Frostbite is caused by a number of mechanisms including direct cellular injury from crystallization of water in tissue and indirect injury from ischaemia and reperfusion. Thermal injury can also occur through cold. Electrical injuries are entirely different because they can cause deep tissue damage that is greater than the visible skin injury tissue damage in electrical injuries is correlated with the electric field strength (amperes and resistance of the tissue), although for ease of comprehension the voltage is often used to describe the circumstances of injury 2. Alkaline chemicals cause colliquative necrosis (whereby the tissue is transformed into a liquid, viscous mass), whereas acidic burn causes a coagulation necrosis (whereby the architecture of the dead tissue can be preserved). For example, a flame or hot grease can cause an immediate deep burn, whereas scald injuries (that is, from hot liquids or steam) tend to appear more superficial initially, due to rapid dilution of the source and energy. Although all burn injuries involve tissue destruction due to energy transfer, different causes can be associated with different physiological and pathophysiological responses. The injuries can be caused by friction, cold, heat, radiation, chemical or electric sources, but the majority of burn injuries are caused by heat from hot liquids, solids or fire 1. The aim of this Primer is not only to give an overview and update about burn care, but also to raise awareness of the ongoing challenges and stigmata associated with burn injuries.īurn injuries are an under-appreciated trauma that can affect anyone, anytime and anywhere. Burn care providers are, therefore, faced with a plethora of challenges including acute and critical care management, long-term care and rehabilitation.
Accordingly, patients with burn injury cannot be considered recovered when the wounds have healed instead, burn injury leads to long-term profound alterations that must be addressed to optimize quality of life.
Of great importance is that the injury affects not only the physical health, but also the mental health and quality of life of the patient. Burn injuries, particularly severe burns, are accompanied by an immune and inflammatory response, metabolic changes and distributive shock that can be challenging to manage and can lead to multiple organ failure. Burn injuries are under-appreciated injuries that are associated with substantial morbidity and mortality.
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