The best first-aid for any burn injury is to cool the area immediately as it limits the heat-damage both in area and depth. For common domestic burns, ice or water are easily available solutions. Keep the injured area under running water or apply ice directly over the area for a few minutes. Even in most chemical burns like acids, water will dilute the concentration and limit the depth of injury. Remember, preventing infection is a priority. Isolation, antiseptic dressings, antibiotics and good nutrition will help. Neosporin ointment is a simple antibiotic cream useful as a home remedy.
Classifying the Degree of Burns
A red area coupled with severe pain usually indicates a first degree burn. Paradoxically the most superficial ones are the most painful. Full thickness burns are almost painless as the nerve endings in the skin are destroyed. A raised bleb containing fluid indicates a second degree burn while black depressed areas without sensation are third degree burns.
Treating and Healing Burns and Scars
Though first aid is the same for all burns — cooling, cleaning, covering — with severe burns, a proper plastic surgical opinion is necessary.
Collagen and other artificial wound covers are used in second degree burns as they reduce pain, hasten healing and reduce the risk of infection and fluid loss.
First degree and some second degree burns heal without any residual deformities. Deep second degree and third degree burns and burns with infection will lead to scarring. Surgical treatment is necessary for contractures and major scars while minor scars can be treated by pressure therapy, creams and sometimes, by laser.
What to Avoid
Old-wives’ remedies like cream, ink, turmeric and vinegar are to be avoided as home remedies.
Extreme Cases
In explosions, accidents in closed spaces and some chemical burns, inhalation of the fumes produce lung injury. It is a very serious complication and often leads to death. In such cases, patients need aggressive management with steroids and ventilators. A seriously injured patient with lot of scarring is unlikely to ever attain pre- injury appearance. In most other cases, considerable improvement is possible.
The writer is senior consultant, cosmetic and plastic surgeon, Apollo Hospitals.