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Radiation (radiation) burns occur in the case of the use of nuclear weapons and the direct contact of radioactive substances with the skin. In medical practice, they are often the result of local irradiation of a part of the body during x-ray or radiotherapy.
During the radiation burn there are four periods:
1. Early reaction to irradiation - manifested by hyperemia (primary erythema), with severe lesions - petechiae, appearing in a period from several hours to several days from the moment of irradiation. Erythema disappears without a trace after 1 - 2 days from the moment of appearance.
2. The hidden period is devoid of external manifestations; duration up to 3 weeks.
3. Acute inflammation - secondary erythema occurs in the affected area, in severe lesions, blisters appear after 1–3 days, after opening which painful bleeding erosion remains. In the presence of a deep lesion, ulcers are formed with necrotic walls and bottom. Period duration - from several weeks to several months.
4. The recovery period is characterized by the disappearance of erythema, healing of ulcers and erosions. Ulcers heal very slowly, sometimes for several years, often recur. In severe lesions, atrophy of the surrounding muscles, contractures and ankylosis of the joints is observed.
According to the severity of radiation burn, there are four degrees:
1. Easy defeat.
It is characterized by a mild early reaction, a latent period of more than 2 weeks, and a slight secondary erythema without blisters and ulcers.
2. Defeat moderate. It is manifested by a pronounced early reaction, the duration of the latent period of less than 2 weeks. In the third period, there is a secondary erythema, sometimes small blisters. Trophic disorders persist for a long time at the site of the burn.
3. Severe defeat. Early reaction occurs in the coming hours and lasts up to 2 days. After a short latent period (3–6 days), severe secondary erythema, edema of the skin, blisters appear, in place of which nonhealing erosions and ulcers form.
4. Extremely heavy defeat. With a rapidly occurring primary reaction, a short latent period, in the third period deep necrotic processes prevail. The recovery period is very long.
Treatment of radiation burns during the reactive period is aimed at improving the trophism of the affected area (novocaine blockade, vitamins), the use of antibiotics and analgesics. Local - ointment dressings. During the period of acute inflammation, ointment dressings are applied to erythema, blisters are emptied by puncture under aseptic conditions, with deep lesions perform delayed necrotomy with subsequent plastic closure of the resulting defects.
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