Op. Dr. Ulvi Güner (Estetik. Plastik ve Rekonstrüktif Cerrahi Uzmanı)

Burnt: I want to talk about a field of plastic surgery other than aesthetic actions; and give some vital first aid information requiring to be known by everybody. It is true because we may not know when we will face such situations.

The cell and tissue deformation on any part of the body due to the effects of a hot thing or burning material is called burnt. The chemical materials, dry heat, electric, flame, radiation and etc. physical impacts may cause such tissue damage.

Burnt requires a substantial treatment since brings out systemic disorders in body and psychological aspects.

1st degree burnt

* Mostly happen for staying too long under sun.
* Defined with redness of the skin and severe pain.
* Self recovery and the skin may turn to its normal appearance.

2nd degree burnt

* Defined with water including saccules besides the redness
* Mostly because of hot liquids. Painful and serious outcomes.
* Opening (bursting out) the water saccules is dangerous.
* Scar and marks left in case no correct treatment is applied. Open to microbe reproduction.

3rd degree burnt

* Effects total skin. Lesser pain. Fatal liquid losses and inflammations may occur.
* The first aim of the person providing first aid in burnt cases is to move away from/the substance or source that has caused the burnt.
* Prevent the escape of the victim. Extinguish the fire on the victim by covering with a sheet or by rolling the victim.
* While dressing off the burnt victim, cut the dresses/clothes since the skin may peel off.
* The first thing to do in all the burnt cases is to apply cold water till the pain is gone and ten minutes more.
* Take of any bracelet, ring etc. accessories on the victim.
* The burnt zone shall be covered with a wet and clean fabric.
* Leave the zone open in case such fabric (wet and clean) is not present.
* If the conscious is open, give liquid food from the mouth. Keep the patient is suitable position against the risk of shock.

The victim should be brought to the hospital in case of second and third level burnt

Heat burnts: The happen due to wet heat (vapor, all sorts of boiling liquids, water, oil) and dry heat (hot metals, iron, flame, sun).

First aid: It is required to prevent more injury by extinguishing the burning process; killing the flame, moving the hot metal away, dressing of the clothes subjected to wet heat etc. (ATTENTION: in case synthetic clothes are attached to the skin in flame burnt, do not touch them; if time has passed after the incidence in boiling water burnt, do not put off the clothes before applying cold water, otherwise the skin may peel off.)

1st degree burnt

* NEVER apply yoghurt, tomato paste, tooth paste, olive oil etc.!
* Apply cold water at least 10 minutes.
* Oily cream may be applied for to reduce the tension or burnt cream may be applied for to reduce the tension and pain.
* The person should drink adequate liquid if conscious is open in wide area burnt.

2nd degree burnt: Treatment same as of the 1st Level Burnt Burnt In addition, the watery saccules should BE NEVER OPENED/BURST OUT! The victim should be brought to the hospital if necessary and sterile dressing should be applied. If the saccules are distributed to a wide area, NEVER PEEL OFF THE UPPER SKIN! If the saccule has been opened, then empty the liquid within and wipe that part with an antiseptic solution. Close with a sterile fabric and wind with wounding fabric.The bands may damage the burnt tissue.

3rd degree burnt: The patient must be brought to a burnt center or hospital. If the victim is conscious (if he/she may drink himself/herself), cause him/her drink plenty of liquid. DO NOT LET THE VICTIM DRINK ALCOHOLIC or ACIDIC BEVERAGES!

* The open burnt injury will cause pain as long as it contacts with the air; thus, cut its contact with the air as soon as possible. Close the injury with a humid and sterile medical fabric. This provides protection from the infection.

Splash of hot substances: If hot substances such as tar, oil etc. splash to the body, their burning effects continue till they get cold. Therefore, the respective arm or leg should immediately be immersed in cold water and kept there for a long time.

Saving from fire and burning: If the burning person is standing, the occurring gases and smokes easily enter to his/her respiratory system and his/her hair may burn. The person suffering from burnt should be laid down immediately and should roll over. This will extinguish the flames on him/her. The flames may be extinguished in the aforementioned manner mostly or by covering a blanket/rug etc. around the burning person. As soon as the flames are killed, the burning clothes should be taken off without losing time. However do not pull while dressing of the person cut the clothes if necessary. Pulling the clothes off will ever damage the underlying burnt tissue.

If cold water or cold is applied within seconds to the burnt zone, the burnt level and extreme pain may be prevented. In addition, tetanus vaccine should be applied for the wide and deep burnt. Electric burnt: Even though the household devices may cause sufficiently serious burnt, the more important burnt will be seen generally in the factories and high voltage plants where strong electricity currents are used. For the electric caused burnt, it should enter from a spot and leave the body from another spot. There are 2 important dangers coming from electric burnt:

1- Tissue damage: It may be much wider in the internal body (in depths of the tissues) even though not apparent from the external examination. The entrance injury may be small however the exit injury may be very wide and deep. The high voltage electric energy may damage the muscles and the skin as in a level requiring amputation.

2-The heart may stop (even after a couple of hours): Thus, the person subjected to high voltage current must be brought to the hospital. DO NOT TOUCH the person being shocked with electric current! First cut the current. Turn off the switch or detach (never leave it in its place after loosening) the old type fuse. If you have no chance to access to the switch breaker or fuse, then take the person away from the electric source or take away the electric source from the person BUT FOR BOTH SITUATIONS using a insulating/nonconductive (dry wood, rubber, plastic) material. Otherwise, the helping person will complete the circuit and himself/herself may also be subjected to the shock. Keep in mind that the electric burnt/burns happen when all or a part of the body complete the circuit between the electric source and the ground.

ATTENTION: After the current is cut, there is no danger about touching the person for first aid. The victim by no means transfer electric to you once the current is broken/cut (i.e. you may not face electric shock in such way). So do not hesitate to touch.

I wish days of happiness in which you never face such electric burnt.