Burns - Introduction
Burn is defined as tissue damage caused by a variety of agents, such as heat, chemicals, electricity, sunlight, or nuclear radiation. Most common are burns caused by scalds, building fires, and flammable liquids and gases.
- First-degree burns affect only the outer layer (called the epidermis) of the skin.
- Second-degree burns damage the epidermis and the layer beneath it (called the dermis).
- Third-degree burns involve damage or complete destruction of the skin to its full depth and damage to underlying tissues. People who experience such burns often require skin grafting.
- The swelling and blistering characteristic of burns are caused by the loss of fluid from damaged blood vessels.
- In severe cases, such fluid loss can cause shock, requiring immediate transfusion of the patient with blood or a physiological salt solution to restore adequate fluid levels to maintain blood pressure.
Burns often lead to infection, due to damage to the skin's protective barrier. In many cases, topical antibiotics (creams or ointments applied to the skin) can prevent or treat such infection. The three topical antibiotics that are most widely used are silver sulfadiazene cream, mafenide acetate cream, and silver nitrate. Each year in the United States, 1.25 million burn injuries require medical attention.
- Approximately 50,000 of these require hospitalization, and roughly half of those burn patients are admitted to a specialized burn unit.
Up to 10,000 people in the United States die every year of burn-related infections; pneumonia is the most common infectious complication among hospitalized burn patients.
- Twenty years ago, burns covering half the body were routinely fatal; today, patients with burns covering 90 percent of the body can survive (but often with permanent impairments).
- Practices that have contributed to this improvement include advances in resuscitation, wound cleaning and follow-up care, nutritional support, and infection control.
- Grafting with natural or artificial materials can also speed the healing process.
Complications following injury, shock, or burns may occur long after the initial incident, often when the patient is in an intensive care unit (ICU). Many ICU patients face similar medical problems regardless of the reason for their admission into the unit.The leading causes of death in ICUs are multiple organ system dysfunction, in which several of the body's organs fail at once, and adult respiratory distress syndrome, in which the lungs in particular fail. In both conditions, the organs of the body are ravaged by the patient's own immune system, leading to severe, debilitating, and uncontrolled inflammation.The cost of maintaining critically ill patients in ICUs is estimated to be roughly 1 percent of the U.S. gross national product.Improving methods of wound healing and tissue repair offers tremendous opportunities to enhance the quality of life for trauma and burn patients, and may also help to reduce health care costs.Scientists are investigating ways to treat wounds caused by trauma, burns, or surgical interventions with biological agents (e.g. growth factors) or new drugs.The National Institute of General Medical Sciences (NIGMS), one of the National Institutes of Health (NIH), sponsors research--mostly basic but some clinical--in the areas of burn, shock, and trauma. Other NIH components support or conduct research in aspects of trauma, burn, and injury related to their missions, as well.
National Institute of General Medical Sciences,
NIH45 Center Drive MSC 6200
Bethesda, MD 20892-6200
Phone: (301) 496-7301
http://www.nigms.nih.gov/Publications/FactSheets.htm
(scroll down to Trauma and Burn Injury)
