the person concerned at the burned area. There is a risk of volume deficiency shock and blood poisoning (sepsis), combined with the loss of function of organs that were initially completely uninvolved (e.g. acute kidney failure). For this reason one speaks of the Burn disease. This is not always treatable even with optimal intensive medical therapy.
Signs and complaints
- 1st degree burn: reddening of the skin, discreet swelling, pain (heals without scars or consequences)
- 2nd degree burn: reddening of the skin, blistering, severe pain (only sometimes heals without scars)
- 3rd degree burn: gray, white or black skin, no pain sensation in the burned skin or body part, since the nerve cells of the skin are destroyed (only heals with scarring, larger defects must be closed with plastic-surgical skin transplants.
First aid measures
Immediate action. Immediately stop the heat supply by pouring water over the person, wrapping them in blankets or rolling them on the floor. Scalded and burned clothing should be removed quickly from the affected areas of the skin, provided that they are Not is stuck to the skin - do not tear off pieces stuck to the skin! Cool the affected parts of the body (not the entire patient) with plenty of running cold water; tap water at a temperature of 10–15 ° C is sufficient, but sterile saline solution would be optimal. Cooling with ice, ice water or packs will do Not recommended; it takes longer for it to work and there is also a risk of cold damage.
Further rules for correct cooling: Cool especially carefully with infants and children. Only start cooling within the first 15 minutes and then do not continue for more than 10 minutes. It is important that the person concerned does not cool down. Smaller burns are continuously cooled until the pain subsides. Second or third degree burns, in which more than 20 percent of the skin is burned, are not cooled - as this affects the body's heat regulation and threatens hypothermia.
Burn wounds should best be covered with metallized foil - alternatively with sterile, moist cloths. Ointments, oils, powders or similar household remedies must not be applied to the wound. Burn blisters should also not be opened because they are a natural protection against invading bacteria.
When to the doctor
The degree of burns and the general condition of the person concerned depend on whether the emergency doctor has to be called to have the person transported to the hospital - or whether an appointment with the family doctor is sufficient.
- Most first-degree burns and even single burn blisters can be treated at home without any problems. If they affect the face or genitals and you are not sure whether the burns are really only first-degree burns, contact the emergency services.
- In the case of second-degree burns - the bottom of the wound looks whitish here - you should see a doctor if blisters form in several places, especially if more than 2-3% of the body surface is burned or scalded. Specialist treatment can counteract the formation of aesthetically and functionally unfavorable scars by having the doctor surgically clean the wounds or even carry out skin grafts.
- If more than 10% of the body surface is affected, this generally requires inpatient treatment.
- All third-degree burns (i.e. if the burned area is black or white and numb) must be treated by a doctor immediately.
- You should also consult a doctor if you have inhaled hot smoke.
Above all, the healed wound should not be exposed to solar radiation. This only damages sensitive skin and leads to unsightly pigmentation. In the case of burns on the face and hands, sun protection should be supported by creams with a high sun protection factor and the like. Intensive skin care is generally recommended.
AuthorsDrs. Med. Katharina and Sönke Müller; Dr. med. Arne Schäffler | last changed on at 11:03
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