Electrical burn: types, features and how to treat

How long burns take to heal depends on the severity of the injury and the individual characteristics of each person’s body. Mild injuries usually heal within 4-8 days, but severe burns can take longer to heal (from 3 weeks to several months).

Classification

Burns are divided into degrees:

• The first is that the upper layers of the epidermis are damaged without affecting the internal fibers. Redness forms at the site of the lesion, which disappears after 2-4 days.
• The second is that in this case the injury affects the subcutaneous tissue. Swelling and watery blisters appear on the surface, and the skin takes on a burgundy tint. The dermis is completely restored after 2 weeks, and the dead parts of the skin peel off.
• The third, in turn, is divided into groups “a” and “b”.
• A – the burn affects almost all layers of the skin. The appearance of large yellow blisters is observed, the skin is covered with a rough crust of dark burgundy color. How long the burns take to heal in this case depends on the use of medications; usually the regeneration process begins 14 to 30 days after the injury, pigmentation disappears after 2-3 months.
• B – ligaments, muscles, subcutaneous fat fibers are affected. Blisters with blood clots form on the dermis, and the wound is covered with gray scabs.
• The fourth is the last and most dangerous degree. The damage affects the bone structure, necrosis spreads to the muscles and tendons. The wound is very deep; the injured area is overgrown with a black crust, which is not sensitive to external irritants. The recovery process can last for months; scars remain on the burned area.

Grodno Regional Children's Clinical Hospital

Details Published September 21, 2015

Head of the 8th surgical department Khmelenko A.I.

Thermal burns

Thermal burns are burns from flame, hot steam, hot or burning liquid, boiling water, from contact with hot objects, sunburn. Thermal burns can occur as a result of exposure to light, flame, boiling water or other hot liquid, steam, hot air or hot objects.

From a burn, living tissues die, first of all, due to the direct impact of flame, hot objects, steam, liquids, the temperature of which exceeds 50 - 55 ° C. But it is known that during prolonged exposure of the human body to infrared radiation, thermal burns can occur at lower temperatures (43-44°C). At a temperature of 60-70°C, partial denaturation of tissue proteins occurs, and at 100°C and above, complete denaturation occurs.

The depth of the burn depends on the temperature and the duration of its exposure to the body. The higher the temperature and longer the exposure, the deeper the burn. Lightning burns are known, which are superficial, despite a very high temperature, when the harmful effect lasts a fraction of a second (an explosion of an atomic bomb, gas in a mine, etc.). But not all parts of the body are equally sensitive to heat. On the neck, in the perineum or groin areas, the burn will be deeper than on the palms and soles, where the rough epidermis more reliably protects the subordinate layers of skin and tissue from the damaging factor.

The low thermal conductivity of the skin reduces the temperature, and therefore the vast majority of thermal burns are limited to superficial damage. However, very hot solid objects (metal, sand, brick, etc.) give off so much heat that deep burns occur - primary coagulative tissue necrosis. Coagulation necrosis also occurs when the skin is exposed to flame. Under the influence of hot liquids and steam, tissue dehydration does not occur, and therefore wet liquefaction necrosis occurs. Classification of thermal burns according to A. Vishnevsky: I degree - skin erythema, II - the presence of blisters; III A degree - superficial skin necrosis, in which islet epithelization of the skin is possible; III B degree - complete necrosis of all layers of skin; IV degree - necrosis of the skin and underlying tissues.

A first degree burn is erythema that appears immediately after a burn as a manifestation of acute aseptic inflammation of the skin. It goes away after a few days, but on the 5-8th day the epidermis begins to peel off, which indicates denaturation of the cellular protein of the surface layers of the epidermis. A second-degree burn is characterized by subepidermal blisters that appear immediately after the burn and may enlarge within one to two days. The appearance of blisters against the background of erythema is caused by detachment and elevation of the stratum corneum and lucidum of the epidermis by plasma due to a sharp expansion of the capillaries and the permeability of their walls. In these exfoliating layers of the skin, protein denaturation occurs, and in the Malpighian and Roscov layers, reactive inflammation occurs, which gradually, unless an infection occurs, subsides. Within 10-14 days, damaged skin is completely restored.

With a thermal burn of III A degree, coagulation of the malpighian and partially papillary layer of the dermis occurs. This degree of burn is determined after cleaning the burn surface from blisters and necrotic tissue and the appearance of small epithelial islands. Thus, III A degree burns, if suppuration does not occur, can heal independently due to the epithelial elements of the dermis and skin appendages. Therefore, III A degree burns are classified as superficial burns. Suppuration of the burn surface leads to secondary necrosis of the epithelial islands under the influence of proteolytic enzymes of the wound, bringing it closer to a III B degree burn. III B degree burns are characterized by necrosis of all layers of the skin, which reaches the subcutaneous tissue, and IV degree burns in deeper tissues.

Causes of burns

Thermal burns occur as a result of exposure to high temperature: - open fire affects a large surface, causing burns mainly of the second degree. — hot liquid can cause small but deep burns. — steam burns usually occur over a large area, but are not deep. - contact with hot objects causes a clearly defined and deep burn - up to the fourth degree. — chemical burns occur as a result of contact with hazardous substances: acids and alkalis. Burns caused by these substances entering the respiratory tract and digestive tract are especially dangerous. - Electrical burns occur at the points where electrical charge enters and exits the body. They occupy a small area, but can be very deep. In addition, if the electrical wiring is short-circuited, arc burns may occur. It resembles a burn from an open flame. First aid for minor household burns:

1. Cool the burned area with cool running water for a few minutes. Do not use strong water pressure.
2. Do not use ice, snow, or frozen foods to cool a burn. Low temperatures can quickly cause frostbite, since the skin at the burn site is already damaged and does not perform its protective function.
3. First degree burns or minor second degree burns can be treated with certified burn ointments or sprays. Remember: such ointments must be made strictly on a water basis.
4. Never apply oil, lard or any other fat, including rich creams, to burns. The oil film traps heat inside the skin and makes the burn deeper.
5. Do not open the blisters left from the burn yourself - this way you risk getting an infection. Burns are prone to inflammation and the development of suppuration more often than other injuries.
6. If the burn causes severe pain, chills or fever, consult a doctor immediately.

How to Prevent Burns Most burns can be prevented. Simple rules will help prevent burns in children:

1. Do not allow your young child to open bathroom and kitchen faucets on his own until he can mix hot and cold water. Even water at a temperature of 60°C can cause a serious burn in just half a minute of contact with it.
2. Do not carry hot liquids or food over areas where your child plays.
3. Do not open the oven if there is a small child in the kitchen.
4. During a picnic, do not let your child get close to the grill. Play with your child away from the place where the barbecue is being prepared.
5. When cooking on the stove, turn on the far burners and turn the pans with the handles facing inward. This will allow you to protect yourself from accidentally turning over a hot pot or frying pan.
6. Don't put off fixing faulty electrical outlets and plugs. Do not use devices with faulty wiring.
7. Avoid using heaters with open coils.
8. Do not teach your child to use lighters or matches until you are sure he understands their potential dangers. Keep such items in places where children cannot reach.
9. Never bring any corrosive liquids into a home where there are small children. Put household chemicals in cabinets, or better yet, under lock and key.
10. Do not allow children to set off fireworks, including playing with sparklers, firecrackers or small firecrackers.

The most important

Burns occur under the influence of various hot objects, liquids, steam and even caustic chemicals. If the burns are deep and large in area, call an ambulance immediately. Never apply grease to the burn area or apply ice to the affected skin.

Healing time

To determine how long a burn will take to heal, the following circumstances must be taken into account:

• acquired stage;
• the substance or object that caused the injury;
• area and depth of skin lesions;
• the age of the person injured;
• individual characteristics of the body for regenerative abilities.

Treatment of wounds with anti-burn agents plays an important role in the recovery process; how long the burn takes to heal will depend on this.

Mild stage wounds (1) heal independently and quickly; on the 3rd day, the skin on the burned area peels off and a pinkish spot remains.

A 2nd degree burn heals depending on whether the blister is punctured.
When the bladder is intact, the skin underneath begins to recover faster. After 2 weeks, dead scabs of the dermis peel off from the damaged area. Opening a blister can lead to infection with various infections; this should only be done by the attending physician using sterile instruments. If you receive a type 3 injury, skin regeneration begins after 3 weeks. After this period, new cells grow in the affected area, from which the restoration process of the burned area begins. Burns of this classification are treated by specialists.

Doctors remove particles of dead tissue from the skin, treat the wound with antibacterial drugs, and perform reconstructive plastic surgery.

Stage 4 leads to disability. The risk of surviving these injuries is not high. Modern technologies use skin grafting and spraying table cells onto burnt parts of the body.

Causes of electrical burn

When a person touches a bare wire, it completes an electrical circuit. Tumors and injuries occur at the site of entry and exit of the discharge. Sometimes there are disturbances in brain function and soft tissue damage.

Experts name several main factors that can cause a burn:

1. Contact with a poorly connected socket.
2. Contact with the device with a wire on which the insulation is broken.
3. Old wiring.
4. Contact with high voltage line.
5. Lightning strike.

First aid

Providing first aid will help significantly speed up the recovery of the injured person. Necessary measures:

• eliminate the source of damage; if the burn was caused by chemical means, the patient’s clothes should be removed;
• the wound should be immediately washed with cool water for 40 minutes;
• to avoid painful shock, you need to take a painkiller;
• To make the injury go away faster, the injury must be treated with antiseptics and a sterile, dry, non-pressure bandage applied;
• escort the patient to the nearest medical center or call an emergency vehicle.

What are the types of electrical burns?

Electrical burns can occur at home, at work, or even in the natural environment. Various types of damage are possible:

1. Thermal ones manifest themselves in the form of a burn on the skin.
2. Biological - muscles contract convulsively, problems with the functioning of the respiratory system, open wounds on the skin, and sometimes fractures occur.
3. Electrolytic - damage to lymph and blood flow is dangerous due to disruption of organ functioning.

Based on the type of interaction, there are two types.

Current (contact)

This type occurs when a person comes into contact with an object or wire through which current passes. Current penetrates in the case of direct interaction. The formation of a current burn is a consequence of the conversion of electricity into heat.

The skin suffers because it has a greater degree of resistance compared to other tissues. More often, grade 1 or 2 is diagnosed. Stronger ones are less common.

Arc

This type of electrical burn is explained by the impact on the body of an electric arc with high temperature (more than 3500 degrees) and high energy.

You can get it when working with high-voltage lines and other high-voltage devices. The injuries are grade 3 and 4. The general condition depends not so much on the force of the blow, but on the area of ​​the affected area.

Types of burns

To properly provide first aid to a victim, you need to know the characteristics and types of electrical burns. Based on the method of production, they are divided into 3 groups.

Household

This kind of burn is often caused at home when safety precautions are ignored. This happens when working with a faulty electrical appliance, breaking the insulation of wires, repairing sockets, replacing light bulbs when the power is not turned off. These burns are the most harmless, but history has known cases of death.

Natural

This type can be obtained in the event of a natural disaster - a lightning strike. The survival rate is negligible, since the effect on the body is too strong.

Production

Electricians most often experience this type of burn while performing their job duties. They are constantly in contact with electrical appliances.

A person whose work involves electricity exposes himself to prolonged exposure to low voltage. However, short-term interaction is no less dangerous.

HOW TO USE BURN OINTMENT IN FIRST AID

There are several stages in providing medical care for burns.

First stage (prehospital)

includes first aid for burns, provided in the form of self- and mutual aid at the scene of the incident. The burn surface for superficial burns is painful, so mechanical cleaning is allowed only in case of severe soil contamination by irrigation with antiseptic solutions. It is necessary to choose the optimal remedy for burns in a particular case. Burn wounds are covered with anti-burn dressings that do not stick to the wounds or sterile dressings with water-soluble ointments (levomekol, levosin, dioxykol, dermazin).

Instead of traditional remedies used in these cases, we recommend the universal, ready-to-use drug EPLAN (ointment and solution). EPLAN has unique properties for providing first aid, especially for sunburn.

EPLAN has the following useful properties: - pronounced absorbent activity (dehydrating activity is 13.5 times higher than that of a hypertonic NaCl solution); -low toxicity; -good permeability in fabric; - no irritating effect; - ease of application on surfaces.

If the ointment (cream) is immediately applied to the damaged areas, redness and inflammation disappear, and blisters with serous fibrous contents do not appear.

For local treatment of burns with EPLAN, two methods can be used: open (without bandages) and closed (with bandages), subsequent dressings are carried out daily or every other day until the wounds are completely healed.

How to understand that a person has suffered from an electric shock

You can find out about an electrical burn by looking at the marks from the electric arc. The skin of the affected area changes color. It turns red or purple-gray. With severe injuries, blackening or even charring may occur. There is no clear location of the pain; it spreads throughout the body. Electric shock is indicated by muscle spasms and convulsions.

The main signs of electrical injuries include:

1. Weak breathing, shallow. Sometimes asphyxia may occur.
2. Cardiopalmus.
3. Muscle cramps.
4. Impaired consciousness, memory loss.
5. Disorientation in space.
6. Loss of sensation in a limb.
7. Unstable vision, inability to focus.
8. A clear outline of the burn on the skin.
9. Unintelligible speech.
10. The victim may complain of nausea and dizziness.

The victim needs to be attentive to the victim. If the current is exposed for a long time, then characteristic marks will remain on the skin. Possible swelling and numbness.

Treatment

If the injury occurs at home, it is most likely minor. Small areas of skin can be treated independently. The wound heals within a couple of weeks.

The affected area should not be treated with iodine or brilliant green, as they will aggravate the burn. It is better to use creams and ointments for healing burns, which include an antibacterial and antiseptic component. Preparations with sodium fusidine help avoid tissue rotting.

In the first week, you need to take especially careful care of the wound:

• daily smear the injury with an antiseptic solution, anti-burn creams, as prescribed by your doctor;
• carry out dressings regularly;
• for pain, use painkillers;
• antihistamines are required.

For treatment in a hospital setting, 2 treatment methods are used: medication and surgery.

Drug treatment

If a person suffers from high voltage, then most likely he will lose consciousness. In this case, a disruption of the heart rhythm and disruption of the cardiovascular system are possible. In this case, doctors send the patient to the intensive care unit. He is prescribed infusion therapy with anti-inflammatory and painkillers. In some cases, a blood transfusion may be required.

After stabilizing the victim’s condition, therapy is supplemented with local treatment for a speedy recovery. All creams and ointments that can be used to treat burns with blisters prescribed by doctors have an antibacterial effect and stimulate regenerative processes.

If the nervous system is disrupted as a result of an electric shock, the patient is prescribed sedatives and sometimes antidepressants. To stabilize the functioning of the cardiovascular system - stimulants. If circulatory disorders or cerebral edema are detected, then taking dehydration medications is recommended.

Surgical intervention

Surgical intervention is necessary only for the 3rd or 4th degree of severity of the injury. Surgeons clean the affected area and transplant healthy skin.

In particularly severe situations, amputation may be required. It is recommended for those patients whose injury is not amenable to conservative treatment methods and skin grafting.

The decision is made individually, based on the patient’s condition. In some cases, surgery is required immediately when there is a real threat to life or health. Sometimes doctors decide to postpone intervention until the patient has partially recovered, that is, they give time to recover from the shock.