Disruption of skin integrity as a result of physical factors such as high heat, electricity or chemical effects is called burns. Burns occur due to various reasons. These causes include scalding with hot liquids or steam, flame burns, burns caused by heat waves generated by explosions (flash), burns caused by contact with materials such as hot metal, plastic glass and special burn causes such as electricity and chemicals.

The most common cause of burns is scald burns. Hot water, tea, soup, milk, tomato paste made in rural areas, molasses, cheese juices are important causes of scalds. Sometimes it may be in the form of splashing and sometimes it may be in the form of splashing on the person. Another common form of scalding in children in our country is falling into boilers and pots filled with hot milk, molasses, etc. Such cases may cause life-threatening burns. Flame burns come second. Flame burns are a common consequence of major disasters and are accompanied by a high incidence of smoke inhalation poisoning and respiratory system burns. They can often be life threatening. Flash burns occur in incidents such as LPG, household cylinder explosion. They cover large areas and affect the respiratory tract. On the contrary, contact burns with hot objects usually cover narrow areas. However, it has a high tendency to be deep according to the heat of the contacted material. It mostly affects the hands. It is often encountered by touching household items such as irons, ovens, trays, stoves and hot metals in industrial work. Electrical burns can be caused by low voltage electricity such as 220 volts on the city line or high voltage lines passing through residential areas. In electrical trauma, the danger to life is extremely high due to the specific severe problems. Chemical burns can be caused by many chemicals, especially acidic and alkaline substances used in cleaning, and these burns can be more severe than they first appear.

How to determine the severity of the burn trauma to which we are exposed?

Regardless of the cause of the burn, burned patients are evaluated by considering some vital and functional criteria in the scene teams, emergency services and burn centres. In this way, it is decided whether the trauma is a ‘major’, ‘moderate’ or ‘minor’ burn. Minor burns are usually treated on an outpatient basis. Moderate burns can be treated by being hospitalised in burn beds in hospitals, even if there is no burn centre, but severe burn trauma should be referred to burn centres.

The width of the burned area on the body surface and the depth of the burns in this area are two important criteria that give an idea about the severity of the burn. The patient’s previous illness and additional traumas, smoke inhalation, the temperature of the heat source and the duration of contact are other criteria that are taken into consideration. In addition to the presence of life-threatening danger, the age of the person, the social environment he/she lived in during the event, whether the event was an accident or an accident, the burned areas (head, neck, hands, feet, genital area, etc.) that will affect the quality of life of the individual after treatment are also taken into consideration. One of the classifications made for this purpose is the grading system, which is also widely used among the public. In this classification, burn depth is referred to as first, second, third and fourth degree. First degree burns (epidermal burn) are superficial. They affect the top layer of the skin called epidermis. Tissue damage is minimal, damage is limited to the epidermis, the skin is red and turns pale when pressure is applied. Oedema may occur and usually there is no water collection in the skin called bullae. The wound is red, dry and painful and heals within 3 to 6 days without leaving a scar. The majority of sunburns fall into this class. 1st degree burns do not leave scars, superficial 2nd degree burns may leave scars in the form of dark or light coloured spots on the skin. Sun protection is the most important measure to reduce and prevent these spots. Second degree burns (burns involving the dermis and epidermis) also affect part of the dermis, the deep layer of the skin. Tissue damage is more than 1st degree burns, oedema, bullae and pain are present, heals in 2-3 weeks with dressings. 2nd degree burns affecting more than 2/3 of the dermis may cause permanent scars and loss of function. For this reason, surgical treatment methods are sometimes used. Third degree burns are burns that affect the entire skin (all layers). The epidermis and dermis are completely burnt. Fourth-degree burns, on the other hand, describe damage to the entire skin and subcutaneous tissue, even tendons, nerves, muscles or bones. The skin may appear as a hard and thick layer, blackened, charred or translucent white and the underlying veins may be visible. There is no feeling. Therefore, pain is not expected, but the patient may complain of pain. This is due to 2nd degree burns in the surrounding tissues. The wounds may range from waxy white to charred black. Surgical treatment methods are needed. The healing process takes a long time and may leave permanent scars and dysfunctions.