BURN: SKIN STRUCTURE, TYPES OF BURNS, FIRST AID, TREATMENT

Classification of injury

To determine what treatment is necessary, you need to briefly describe what degrees of damage are distinguished:

• First degree burn . Redness, slight pain and swelling appear in the superficial layers of the epidermis.
• Thermal wound II degree . Severe redness, swelling, detachment of the damaged layer, formation of blisters filled with yellow liquid. The affected area heals in 11-15 days, skin pigmentation can persist for 2.5-3 weeks.

Wounds of the first two degrees are considered superficial. Their treatment is possible on an outpatient basis. They are able to heal with conservative treatment.

• IIIA degree burns are accompanied by damage to the epidermis and dermis. A light-colored scab forms. Beneath it there are noticeable pink areas - the papillae of the dermis. As the scab moves away or changes, areas covered with epithelium appear in patches. Recovery occurs after 3-6 weeks. The result is a rough scar.
• IIIB degree : skin damage, muscles are often injured. The wound is cleared of dead tissue after 4-6 weeks.
• IV degree is the most prognostically unfavorable and severe. These injuries affect the fascia, muscles, tendons and bones. The scab is thick and charring may occur. Possibly accompanied by purulent complications such as arthritis, abscesses and phlegmon.

Lesions of IIIB and IV degrees are deep wounds that require hospital stay and surgical treatment, as well as the issue of skin restoration using skin grafting. It is necessary to seek specialized help and rational treatment from appropriate specialists without delay.

Lesions of IIIB and IV degrees require hospital stay and surgical treatment.

LEATHER. SKIN STRUCTURE. SKIN FUNCTION

SKIN is one of the most complex organs of our body, subject to the strongest physical and physiological stress. Skin is the largest organ of our body. The complex structure of the skin with its numerous vessels, nerves, sebaceous and sweat glands is necessary to perform certain functions.

Skin is: -Preventing fluid loss by the body; -Protection of internal organs from the negative influence of external influences; -Ability to evaluate pressure, touch and vibration. Nerve endings and receptors inform the body about temperature and pain effects; -Barrier functions. This is protection against bacteria and microorganisms; -Protection from ultraviolet radiation; -Maintaining optimal body temperature.

The skin consists of two layers: EPIDERMIS and DERMI

. Under these layers is subcutaneous fatty tissue.

EPIDERMIS

- avascular upper thin layer of skin (does not have its own blood supply). The epidermis receives nutrition from the capillary bed of the dermis due to the diffusion of nutrients. The epidermis consists of numerous layers of living cells, on top of which are dead cells.

The layers of the Epidermis can be represented as follows:

1. Basal (germ layer).
   The lower layer of the Epidermis. Consists of cells capable of regeneration (cell division) - cylindrical keratinocytes. The basal layer ensures constant regeneration of the Epidermis, however, cell division is regulated by certain factors: hormones, vitamins, kelons. Keylons are simple substances that suppress growth and regulate the functioning of the basal layer. Thanks to keylons, basal cells have limited growth (proliferation). Beneath the stratum basale is the basement membrane, which separates the stratum basale from the dermis.
2. Spiny.
   Contains up to 6 layers of irregularly shaped cells. They have little activity for cell division (limited mitotic activity).
3. Grainy.
   The death of Epidermal cells begins in this layer. Contains up to 3 layers of cells.
4. Brilliant.
   The stratum pellucida consists of anucleated cells in which intense enzymatic activity is observed. Eleidine is formed in the stratum lucidum. Eleidin is a substance rich in fats and proteins with a high refractive index of light, looks like a homogeneous dense shiny layer, which gives its name to this layer of cells. The shiny layer protects the body from the effects of various aqueous solutions.
5. Horny.
   The stratum corneum consists of anucleated keratinized cells (keratin is a protein that has high mechanical strength and performs protective functions), which are called corneocytes. The cells of the stratum corneum lie with some overlap, like brickwork, and are firmly connected to each other by the finest fibers (tonofibrils). The stratum corneum has 15 to 20 layers of cells, with the outer layer continually being shed as detached flakes of skin.

So, in general, the Epidermis works like this: in the lower, basal layer, cells are constantly dividing. After division, one of the newly formed cells passes into the next layers of the Epidermis. From layer to layer, cells lose contact with nutrients coming from the Dermis and lose the ability to divide. The closer a cell approaches the surface of the skin, the more strongly external environmental factors begin to act on it, keratinization of the cell occurs, the cell loses its nucleus and turns into a scale of the stratum corneum.

The stratum corneum, the upper layer of the epidermis, easily allows low-molecular substances such as oxygen from the environment to pass through. Bacteria, which are significantly larger in size, are not able to overcome the upper layer of the Epidermis, therefore the Epidermis is the skin protection that is optimal for the body. In the Epidermis, the processes of cell division of the lower Basal layer, regulated by keylons, the gradual transition of cells to the upper layers, transformation into keratin scales and, finally, exfoliation of the outer scales in the stratum corneum occur in a balanced manner. Complete renewal of the Epidermis lasts from 10 to 30 days.

The high strength of the Epidermis serves as a good barrier to various substances and does not allow them to penetrate the body. This also applies to most cosmetics.

DERMIS

- the frame, the skin itself, which provides its mechanical properties: elasticity, strength and extensibility. These properties are provided by connective tissue that has elastic fibers, Elastin, which allows the Dermis to stretch, and collagen fibers, which strengthen the Dermis.

The following structures are located in the Dermis: blood vessels, sweat glands, nerve endings, hair roots with sebaceous glands. Deeper is the subcutaneous fatty tissue - the hypodermis. It absorbs the effect of mechanical factors on the skin and participates in the thermoregulation of the skin. In this part of the skin there are clusters of fat cells separated by bundles of collagen fibers.

Complications

A more serious condition in the case of deep burns occurs if they occupy more than 5-11% of the body or the total burn area is more than 20%, then in this case burn disease occurs. This disease is associated with loss of skin and profound impairment of their functions (protection against infection, loss of pain and tactile sensitivity, maintaining water balance, thermoregulation). A serious condition requires a systematic approach and comprehensive treatment aimed at preserving the life of the victim, being in intensive care conditions and a multidisciplinary approach of specialists. It is important to note that for children under one year old, 3-5% of the burn area is sufficient for this complication to appear.

OBJECTIVES OF TREATMENT OF BURNS

FIRST AID FOR BURNS

The goal of treating burns is to preserve the life of the victim and restore the skin. In this regard, it becomes important to provide first aid:

1. Stop the victim's contact with the damaging factor.
2. Prevent microbial contamination.

ACTIVE TREATMENT OF A BURN

During further treatment, the doctor prescribes the following measures:

1. Restoration of microcirculation to preserve the paranecrotic zone.
2. Protection against infection and suppression of bacterial growth in the affected area.
3. Excision of necrotic tissue.
4. Stimulation of regeneration processes (granulation and epitilization).
5. For dermal burns - surgical restoration of the skin.

First aid for a thermal wound

First of all, when you receive a wound, you should not panic. If you are at home, to alleviate the condition, it is enough to immerse the affected areas in cold water until the pain stops . In case of a burn, your first aid kit should have the following items:

• Panthenol 5% in the form of cream or aerosol. Among the agents that can improve microcirculatory disorders and wound cooling, 5% water-soluble anilocaine ointment “Anikol” is also used. The use of antioxidants, for example Soderm ointment, vitamin E promotes faster recovery of the affected skin area.
• Sterile bandage to cover the wound.
• Hydrogen peroxide 3% or another antiseptic if the burn also causes contamination of the wound. Important! If the wound comes into contact with the ground, vaccination against tetanus is necessary.

EPLAN: PROTECTION, FIRST AID, TREATMENT OF BURNS

EPLAN - SKIN PROTECTOR

Eplan is able to penetrate the upper layers of the Epidermis, completely fill the free intercellular space of the Epidermis and create an additional barrier layer, which provides skin protection for a long time. Skin protection after treatment with Eplan lasts up to 8 hours.

EPLAN does not disrupt the intercellular connections of the stratum corneum of the skin, so the skin does not lose its strength and natural protective functions.

When EPLAN is applied to intact skin: EPLAN does not penetrate into the deep layers of the epidermis (Basal layer) and does not affect the natural proliferation of Epidermal cells, does not change the water-lipid balance of the skin.

EPLAN IS EFFECTIVE AT ALL STAGES OF BURN DISEASE.

EPLAN reduces pain in the burn site by blocking irritation of damaged nerve endings in the affected area, protects the skin after a burn from environmental influences and infection, and does not allow the body to lose fluid through the burn wound.

EPLAN reduces the flow of decay products of dead tissue into the victim’s blood and prevents intoxication. When treating large areas of burns, such as the treatment of burns with boiling water, steam, sunburn, the use of the drug does not lead to toxic damage due to the formulation itself - EPLAN is not toxic and does not contain hormonal components.

When treating burnt skin, EPLAN acts as an antiseptic, preventing infection of the burn wound (both for first aid for a burn and for protection against secondary infection), and eliminates skin itching.

FIRST AID AND TREATMENT OF BURN WOUNDS: EPLAN TASKS TO PREVENT INFECTION

EPLAN has high antimicrobial activity. The reason for this is the lanthanides that make up Eplan.

Phagocytosis is a process in which special blood cells and body tissues (phagocytes) capture and digest pathogens of infectious diseases and dead cells.

The phagocytic activity of blood leukocytes leads to rapid cleansing of the wound from pathogenic microorganisms: leukocytes begin to more actively destroy bacteria, and EPLAN does not interfere with the access of oxygen to the wound area. Thus, the use of EPLAN in the treatment of burn wounds can be considered as a drug for local enhancement of the patient’s immune status.

EPLAN is non-toxic, made without the use of antibiotics or hormonals. The use of the drug EPLAN becomes especially important in first aid for burns with boiling water and treatment of infected wounds with a large affected area. EPLAN is effective in treating the following injuries: treatment of burns with boiling water, steam, treatment of sunburn, thermal burn.

EPLAN IS A CATALYST FOR SKIN REGENERATION.

The effect of EPLAN as a drug for skin regeneration, skin restoration, rapid healing of wounds and burns is due to the presence of lanthanides in its composition. Lanthanides influence the process of cell proliferation. Application of EPLAN to damaged skin, a burn or a wound, triggers the process of lanthanide exposure to the membranes of proliferating skin cells, which leads to stimulation of their cell division. EPLAN cannot be considered as an inhibitor of kylon tissue activity, therefore its effect is local and has no aftereffect after use.

EPLAN WITH BANDAGE

Eplan-cream and Eplan-solution for the treatment of wounds and burns EPLAN WITH BANDAGE: maintains a moist environment and temperature of the wound, prevents the formation of a scab, provides access of oxygen to the wound, does not create obstacles to the removal of exudate from the wound into a dressing, prevents infection of the wound. EPLAN does not contain toxic components, antibiotics, hormonal or analgesic agents, and wound dressings with EPLAN allow the bandage to easily come off the wound without damaging injured healing tissue.

Modern headbands

There are a huge number of new dressings that can be used at home to promote rapid healing. The main difference from a regular bandage is that they create a favorable microclimate in the wound. After all, if the affected area of ​​the skin dries completely, it will not speed up healing.

Branolind N with Peruvian balsam

The patch has a specific odor; it is used for wounds of 1-2 degrees; it cannot be used for necrotic damage. You can change the bandage once every two days. A contraindication is an allergic reaction to the patch, manifested by redness and swelling.

Hydrocoll

Gel dressing, which is used for 1-2 degree burns. The package contains a 15x15 cm bandage that can be adjusted to the size of the wound. The bandage should cover the damaged area by 1-2 cm.

Silkoplast Comfort IT-Burn

Used for grade 1-2 wounds, relieves pain and promotes rapid healing.

SUNBURN. PREVENTION AND TREATMENT

TIPS FOR TREATING SUNBURN

When going on a trip, do not forget that the skin is defenseless against active sunlight, and the desire to quickly get a brown tan is understandable, but not entirely correct. The result of prolonged and uncontrolled exposure to the sun is a sunburn. This is characterized by poor appetite, sometimes vomiting, insomnia, fever, and tachycardia. Against this background, drowsiness may occur. Children suffer especially hard from sunburn.

What should you do to protect yourself and your family from sunburn?

Firstly, you need to actively moisturize your skin and drink as much water as possible, because the very first negative effect that solar ultraviolet radiation has is dehydration. Secondly, in the first hours after getting a sunburn, you can take antihistamines (suprastin, tavegil, etc.) - this will reduce skin inflammation and simple painkillers (ibuprofen, paracetamol) - this will reduce pain. Thirdly, use EPLAN burn ointment (or solution) to treat the affected area. Repeat the procedure 3-4 times a day. We recommend that you first lubricate the affected area with the solution in order to instantly relieve redness and swelling. EPLAN solution also has a cooling and analgesic effect. To consolidate the effect and soften the skin, we recommend continuing treatment of sunburn in the evening, using EPLAN cream. Fourth, to protect the skin from sunburn, we recommend applying Eplan solution to the skin 10-15 minutes before going out into the sun. Eplan forms a protective film on the skin, which will protect the skin from burns in the future.

Must remember! Changes in the structure of the skin are irreversible after any burn (including sunburn and boiling water burns); in the future, the skin may constantly react in a more severe form to new portions of sunbathing.

Detailed information on the use of EPLAN for the treatment of burns, wounds and skin lesions in the EPLAN section: AREAS OF APPLICATION

Causes of thermal burns

The main causes of thermal burns are industrial accidents and carelessness at home. You can get burned:

• flame (most often this is a second degree burn, which affects the respiratory and visual organs);
• liquid (often this is II–III degree of damage involving deep tissues);
• steam (shallow but extensive burn);
• with a hot object (II–IV degree of damage) with a clear contour and deep damage and possible peeling of tissue.

Pathogenesis of thermal burn

A thermal burn causes local changes in the skin that go through several stages of development.

The most comfortable body temperature to ensure normal biological activity of enzymes is +36…+37 ℃. The range of +37…+41 ℃ is also acceptable, and at +42 ℃ protein destruction begins.

When the body is exposed to high temperatures, burns of varying degrees of severity occur. Moreover, not only the temperature of the damaging agent is important, but also the time of exposure. The depth of tissue damage directly depends on the time of exposure to the damaging factor due to the physical properties of the skin. Brief exposure to even very hot objects and liquids may not result in a burn.

In case of deep burns, three lesion zones are distinguished: the coagulation zone, the paranecrosis zone and the peripheral zone.

Damage to the epidermal barrier leads to bacterial infection, fluid loss, and impaired thermoregulation. A tissue burn is accompanied by edema and hypothermia, since thermoregulation decreases as the dermis is damaged and is completely absent in open wounds.

The severity of the victim’s condition depends on the area of ​​the affected surface and the depth of the burn. In the first days, the severity of the condition is influenced mainly by the extent of the lesion, and in subsequent days - by its depth.

What is a thermal burn?

Thermal burn

is a burn that is caused by contact with a liquid, solid or gaseous heat source. Such a heat source can be hot bodies, flames, steam, or hot liquids. The first place in statistics is occupied by flame burns (about 84% of all thermal burns), followed by burns with liquid substances and electrical burns (approximately 7% for each type). In 2% of victims, burns were caused by other factors.

A thermal burn can damage several layers of skin at once: epidermis (outer layer), dermis, subcutaneous tissue. Depending on the number of damaged layers, four degrees of thermal burns are distinguished. Often a burn includes all these degrees at the same time. Many doctors, when describing burns, classify them according to the depth of the damage: superficial, partial, complete.

The severity of the burn also depends on the area of ​​the affected tissue. It is expressed as a percentage relative to the area of ​​the entire surface of the skin. When roughly assessing a burn, the so-called “palm rule” is used: the area of ​​the human palm is equal to one percent of the body area.

Degrees of thermal burns

It is customary to distinguish four degrees of burns depending on the depth and severity of the injury. Burns of the 1st and 2nd degrees are considered superficial, 3rd and 4th - deep.

• First degree thermal burn
  The affected area swells and turns red. A person is disturbed by pain and burning, especially acutely felt when touched. The skin temperature in the affected area increases. The listed symptoms last for 2, sometimes 3 days, gradually disappearing. The burn site continues to disturb the victim for some time; the epidermis begins to peel off. Gradually (after 3-5 days) the injured area looks almost healthy.
• Thermal burn of the second degree
  This burn occurs due to prolonged or sudden exposure to high temperature. There is also redness and swelling of the tissues, but blisters also form. They are filled with tissue fluid exuding from dilated skin vessels. Later, the contents of the blisters, due to protein coagulation, turn from a transparent mass into a jelly-like mass containing leukocytes. The tissue fluid and the skin of the blisters themselves protect the tissues located under the lesion from injury and infection; for this reason, the blisters cannot be opened. Patients with a second degree burn typically suffer from severe pain. But after a few days, tissue irritation and circulatory disturbance begin to decrease, and the liquid is gradually absorbed. At the bottom of the blisters, epidermal cells are actively dividing, and after a week a new stratum corneum begins to appear.
• Third degree thermal burn
  It occurs during prolonged exposure to high temperature. It is characterized by skin necrosis - tissue necrosis, which can be dry or wet. When tissue is exposed to steam or boiling water, wet necrosis usually occurs. The skin becomes swollen, pasty, acquires a yellowish tint, and may become covered with blisters. This inflammation occurs in a manner similar to the melting of dead tissue. When necrosis is dry, the skin is also dry, dense, dark brown or black. The edges of the area with dead tissue are clearly visible. Healing of burns of this degree occurs through scarring. However, when at least small areas of the germ layer of the epithelium are preserved, epithelization cannot be ruled out.
• IV degree thermal burn
  This is, without exaggeration, the most terrible degree of burns. Often such burns cover a large area. All layers of the skin and even tissues located outside it die: subcutaneous fat, tendons, muscles, bones. Several large blisters often merge into one huge one; the skin color becomes dark red, reaching black. Such damage threatens not only human health, but also human life. III and IV degree burns are, of course, more dangerous, but superficial burns can also be fatal if they involve more than a third of the body surface.

First aid for thermal burns

1. The first thing to do as quickly as possible is to extinguish the flame (if there is one) on the victim’s clothing and skin. It is necessary to throw off burning clothes from a person or throw a cloth over his body to stop the access of air to the fire. A burning area of ​​clothing can be covered with earth, sand, snow, or doused with water.
2. Try to calm the victim and the people around him.
3. Carefully remove from the injured person any smoldering remains of things that do not get into the wound. Under no circumstances should you remove clothing that is stuck to a burn. You should also not touch the burned body with your hands.
4. If it is a sunburn, you need to move the affected person to the shade.
5. If you do not have information about what happened, quickly clarify the circumstances of the accident (“the child knocked over a bowl of hot broth,” “clothes caught fire from the fire,” etc.).
6. Hold the affected part of the body for 10-20 minutes under running cold running water (you can put it in a container with cool, clean water). This must be done so that the heated wound does not deepen or expand. In addition, it activates blood circulation in the wound. However, ice should not be used to cool the burned area to avoid the possibility of another injury - frostbite. In extreme cases (if there is no water nearby), cooling the wound with urine is allowed, but in practice there is almost never a reason to use this method.
7. Apply any available anti-burn agent (ointment, gel) to the affected surface, and apply a sterile (if possible) dry bandage on top. You cannot use cotton wool, only gauze, bandages - fabric materials. It happens that you have neither anti-burn agent nor sterile bandages at hand, then you should apply any dry, clean bandage to the wound. You should not apply any folk remedies to the burn: vegetable oil, vodka solutions, kefir, sour cream, etc. You should also not apply Kalanchoe or aloe leaves or other “miracle remedies” to the burned skin. In case of a first degree burn (if there is no extensive damage to the skin or blisters), a bandage may not be applied at all, only an anti-burn gel can be applied.
8. If there are extensive burns of the extremities, you need to carefully fix them with a splint (any available means), raising the burned arms (legs).
9. If a large area of ​​the body is burned and there are signs of burn shock (the person is weak, pale, has increased anxiety, there is tachycardia and a drop in blood pressure, cold sweat, breathing and heart rate are disturbed), you should give him as much liquid as possible to drink - juice, compote or plain clean water. Thanks to the intake of fluid into the body, intoxication resulting from the penetration of decay products of burnt tissue into the blood will decrease.
10. If the victim complains of pain, then in order to avoid painful shock, you should give him any available painkiller (spasmalgon, analgin, etc.).
11. If a person has no cardiac and (or) respiratory activity, cardiopulmonary resuscitation (artificial respiration, chest compressions) should be performed.
12. In case of severe burns, call an ambulance for hospitalization of the victim or independently deliver him to a specialized medical institution. It is preferable to use, since not everyone can accurately say in which hospital or department burns are treated. It’s good when it’s a specialized clinic or at least a specialized department.

Treatment of thermal burns

Treatment of patients who have received thermal burns should include a set of means aimed at correcting the disorders that appeared in the body due to the burn. Antishock therapy should be adequate to the stage of medical care, the severity of burn shock and the age of the victim. It should include the following activities:

1. pain relief;
2. replenishment of blood deficiency (its components);
3. prevention, treatment of hypoxia;
4. correction of water-electrolyte, protein metabolism and acid-base balance of the blood;
5. fight against intoxication;
6. compensation of the body's energy costs;
7. prevention, treatment of heart disorders;
8. prevention, treatment of acute hepatic-renal failure.

In a specialized clinic (specialized department), primary care of burns is performed under anesthesia. Gentle treatment of wounds and the skin surrounding them is carried out with gauze wipes soaked in warm soapy water or a 0.5% solution of ammonia. After this, the burn surface is carefully washed with warm water or alcohol (40-70 degrees), dried and irrigated with antiseptic solutions.

Very dirty burn areas are cleaned with a 3% hydrogen peroxide solution. Particles of the epidermis are removed from superficial burns with tweezers or scissors. Small blisters are not opened, but large detached blisters are cut at the base and then emptied by lightly pressing them with a gauze swab. For burns caused by tar or bitumen, use purified gasoline.

With the open method of treatment, a thin layer of a special ointment or another synthetic (biological) coating is applied to the surface of the wound. With a closed method of treatment, a bandage with a special ointment (synthomycin, streptomycin) or emulsion (for example, sulfidine) is applied to the burn. Vishnevsky's anti-burn oil-balsamic emulsion is also effective. Such dressings do not interfere with the healing of the burn, do not cause pain when changing, and provide high-quality protection of the wound from infection. The bandage is carefully bandaged, lightly pressing on the tissue. It should not move; if the disease progresses successfully, the bandage is not removed until 7-9 days. This period is enough for the burn surface to epithelialize.

If the limbs are burned, immobilization is required, i.e. temporary immobilization. Any position convenient for the victim can be selected. In order to avoid the negative consequences of immobilization, every 2-3 days it is necessary to pause immobilization in order to make movements in the joints.

There is no single correct opinion on what should be done with burn blisters. Some doctors quickly remove them, explaining that their internal contents are not sterile; other doctors release liquid from the blisters, but do not remove the blisters themselves.

To restore the body of a victim who has received a fourth-degree burn, prompt, competent treatment and skin grafting are required.

Forecast of thermal burns

Pathophysiological changes that inevitably develop in the body affected by a burn provoke disturbances in the vital systems of the body and even threaten human life. The prognosis largely depends on the area of ​​the lesion, the extent of the lesion and the age of the victim. Mortality from burns is high in old people over 60 years of age and children under 3 years of age. However, even for patients of this age, burns cannot be considered a death sentence.

A critical condition is considered to be 100% - a total burn of the first degree, and burns of the second-third degree when more than a third of the body surface is affected. Life-threatening are third- and fourth-degree burns that affect the genitals, face, perineum (if they affect 10% of the body surface), and burns of the torso and limbs if the affected area is more than 15%. For more accurate predictions of burns, special methods have been developed - the “Rule of Hundreds”, “Frank Index”, which take into account the depth, extent of the affected area and the age of the victim.

You need to know: if the thermal effect on the skin lasts longer than 1 minute and exceeds 45 ° C, this inevitably leads to overheating of cells and their death due to inactivation of enzymes, protein denaturation, paralysis of tissue respiration and other metabolic disorders. After the cessation of thermal exposure, hyperthermia in the tissues does not stop, but continues and even becomes more active!

What can a chemical burn be like?

• Alkaline. This is the most dangerous type of chemical injury to the eye - alkali dissolves the tissue of the eye and penetrates deep into it. The higher its concentration, the faster necrosis occurs. Possible if ammonia bleach, cleaner, lime, cement or magnesium comes into contact with eyes;
• Acidic. It is caused by vinegar, acetone, peeling solutions or glass polish. Typically, with such a burn, only the cornea is affected. But concentrated hydrofluoric or sulfuric acid can melt tissue right down to the lens. Damage to the cornea itself can also cause loss of vision - a thorn appears on the eye;
• From other irritants, such as pepper spray.

Stages and symptoms of thermal injuries

First aid for thermal burns is carried out taking into account the stage (depth) of tissue damage. In medicine there are four stages:

• I - partial damage to the surface layer of the skin. Accompanied by slight swelling, burning, redness;
• II - complete damage to the skin surface. Characterized by blistering, burning pain;
• III - the lesion reaches the deep layers of the skin. There are grades IIIa and IIIb. The first is accompanied by fragmentary damage to the deep layers and the formation of dry dark crusts (scabs). The second is characterized by the death of layers of the epidermis and damage to fatty tissue;
• IV - the most dangerous burns, in which all layers of skin, muscle, bone tissue and tendons are injured.

In every case, except for the mildest skin injuries, you should immediately call an ambulance. You should not try to apply medications yourself, treat the affected areas with alcohol, or carry out other manipulations. The main thing is to alleviate the victim’s condition before the doctors arrive. Specialists will assess the extent of the damage, provide professional assistance, and, if necessary, hospitalize you.