Causes of burns and classification of burns

This is an automatically translated article.

The article is expertly consulted by Master, Doctor Nguyen Tung Hoanh - Interventional Cardiologist - Department of Resuscitation - Emergency - Vinmec Nha Trang International General Hospital.
Burns are a common accident in daily life and work, can occur in both adults and children and tends to increase. Burns not only cause immediate damage to health but also leave long-term consequences.

1. Overview of burn status

A burn is an injury to the body caused by direct exposure to sources of heat, electricity, chemicals, and radiation. The skin is a part of the body that is often burned, in addition, there may be airway burns (due to inhalation of hot vapors, gaseous chemicals ...), gastrointestinal burns (due to drinking hot liquids or chemicals), burns eye . Subcutaneous parts (tendons, muscles, bones, joints, blood vessels, nerves...), organs in the body can also be burned.
Every year in the United States about 1.4-2 million people are burned; 70,000-108,000 patients entered treatment. At the Vietnam National Institute of Burns, every year 5000-6000 burn patients come in for treatment.

2. Circumstances of burns

Domestic accidents account for 60-65% of the total number of burn victims with common circumstances: negligence in the kitchen causing burns due to hot food or the fuel used to cook food, due to the storage of petrol or oil or flammable materials, household electrical appliances or in an unsafe living environment. Burns are also caused by negative causes such as self-immolation, burning each other, throwing acid for revenge, electric traps ...
Work accidents account for about 5-10% of victims, or accidents due to non-compliance with regulations Safety procedures, fire prevention and control in boilers, tunnels, production lines, factories, electrical failures...
Traffic accidents are less common, accounting for about 2-5%, often due to pipe burns. discharging motorbikes, molten asphalt, electric burns caused by cargo cranes, there are also car and passenger car fires, ship tunnel fires...
Accidents caused by other undesirable factors: nature disaster, forest fire, disaster, explosion ...

3. Burning agents

There are many causes of burns such as heat, electricity, chemicals and some other factors.

3.1. Heat burns

Heat burns account for a high proportion of common wet and dry heat burns:
Wet heat: is the leading cause of burns. Victims are burned by boiling water, hot food such as fat, porridge, soup, pig bran, honey, wine residue, tofu juice, boiling hot steam.. Dry heat: common in burn accidents. Fire burns are common in fires (such as burning objects, house fires, forest fires), burns caused by contact with heated objects such as hot metal, coal powder, clinker, hot slag...

3.2. Electrical burns (electrical burns)

Electrical burns (electrical burns) when an electric current is passed through the body. Based on the voltage difference, electric burns can be divided into 2 groups:
Low voltage burns (voltage difference below 1000 volts): civil electrical burns, victims are in direct contact with electric current. High voltage electrical burns (potential difference over 1000 volts). When the voltage is high, people may not be in direct contact with the current (current magnetic field) but still get electric shock due to the discharge phenomenon. Lightning is caused by electrical currents with voltages as high as millions of volts in the atmosphere.

3.3. Chemical burns

Chemical burns caused by acids (such as sulfuric acid in battery charging, nitric acid in soldering) or alkalis (such as hot slaked lime, caustic soda, detergents). Chemical burns are encountered in domestic accidents, in laboratories, in production accidents, in unsafe transportation or in criminal acts (smashing acid for revenge...).
Burns caused by some rarer agents such as radiation burns, drug burns...

4. Classification of area and depth of burns

There are many ways to calculate the burn area, but to quickly estimate the burn area, the patient hand measurement method can be applied. The area of ​​1 hand (from the wrist to the fingers) of the patient's liver or dorsal side corresponds to a burn of 1% of the skin area. In children, burns even small areas are dangerous. Children with burns on more than 5% and adults with burns on more than 15% of the body are at risk of shock, which is directly life-threatening, requiring prompt emergency care (emergency measures such as pain relief, infusion...).
Skin is a part of the body that is prone to burns, burns can cause skin damage or deeper. There are many ways to classify burn injury depth. However, basically, burn depth can be divided into 2 types:
Superficial burns: partial burns of the skin. Burns can heal on their own during treatment and dressing changes, without surgery, leaving no scars when healed. Some common signs in superficial burns: reddened skin like when sunbathing, burns with thin or thick dome blisters, internal blister fluid... Deep burns: burns the entire skin or deeper to the tendons, muscles, bones, joints, nerves, blood vessels, organs in the body. Treatment of deep burns requires surgery (burns >5cm in diameter). Deep burns when healed leave different forms of burn scars. Some common signs of deep burns: black and dry necrotic burns, hands twitching, loss of pain sensation or wet necrotic burns of gray-white, yellow-gray color... The burn area is strongly edematous. Deep burns are common due to electric burns, acid burns, fire burns in victims who have lost sensation such as having a seizure or falling drunk on the fire, the victim sets himself on fire...

The diagnosis of superficial or deep burns will determine the different management attitude (surgical or non-surgical). However, to accurately diagnose burn depth requires specialized knowledge (usually private medical facilities do not have a burn specialist, and healers are not equipped with this knowledge). Therefore, burn victims need to be taken to a medical facility for professional examination and treatment.
Vinmec International General Hospital is the address for examination, treatment and prevention of diseases. When performing the examination process at Vinmec, customers will be welcomed and used modern facilities and equipment along with perfect medical services under the guidance and advice of experts. Good doctors, well-trained both at home and abroad.

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Source: Ministry of Health