George Richards, age 13, of Marquette, Mich., for his question:
WHAT IS A FIRST DEGREE BURN?
A burn is an injury to the skin caused by intense heat, caustic chemicals, electricity or radiation. Burns are classified by depth of damage.
A first degree burn is one where the surface of the skin is red. The first layer of the skin, the epidermis, is blistered when second degree burns occur. In third degee burns, both the epidermis and the dermis (the layer of skin below the epidermis) are destroyed and underlying tissue may also be damaged or destroyed.
The severity of a burn depends not only on the degree but also on the extent of body surface affected.
Each year about 2 million persons in the United States suffer serious burns, of whom almost 150,000 are hospitalized and about 10,000 die.
Advances in treatment improved the survival rates for serious burn victims during the 1970s. Before that time, a person under the age of 45 with serious burns covering 65 percent or more of the body had a survival rate of less than one percent. Today that person has a much better than 50 percent survival rate.
Destruction of the skin removes two essential functions: keeping infectious organisms out of the body and regulating water loss. More than half of burn victims die of infections or of complications caused by infections.
Loss of water and blood salts by evaporation and bleeding at the wound site causes dilation of small blood vessels. This can bring on shock, with a sudden drop in blood pressure and kidney failure.
For mild burns, treatment includes the immersion of the affected area in cold water. This reduces swelling and pain. The use of butter or Vaseline is no longer recommended.
Severely burned persons should receive immediate medical attention.
If severely burned persons are taken to a hospital with a burn treatment center within an hour of injury, the chance of survival becomes very good. Eight of 10 persons with burns covering 30 percent of the body now survive with such special treatment.
In the U.S., 25 burn centers had been established by 1980 as well as more than 80 hospital based units with the necessary materials, equipment and specialized medical staffs to help patients with severe burns.
The first step for doctors with serious burn patients is to provide something to reduce the pain. Special drugs are used. Next the doctor removes the dead skin to reduce the chance of infection and also to provide a clean bed for skin grafting.
The exposed area is covered with a water soluble ointment containing an antibiotic.
Seriously burned patients may not be able to eat due to paralysis of the intestine and nutrients are then supplied through the veins.
Skin grafting starts as soon as the doctor feels the patient is ready.