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CLASSIFICATION OF BURNS BY DEPTH AND AREA FOR TISSUE OF TISSUE

Classification of burns by 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 A.A. Vishnevsky and adopted at the 27th Congress of Surgeons, which provides for the division of burns into 4 degrees.

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

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

The clinical signs of burns of 3A and 3B degrees do not have distinctive features, however, their differentiation is important, since at 3A degree the papillary dermis with particles of the epidermis partially survives, allowing the burn wound to subsequently epithelize itself, while at 3B degree, self-healing wounds occur very slowly and only due to epithelialization from its edges.

With a burn of the 4th degree, there is a brown or black scab, the density and thickness of which can be different. It is clear that the possibility of self-repair in such burns is very limited.

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

However, the practical determination of the area and depth of the burn is often quite complicated and requires sufficient experience.
Most burns are mosaic, i.e. when burns of various 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 lesion area

The approximate methods for determining the area of ​​the burn according to the rule of "nines", the rule of the palm, using special tables (Table Postnikova) are fully described in the textbook. In determining the area of ​​the lesion, it is necessary to take into account Frank's rule, which established that 1% of the area of ​​a deep burn should be equated in severity to 3% of the surface. The Franca Index is obtained by adding the surface burn area in (%) and the triple deep burn area. 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 predictive trick is the so-called rule

“hundreds”: the area of ​​the burn in percent must be added to the age of the patient (taking into account the Frank rule). With the result of summing up to 60, the forecast is favorable; 61–80 - relatively favorable; 81 - 100 - doubtful; more than 100 - unfavorable.
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CLASSIFICATION OF BURNS BY DEPTH AND AREA FOR TISSUE OF TISSUE

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