Burns

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By Ebrima Jobarteh

The technological advancements in the world have had a greater impact on the lives of people. Most of these advancements are highly electrically dependant. The inventions of gas cookers and electric irons have certainly made household chores more efficient. Although the use of candles has decreased, these electric devices when handled carelessly tend to cause fires. The most common effect of fires is burns. In this article, we will take you through the definition, major causes, and degrees of burns, the body’s response to burns, medically related complications, prevention and a few words of advice on burns.

A burn is the response of the skin and subcutaneous tissue to thermal injury. The word “thermal” suggests that one only gets burnt when one is exposed to heat beyond which the body tissue can handle. This clearly points out that the human body is programmed to tolerate temperature at defined ranges. With normal body temperature being in the range of thirty six and thirty seven degrees Celsius, temperatures mildly increased above thirty eight degrees can predispose the skin to burns.

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CAUSES
The causes of burns are primarily of environmental origin. They are; Thermal, Sunlight, Chemical, and Electric. These causes elicit different degrees of damage to the skin.
1.Thermal- Thermal sensations as mentioned earlier cause burns when some substances under immense heat are exposed to the skin. Thermal related causes of burns are categorised into dry (i.e flames and hot metals) and moist (i.e hot liquid e.g., water and hot gases). The most common causes of burns in The Gambia are flames and hot water.

2.Sunlight- Excessive exposure to the Ultraviolet (UV) rays of the sun can cause the skin to burn. However, this is genetically dependent. Too much UV light damages the skin’s DNA. Accumulation of damaged DNA predisposes the individual to skin cancer. One of the obvious symptom of a sunburn are painful redness on skin accompanied by blisters.

3. Chemical- Chemicals or caustics can cause burns if ingested or spilled on the skin or eyes. They account for one of the most dangerous causes of burns. Chemicals that can cause burns include bleach, car battery acid, teeth whitening products, ammonia and pool chlorination products.
4. Electric- Electric burns involve the passage of electricity through the body. For a burn to be classified as electric, electricity must be the direct cause. The severity of the electric burn depends on the voltage, amount of current passed and the resistance offered by the individual. Electric burns can cause brain shock, heart failure, and other organ damage.

SEVERITY
The degree of damage caused by burns is classified in four stages. First degree burns only elicit redness of the overlying skin. They are in fact referred to as superficial burns and are likely to heal in week or two. When this redness is accompanied with blisters and underlying skin is exposed, the burn is described as second degree. Although there are four degrees of severity, most often than not, third degree burns in the absence of the fourth class are regarded as the most severe. This category of burns is similar to the second degree burns; however, it does not elicit blisters. It penetrates tissues deeper than second degree burns. Fourth degree burns includes damage to deeper tissues such as bones and tendons.

How does the Body respond to burns?
The body’s response to burns depends on the cause of the burn. The manner in which the body physiologically reacts to a thermally-induced burn is slightly different to an electrically-induced burn. These differences are the key determinants in the level of management of a burn. The body responds to a burn in two ways; Local and systemic.

Local response is basically what is seen on the outside (i.e skin). It depends on the severity of tissue or skin damage. This is grouped into three zones from internal to external are:
1. Zone of Coagulation- This area is mostly present when there is a high damage burn as a result of heat. Damage of this cause destroys the blood vessels thus impeding blood flow to the burnt area. Cells in that area are deprived of oxygen which is carried in the blood. As a result, the cells die, and tissue death otherwise called necrosis is imminent.

2. Zone of Stasis- This zone is external to the above zone (coagulation zone). This zone is repairable and is basically the area of focus in burn management.

3. Zone of hyperaemia- In this area, there is an increased blood flow and thus tends to heal normally.
The systemic alterations accompany the local responses. The systemic alterations that occur are mostly under the influence of certain hormones (e.g. Cytokines, Histamine and Bradykinin) released by the body to elicit an inflammation. Most of these hormones tend to dilate the blood vessels in order to increase blood flow to that burnt area. These hormones otherwise known as inflammatory mediators cause the constriction of the respiratory airways in the lungs. In severe burns, excessive constriction of these structures causes respiratory distress. More serious systemic alteration are better described as complications related to burns as explained in the next section.

Complications of Burns
Besides the above mentioned systemic alterations, other complications can result from burns. One of the most likely complications is infections. A burn exposes the skin to harmful aerial bacteria. These bacteria can enter the burnt area and cause sepsis. This could travel through the blood stream and cause damage to other tissues and organs of the body. Other complications include scarring which can accumulate to form a large masses known as keloids which require surgery for removal.

Prevention of burns
Burns account for one of the most frequent emergency cases in the hospital. Majority of its victims are children hence, the need to prevent this calamity. So how does one prevent burns? Firstly, keep children away from electricity, boiling or hot water. This will really go a long way in saving you the cost of treatment involved should a child be burnt. Another important and modernised method of preventing burns is the use of fire extinguishers. In this day in age where fires are so rampant and devastating, having a fire extinguisher hanged safely in the house could be really vital.

Word of Advice
To round it up, it is in our best interest dear reader to prevent fires. And since fires are the major causes of burns, our collaborative efforts and awareness of the dangers of fires should go a long in preventing burns.
Thank you.

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