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Radiation (radiation) burns occur in the case of nuclear weapons and direct contact of radioactive substances with the skin. In medical practice, they are more often the result of local irradiation of a part of the body during X-ray or radiotherapy.
During the radiation burn four periods are distinguished:
1. Early reaction to irradiation is manifested by hyperemia (primary erythema), with severe lesions by petechiae, which appear within a period of several hours to several days after irradiation. Erythema disappears without a trace in 1 - 2 days from the moment of appearance.
2. The hidden period is devoid of external manifestations; duration of up to 3 weeks.
3. Acute inflammation - there is a secondary erythema on the affected area, with severe lesions in 1 to 3 days, there are bubbles, after the opening of which remain painful bleeding erosion. In the presence of a deep lesion, ulcers with necrotic walls and a bottom are formed. The duration of the period is from several weeks to several months.
4. Recovery period - characterized by the disappearance of erythema, healing of ulcers and erosion. Ulcers heal extremely slowly, sometimes for several years, often recur. At severe lesions, atrophy of the surrounding muscles, contracture and ankylosis of the joints is observed.
According to the severity of the radiation burn, four degrees are distinguished:
It is characterized by a mild early reaction, a latent period longer than 2 weeks, minor secondary erythema without blisters and ulcers.
2.Painting of moderate severity. It is manifested by a pronounced early reaction, the duration of the latent period is less than 2 weeks. In the third period, there is secondary erythema, sometimes small blisters. On the burn site, trophic disorders persist for a long time.
3. Heavy defeat. An early reaction occurs within the next few hours and lasts up to 2 days. After a short latent period (3 to 6 days) there is a pronounced secondary erythema, swelling of the skin, blisters, in the place of which long-lasting non-healing erosions and ulcers are formed.
4. Extremely heavy defeat. With a rapidly emerging primary reaction, a short hidden period, in the third period deep necrotic processes prevail. The recovery period is very long.
Treatment of radiation burns in the period of reactivation is aimed at improving the trophism of the affected area (novocain blockades, vitamins), the use of antibiotics and analgesics. Locally - ointment dressings. In the period of acute inflammation, ointment bandages are applied to erythema, bubbles are emptied by punctures in aseptic conditions, with deeper lesions performed by delayed necrectomies followed by plastic closure of the defects formed.
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