Dermatography

Burns
General

Introduction

Almost all patients with burns have a substantial damage of the skin. The skin is our largest organ and has many important functions.

Skin burns are classified according to their depth of damage to the skin.

Burns develop as a consequence of heat exposure to the skin during a certain exposure time and with a temperature above a critical value (normally 40º C). By a temperature higher than this critical level damaging of the skin takes place.

The burn depth is dependent on:
● the quantity of heat exposed and the time of exposure.
● the cause of the burn: water, other liquids, acids, petrol, fire.

Afhankelijk van de diepte van de wond spreken we van een:
● first degree burn
● second degree burn
● deep second degree burn
● third degree burn

cross-section of the normal skin

After treatment by the GP or admission to hospital or burn centre, many burn patients have often severe psychological traumas. In most cases patients have a clear awareness at the time of the accident. Beyond the treatment of burns can be very painful and take a long time to heal. Burn patients have additional to physical and visible injury also more or less psychological traumata – and in case of children, this is also valid to their parents.

As a result of scientific research and in practice it became clear that many burn patients are unhappy about their treatments and aftercare and have difficulties to find their way to the right aftercare.

About 1/3 of the burn patients are unsatisfied about the treatment and support. In case of burns medical and psychosocial problems often come together. But the way care is offered to these patients does not support this. At the moment the burn injury has healed physically, the care stops, although psychological symptoms tend to occur after the patient is released from hospital.

This can be partly explained by the complexity of the problems that occur in case of burns. The traumatic accident, the long and uncertain stay in the hospital, the confrontation with you own disfigured body, the negative reactions in the environment related to scars, the problems with starting relationships, the reduced chances for employment, long lasting judicial proceedings, etc. are all aspects that can leave deep scars in the mind. Unfortunately, there are only a few medical and social practitioners who recognize this problem in its full breadth and act. Most focus their attention on a sub-problem, for example, only on the processing of the trauma.

This is confirmed by research. 70% of burn patients regret that there is no body that approximates their problems from a multidisciplinary perspective.

More information

Medical links: http://www.brandwonden.nl

first degree burn of the lower leg, caused by the silencer of a motorcycle

second degree and deep second degree burn of the upper leg, petrol burning

deep second degree burn of the foot, boiling water on the instep



Traumata

One of the traumata that burn patients face are the physical and psychological scars.

Regarding the physical scars, mainly the head-, throat- and neckscars as well as scars on the hands cause problems, physically as well as psychologically. This is the outcome of scientific research during the last 15 years. It seems like our culture is almost free of scars: the contemporary European men do not accept any longer imperfections that are visible to the outside world. Patients with burns who continuously see advertisements in lifestyle magazines of beautiful people tend to believe that people with visible scars are not accepted in society.

Patients with burns who continuously see advertisements in lifestyle magazines of beautiful people tend to believe that people with visible scars are not accepted in society.

The usual follow-up treatment of burns

In various ways we try to reduce the formation of scar tissue. Compressors, pressure suits, bandages with silicon gel, scar creams and scar plasters show as less result as other methods. Also for the treatment of hypo- and hyperpigmentation of burns there are methods available that are not very effective.

The use of grinder-dermabrasion or the laser apparatus to make the scar entanglement smoother, usually means a long-term course of treatment with anaesthesia and hospitalization, but with minimal results.

scar cream in many species that do little or nothing for relatively big money

scar blurring, results unknown

CO2 lasers are also used