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DEFINITION. Burns are tissue damage caused by thermal, chemical, electrical or radiation energy. Accordingly, the etiological factor of burns is usually called thermal, chemical and radiation.


The high power density of modern production, everyday life, transport, the widespread use of high voltage current, aggressive chemical products and explosive gases have led to a significant increase in the incidence of burns in the last few decades. According to WHO, thermal injuries rank third among other injuries, and in some countries - the second place, second only to mechanical trauma. According to US researchers, the total number of burns in the US has increased to 3 million a year, which is about 1% of the total population of the country.

A special problem is burns in the practice of military medicine. According to the foreign press, in recent military conflicts without the use of nuclear weapons burns were noted in 10-30% of all combat injuries. As a result of the use of nuclear weapons, thermal impact is one of the leading striking factors. During the explosions of the first atomic bombs in Hiroshima and Nagasaki, thermal injuries were observed in 80-85% of the victims, and the cause of death in half of the victims were burns.

All this served as the basis for conducting serious scientific research in this field.
Therefore, by the mid-sixties, the division of medicine about the treatment of thermal damage, which existed earlier in the framework of surgery, was separated into an independent scientific discipline - kambustiology.

Pathophysiology of local lesions

The local effect of high temperature on the human skin leads to the destruction of cells at the site of its application. At temperatures below + 44 ° C, cell death occurs only with prolonged exposure to heat, at T ° up to + 51 ° C, a brief exposure is sufficient, and when tissues are heated above + 52 ° C, death occurs almost instantaneously.

Thus, the amount of damage depends both on the height of the temperature, and on the duration of its impact. Around the central part - the zone of coagulation or necrosis - a zone of paranecrosis or a zone of stasis, cells of which are not dead in the first minutes after the injury. However, as a result of developing disturbance of microcirculation and, consequently, ischemia, their death occurs within the next 1 - 2 days.

Around the zone of stasis there is a so-called zone of disorders of microcirculation or hyperemia, cell damage in which is restored within 7 to 10 days.
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  1. Burns. Kinds, degrees of burns, first aid.
    Burns in children are often found as traumatic injuries of soft tissues and most often occur as a consequence of neglect of children or improper organization of their leisure. The greatest number of burns is formed from the action of hot liquids, more often - in children ml of respiration. The depth of the skin lesion is divided into the following degrees: I degree - skin hyperemia, II degree - epidermal detachment with preservation
  2. Burn disease
    Clinical manifestations. In case of burn disease, the central and peripheral nervous system is involved in the pathological process, which undergoes significant functional and morphological changes. In the first hours of burn shock, about 25% of the affected people are experiencing excitement, which is replaced with a slowing of the shock by inhibition. Deep reflexes in this case are increased, can
  3. Burn disease
    Clinic. Burn disease develops after the thermal effects (II-IV degree) by 10-15% or more than 50% of the body surface (with burns of the 1st degree) with disorders of the vital activity of the whole organism (changes in the functions of the nervous system, internal organs, metabolism) and (flow difference The phases of burn disease: burn shock, burn infection (toxemia), burnout
    With limited surface burns, the body's response to trauma is usually not very pronounced. Deep and extensive burns are manifested by a general reaction of the body, called burn disease. However, it must be remembered that both superficial and extensive, as well as small in area, but deep burns can cause quite serious pathophysiological disturbances. During
    Since the prehistoric times, the question of treating wounds and injuries, received as a result of armed conflicts, wars, natural disasters and man-made disasters, is acute before mankind. Of the five and a half thousand years of development of human civilization, traced and studied by historical science, only for 300 years on Earth there were no significant armed conflicts. Practically
  8. Treatment of Burn Disease in the Stage of Toxemia and Septicothoxemia
    The main principles of treatment are: 1. Detoxification The basis of detoxification therapy are two mutually complementary directions: the elimination of the source of intoxication and the removal of toxins from the internal environments of the body. The source of intoxication is a burn wound (see "Local Treatment of Burns" for treatment tactics below). Elimination of toxic products sucked into the blood and lymph
  9. Features of intensive care during other periods of burn disease
    Period II (acute toxemia) of burn disease is characterized by intoxication and further circulatory disorders. On average, it lasts up to two weeks. After the burn out of shock, resorption of the liquid begins from the lesion. A large number of toxic substances enter the vascular bed, which is facilitated by an increase in the level of proteolytic enzymes. Developing
  10. Burn shock
    Scope of the survey 1. In the anamnesis, clarify the cause, nature and timing of the source of the injury and the presence of concomitant injuries. 2. The degree of shockogenic burn injury is determined by the area and depth of tissue damage: extensive burns are considered in newborns and children under 1 year with an area of ​​5-7% of the body surface, in children over 1 year - more than 10%. 3. To determine the vastness
  11. Burn shock
    Burn shock is an acute hypovolemic condition that occurs as a result of plasma loss in extensive skin burns. DIAGNOSTICS Adult patients may develop a burn shock if the surface burns (excluding the 1st degree burn) is 25% of the body surface or the area of ​​deep burns (SB-IV degree) exceeds 10%. In persons of senile age and children, a shock occurs with a smaller
    At the heart of the pathogenesis of burn toxemia is the resorption of the products of decay of tissues from the burn wound into the blood and lymph. This process is especially pronounced in the first several days after the burn was received, when granulation, which is a "wound barrier" in the way of toxins absorption, has not yet formed. It is now clear that in the pathogenesis of intoxication from the very beginning,
  13. Burn shock
    The period of burn shock has a direct effect on the entire course of the burn disease. This is due to the fact that functional deficiency of organs and tissues caused by hypoxic, stress injuries and death of cells and subcellular structures can sharply limit the body's ability to reach long-term adaptation to severe trauma. Burn shock is a pathological
  14. Burn injury
    Burn is a type of injury resulting from local exposure to the body's cover tissues of high temperature, a chemical or ionizing radiation. Burn disease is characterized by a staged course, local and general clinical manifestations. DIAGNOSTICS = Determination of the area and depth of the burn. -The area of ​​the burn is determined by the rule of "nine" or "palm" (in children
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