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BURNS. BURN DISEASE

DEFINITION. Burns are tissue damage caused by thermal, chemical, electrical, or radial energy. According to the etiological factor, burns are usually called thermal, chemical and radiation.

EPIDEMIOLOGY

The high energy intensity 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 burns in the past few decades. According to the WHO, thermal lesions occupy the third place among other injuries, and in some countries - the second place, second only to mechanical injury. According to American researchers, the total number of burns in the United States increased to 3 million per year, which is about 1% of the total population of the country.

A particular 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 military traumas. As a result of the use of nuclear weapons, thermal effects are one of the leading damaging factors. During the explosions of the first atomic bombs in Hiroshima and Nagasaki, thermal lesions were observed in 80-85% of the victims, and burns were the cause of death in half of the dead.

All this was the basis for serious research in this area.
Therefore, by the mid-60s, the section of medicine on the treatment of thermal injuries, which existed earlier in the framework of surgery, was distinguished as an independent scientific discipline - combustiology.

PATHOPHYSIOLOGY OF LOCAL INFECTION

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

Thus, the volume of a lesion depends on both the height of the temperature and the duration of its impact. A paranecrosis zone or a stasis zone is formed around the central part - the coagulation zone or necrosis zone, the cells of which are not dead in the first minutes after injury. However, as a result of a developing impairment of microcirculation and, therefore, ischemia, their death occurs within the next 1–2 days.

A so-called zone of microcirculation disorders or hyperemia occurs around the stasis zone, in which cell damage is restored within 7–10 days.
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BURNS. BURN DISEASE

  1. Burns Types, degrees of burns, first aid.
    Burns in children are often found as traumatic injuries of soft tissues and most often arise as a result of the neglect of children or improper organization of their leisure time. The greatest number of burns is formed from the action of hot liquids, more often - in children ml of age. The depth of the skin lesion is divided into the following degrees: Grade I - skin flushing, Grade II - epidermis detachment with preservation
  2. Burn disease
    Clinical manifestations. In a burn disease, the central and peripheral nervous system is involved in the pathological process, which undergoes significant both functional and morphological changes. In the first hours of a burn shock, approximately 25% of the victims experience excitement, alternating with inhibition of the shock. Deep reflexes are enhanced, may
  3. Burn disease
    Clinic. Burn disease develops after thermal effects (II – IV degrees) by 10–15% or more than 50% of the body surface (with I degrees burns) with disorders of the vital activity of the whole organism (changes in the functions of the nervous system, internal organs, metabolism) and (current difference Phases of burn disease: burn shock, burn infection (toxemia), burn depletion
  4. BURN DISEASE. DETERMINATION, FLOW STAGES
    When surface burns are limited in area, the body’s response to injury is usually poorly pronounced. Deep and extensive burns are manifested by a general reaction of the body, called a burn disease. However, it must be remembered that superficial, but extensive, as well as small in size, but deep burns can cause quite serious pathophysiological disorders. During
  5. Traumatic Disease. COMBAT FIRE INJURY. BURN DISEASE
    Since prehistoric times, mankind has an acute problem of treating wounds and injuries resulting from armed conflicts, wars, natural disasters and man-made disasters. Out of five and a half thousand years of the development of human civilization, traced and studied by historical science, there were no significant armed conflicts on Earth for only 300 years. Practically
  6. BURN DISEASE
    BURNT
  7. BURN DISEASE
    BURNT
  8. TREATMENT OF THE BURN DISEASE IN THE STAGE OF TOXEMIA AND SEPTICOTOXEMIA
    The main principles of treatment are: 1. Detoxification The basis of detoxification therapy consists of two complementary directions: elimination of the source of intoxication and elimination of toxins from the internal media of the body. The source of intoxication is a burn wound (treatment tactics, see below - "Local treatment of burns"). Removal of toxic products absorbed into the blood and lymph
  9. Features of intensive care in other periods of burn disease
    Period II (acute toxemia) of a burn disease is characterized by signs of intoxication and further circulatory disorders. On average, it lasts up to two weeks. After the burned-out shock comes out, the resorption of fluid from the lesion begins. In the bloodstream enters a large number of toxic substances, which contributes to the increase in the level of proteolytic enzymes. Developing
  10. Burn shock
    Examination 1. In the history, clarify the cause, nature and time of exposure of the source of injury and the presence of associated injuries. 2. The degree of shock injury of a burn injury is determined by the area and depth of tissue damage: extensive burns are considered in newborns and children up to 1 year old with an area of ​​5-7% of the body surface, in children over 1 year old - more than 10%. 3. To determine the vastness
  11. Burn shock
    Burn shock is an acute hypovolemic condition resulting from plasma loss due to extensive skin burns. DIAGNOSIS In adult patients, burn shock may develop if the area of ​​superficial burns (excluding I degree burn) is 25% of the body surface or the area of ​​deep burns (SB — IV degree) exceeds 10%. In older people and children, shock occurs at a lower
  12. PATHOGENESIS AND CLINIC OF BURNING TOXIMIA AND SEPTICOTOXEMIA
    The basis of the pathogenesis of burn toxemia is resorption of tissue breakdown products from a burn wound into the blood and lymph. This process is particularly pronounced in the first few days after receiving the burn, when granulations have not yet formed, which are the "wound barrier" in the path of absorption of toxins. It has now been found that in the pathogenesis of intoxication from the very beginning, essential
  13. Burn shock
    The period of burn shock has a direct impact on the entire course of the burn disease. This is due to the fact that functional insufficiency of organs and tissues, caused by hypoxic, stressful injuries and cell death and subcellular structures, can sharply limit the body’s ability to achieve long-term adaptation to severe injury. Burn shock is pathological
  14. Burn injury
    A burn is a type of injury resulting from a local effect on the surface of the body’s tissues of high temperature, a chemical or ionizing radiation. Burn disease is characterized by phasic course, local and general clinical manifestations. DIAGNOSTICS = Determination of the area and depth of the burn. -The burn area is determined by the rule of "nines" or "palm" (in children
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