Burns and scalds
by Dr John Winsor - The Sunday Times of Malta

There are three different types of skin injury that are classified under the heading ‘burns and scalds’.

Dry burns are caused by fire, electricity, friction, or contact with something that is very hot; chemical burns are caused by acid, alkalis or other strong chemicals and scalds are caused by hot liquids or fat.

Among children, scalds are the most common type of injury in this group as they frequently pull hot teapots and saucepans down on top of themselves, or get into baths that are filled with water that is far too hot.

Whatever the cause of a burn or scald may be, injuries of this type are classified in three different ways, according to the depth and extent to which the skin has been damaged.

Superficial or first degree burns simply cause reddening of the skin and some pain. They do not usually produce any long-term scarring and unless they cover large areas of skin, first degree burns really aren’t all that dangerous.

Second degree burns always cause blistering of the skin, in addition to the inevitable reddening. The blisters are caused by fluid leaking out of the blood vessels that have been damaged inside the tissue.

Second degree burns are serious and dangerous if they involve more than ten per cent of the skin’s surface area.

Third degree burns are the deepest and most serious of all and involve the depth of a full layer of skin.

A burn like this, however small, is potentially dangerous since it can result in infection and scarring.

Finally, it is important to remember that any burn that affects the joints or the face can be dangerous since the result may be permanently disabling, or scarring, or both.

To start treatment of a burn, the first thing to do is to separate the skin from the source of the burn. So, put out any flames, wash off any chemicals with plenty of water and, if electricity is the cause of the problem, switch off the current before touching the patient.

Once you’ve done that, use plenty of fresh, cold water to cool the burnt area. The cold water will prevent blistering and will minimise the damage to the skin. A burn should be kept in or under cold water for ten minutes.

If the burn is second or third degree, if it covers a large area of skin, or if you are worried at all, then obviously you should contact your doctor or call Emergency without delay.

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