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Burns (Heat, Electric and Chemical) in Seniors

Burns are usually caused by heat, electricity, chemicals, light and radiation. The severity of burn ranges from a minor problem managed easily at home to a life-threatening situation requiring immediate medical attention, hospitalization and treatment in a specialized burn unit. Although any person can sustain a burn, usually as a result of an accident, seniors are especially prone. Age-related changes in movement and mental functions, diseases and a lack of care for the immobile make burns a more likely occurrence in the elderly.

Degree of Burns

The severity of the burn injury depends upon the extent of skin penetration. Burn injuries are therefore classified under four degrees.

First degree

Only the epidermis (outer layer) of the skin is involved, characterized by painful dry leathery appearance of the injury. Complete healing occurs usually within one to two weeks. Apart from first aid, no further medical care may be needed.

Second degree

These burns are classified under two categories :

  • Superficial partial thickness : injury involves upper part (superficial layer) of the dermis (next to the epidermis) leading to painful, moist, fluid-filled blister formation. About 2 to 3 weeks are required for complete healing. Secondary bacterial infection may occur at the affected area of the body.
  • Deep partial thickness : extends into the deeper dermis forming moist, painful blister formation. This type of injury in the long-term can produce scarring of the affected body part and ultimately contraction of the area and restricted joint movement. Plastic reconstructive surgery using skin grafting may be required.

Third degree

Involves the whole of the dermis (layer just beneath the superficial epidermis of the skin). The burn lesion may appear stiff, white and leathery. It is usually painless because the burn injury damages or destroys the nerves.

Fourth degree

Injury extends beyond the skin into the muscles and bones. Both third and fourth degree injuries require immediate hospitalization and prompt treatment to prevent death.

Severe and Untreated Burns

Complications can be :

  • Painful blister
  • Superficial infection (cellulitis)
  • Diminished blood flow
  • Low temperature
  • Scarring
  • Difficulty in affected joint movement
  • Death (due to neural or vascular shock, choking at the time of burning)

Types of Burns

Burns can be caused by a variety of external factors like :

  • Scalding due to contact with hot liquids or steam due to spillage of hot drinks, contact with excessively hot bath waters.
  • Chemical burn due to contact with strong acids (like hydrochloride acid, sulphuric acids) and bases (sodium hydroxide).
  • Electrical burn due to electrical shock and lightning injury are the main causes. Sometimes the person may not have any superficial damage, but internal organ damage (cardiac abnormality-cardiac arrest) is common.
  • Radiation burn due to UV radiations from sun exposure (UV rays), X-ray and radiation therapy for the treatment of cancer. Even microwave burns can cause radiation burns.
  • Inhalational injury which can occur with steam or smoke.

Burns Treatment

Treatment depends upon the severity (degree) of burn.

  • Local wound care with dressing.
  • Painkillers (analgesics) to ease pain.
  • Antibiotics for secondary infection.
  • Intravenous (IV) fluid replacement.
  • Surgery (using skin grafts or amputation) may be required.
  • Physical therapy.

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