Serious burn injury is the most devastating trauma for the human body. Almost everybody experienced some kind of burn injury in lifetime. Most known one is sunburn. Even least important sunburns may cause suffering for some time.
Burns may result from:
- Flame or contact to the hot material
There are two factors for determining the seriousness of burn injury:
- Dept of burn
- The extend of burned area
Dept of burn injury is classified usually in 3 (sometimes 4) degrees.
- 1st degree burns: They are superficial but very painful. The burned skin appears red. They usually heal in one or two days even any treatment
- 2nd degree burns: They are very painful. Blisters are seen on the burn surface. Dept of the burn extends some distance inside the skin but not effect all height. Their seriousness depends of their depth. If they are not deep heal in 5-10 days and may not leave a scar. If the burn is deep it heals in 10-30 or more days and my leave an ugly scar.
- 3rd degree burns: They may be painful but when the burned skin is touched or punctured with a needle there is no sensation. The burned skin looks like a wax. Whole skin layers are destroyed and in some occasions tissues under the skin (fat or muscle) may be burned (4th degree burn). They are not expected to heal with conservative treatment.
The extend of burned area is determined by calculating the burned surface. Burns of the face, hand, foot or genital area always serious and advised to be treated in a hospital. 2nd degree burns which cover more then 20% of body surface should be hospitalized. Most 3rd degree burns need hospitalization. In children most 2nd degree and all 3rd degree burns need hospital treatment.
Treatment of 2nd and 3rd degree burns should be done by specialized medical staff. Sequels after burn healing are directly correlated by the healing time. If a burn completely heals in 10 days no scars will be expected. If healing occurs more then 10 days unwanted consequences may appear in variable extent worsening by the elongated healing time.
Treatment of healed burn scars
For burn injury survivers most sequels are related to the scar and scar shortening. Shortening of scar is called as contracture and may interfere with the functions of eyelid, mouth, neck, hand, foot, arm, leg and other parts. Treatment of scar related complications targets to reestablish the functional integrity. Aesthetics are secondarily considered and usually not achieved. But obvious scars without causing functional problems are also common after burn healing. Most of the this kind of scars create cosmetic disturbances.
Burn scars without functional problems are difficult to treat. They usually covers a wide area and cannot be eliminated by excision and direct closure. If the scars are red and hypertrophic (bulging out) steroid application by ointment or injection, some laser lights, external silicone application and external pressure application may be beneficial. If the scars are discolored, and thin (atrophic) treatment is consist of soft tissue (mostly fat) injections, and superficial abrasion of scars followed by epidermal grafting.
Even today’s technology burn scars cannot be eliminated 100%. But considerable improvement can be achieved in experienced hands.
For the treatment of hypopigmented (white or pale) scars Dr. Ozgentas uses fat injections, superficial peeling (by abrasion) and epidermal grafts with promising results.