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CLASSIFICATION OF BURNS ON THE DEPTH AND SIZE OF FABRICS OF TISSUE

Classification of burns in the depth of tissue damage.

Different countries have adopted different classifications. We use the classification developed under the guidance of Academician of the Academy of Medical Sciences of the USSR AA Vishnevsky and adopted at the 27th Congress of Surgeons, which provides for the division of burns into 4 degrees.

1 degree of burn, representing superficial damage only to the epidermis, is characterized by redness and swelling of the skin.

2 degree of burns - damage to the epidermis and partially underlying dermis. This degree is expressed by redness, swelling, the formation of blisters filled with a transparent yellowish liquid

The clinical signs of burns of 3A and 3B degrees do not have bright distinctive features, nevertheless their differentiation is important, because at 3A degree the papillary layer of the dermis with particles of the epidermis partially retains the ability to self-epithelialize the burn wound, while at 3B the degree of independent healing The wound is very slow and only due to epithelization from its edges.

With a fourth-degree burn, there is a brown or black scab, the density and thickness of which may be different. It is clear that the possibilities for independent reparation of such burns are very limited.

The ability to self-epithelize the burn wound served as the basis for developing a simpler classification, suitable for the purposes of medical-medical sorting of the victims. According to her, 1st, 2nd, 3rd degree burns are classified as superficial, and 3B and 4 are deep, requiring specialized medical care.

However, the practical determination of the area and depth of the burn is often quite complex and requires sufficient experience.
Most burns are characterized by a mosaic, i.e. burns of different depths are localized in different parts of the skin, in addition, the depth of necrosis can also increase due to the stasis zone.

Classification of burns by area of ​​injury

Methods of tentative determination of the burn area according to the rule of "nine", the rule of the palm, with the help of special tables (Table Postnikova) are fairly fully described in the textbook. When determining the area of ​​damage, it is necessary to take into account Frank's rule, which established that 1% of the area of ​​deep burn should be equated to 3% of the surface by gravity. The Franc index is obtained from the addition of the surface burn in (%) and the tripled area of ​​deep burn. If it is less than 30, then the forecast is considered favorable, if 30-60, then relatively favorable; 61-90 - doubtful, at 91 and above - unfavorable.

Another simple prognostic technique is the so-called rule

"hundreds": by the age of the patient it is necessary to add the area of ​​the burn in percents (taking into account Frank's rule). When the result of summation to 60 - the forecast is favorable; 61 -80 - relatively favorable; 81 - 100 - doubtful; more than 100 - unfavorable.
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CLASSIFICATION OF BURNS ON THE DEPTH AND SIZE OF FABRICS OF TISSUE

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