BURNS & SCARS
People of all ages are susceptible to minor burn injury. The highest incidence occurs during the first few years of life and in those aged 20-29 years in Cyprus. For children younger than 2 years, liquid scalds and hot surface burns account for nearly all serious burn injuries. After age 2 years, flame burn is the most common cause of serious burn injuries. Depth of burn injury is usually classified according to degrees.
In first-degree burns, minor epithelial damage of the epidermis exists. Redness, tenderness, and pain are the hallmarks of this injury. Blistering does not occur, and 2-point discrimination remains intact. Healing takes place after several days without scarring.
Second-degree burns Superficial partial-thickness burn involves the epidermis and superficial (papillary) dermis, often resulting in thin-walled, fluid-filled blisters. These burns appear pink, moist, and soft and are exquisitely tender when touched by a gloved hand. They heal in approximately 2-3 weeks, usually without scarring, Deep partial-thickness burns extend into the reticular dermis. Skin color is usually a mixture of red and blanched white. Because these burns have less capacity for re-epithelializing, a greater potential for hypertrophic scar formation exists. In deep partial-thickness burns, treatment with topical antimicrobial dressings is necessary to prevent infection as the burn wound heals.
Third-degree burns are full-thickness burns that destroy both epidermis and dermis. Unless a third-degree burn is small enough to heal by contraction (<1 cm), skin grafting always is necessary to resurface the injured area.
Most partial-thickness burns respond satisfactorily to daily antibiotic dressings. Polysporin, Bacitracin, and Bactroban creams may be used. Indications for surgery are full-thickness burns or partial-thickness burns that are unlikely to heal within 3 weeks. Provide tetanus prophylaxis if indicated. Prophylactic antibiotics are not recommended. Treat burn wounds either by the open or closed technique. Open therapy of minor burn injuries usually is reserved for burns of the face. These burns are covered by bacitracin ointment, which is reapplied every 6 hours after gently washing the skin.
Causes of Burn Scar: Tension on the wound, excess inflammation in wound bed, inflammatory stimulus, Infection, wound open for more than 3 weeks, lack of dermal elements, genetic predisposition. Treatment Modalities for burn scars are: Surgery Therapies: excision, cryotherapy; biophysical therapies: compression, silicone gel sheeting, scar massage. Pharmacologic Therapy: corticosteroids.
Prevention is always easier that treatment and you have to be very cooperative with your plastic surgeon in Cyprus to achieve best possible results.