Burning your skin is a very traumatic experience and can leave behind scars that remind one of the traumatic incident. Scarring caused by burns may fade a little with time but are usually permanent. Apart from affecting your appearance severe burns can also affect the functioning of the body. Burns can make a person withdraw socially by making him or her afraid of how people will accept them with their scars as well as make them depressed about their appearance.

Burn repair surgery can be categorised under two headings: Acute and Reconstructive

Acute repair surgery happens immediately after the burn and deals with large burns and deep burns that affect critical areas. The focus here is to aim for saving of life of burn patient with earliest wound healing with various surgical means.
Reconstructive burn surgery addresses the deformities & scars after the initial burn wounds have healed. The goal here is to improve the appearance of the scars and ensure improvement of functioning. 
There are many types of reconstructive surgeries for burns and the type of surgery best suited to a patient is based on the location of the scar, the extent of scarring and the patient s personal goals.

Skin grafts: This involves the removal of healthy skin from one part of the body and transplanting it to the burn site. This split thickness skin graft include only a few outer layers of skin & full thickness graft involve the entire dermis. This is used in cases of deep burns where full thickness of dermis is affected. Also skin grafts are used for defects following release of burn contracture . 
Flaps: These are thick skin tissues with its own blood supply, used to cover exposed vital structures like vessels , tendons, nerves, bones, etc especially in deep electrical burns of extremities. 
Free flap procedure: In this Microvascular Surgery , muscle, bone or skin is transferred from one part of the body to another to reconstruct huge defects after contracture release or for cosmetic improvement of ugly burn scars. 
Tissue expansion: This involves the insertion of a balloon expander under the skin near the burn scars & deformities. As the balloon is filled with saline, the skin stretches and grows. Once the skin has stretched enough, the expander is removed and the skin can then be used to replace the burn scars & deformities.
This procedure has many advantages as the skin colour and texture are a near perfect match thus reducing scarring to a large extent. However, it is a very slow procedure and can take a few months.

Burn Repair Surgery - How Can It Help To Reduce Deformities & Scars?

A chemical burn can occur owing to a number of substances, for instance, if the skin comes in contact with strong acids, bases, irritants, gasoline, paint thinner and drain cleaners then it react with your skin. Chemical burns are also termed as caustic burns. The symptoms usually depend on the intensity of a burn, which include redness, irritation, numbness, pain, the skin turning black and dead or even vision loss, if the chemicals come in contact with the eyes.


What are the Do s and Don ts?
Do away with those chemicals, which have caused the burn or wipe off the dry chemicals. It is safe to use towels or put on gloves for this work.
Remove jewelry or any contaminated clothing to avoid further burning and inflammation of the skin.
Rinse off the affected area immediately with cold water. 
Loosely wrap the area with sterile gauze or a bandage.
If required, you can even opt for pain relievers such as naproxen sodium, ibuprofen or acetaminophen.
Consider taking a tetanus injection, but at the same time, ensure that your booster is up-to-date.
Refrain from applying an antibiotic ointment over the burnt area or neutralizing it with an alkali or acid. This may aggravate the burn.


When should you seek an emergency care?
When the person exhibits sign of shock such as shallow breathing, pale complexion or is experiencing bouts of fainting.
When the chemical burn pierces through the upper layer of the skin, occupying an area of above 3 inches in diameter.
When the chemical burn has spread to the buttocks, groin, face, feet, hands, eyes or even the limb.


Chemical Burns - Do's and Don'ts You Must Follow

There are mainly three kinds of burns. The degree of burns is determined by the extent of damage that the burn causes. First degree burns are minor while third degree ones are extremely severe. Variety of factors could lead to a burn. They may be chemical, electrical, fire and even sun induced. Boiling or scalding liquids might result in burns as well. The burn type isn t necessarily determined by what causes it. Scalding hot water might cause all the three types of burns; based on the duration of the skin being in contact with the water and how hot the water is. 

Electrical and chemical burns need immediate tending to by a doctor as it might affect the internal body without it being apparent as the damage to the skin is not much. There are also fourth-degree burns. This type of burn includes all of the symptoms of a third-degree burn and also extends beyond the skin into tendons and bones.

First-degree burns: These result in the least skin damage and are also known as  superficial burns  as they only affect the skin s outermost layer. Redness, pain, minor swelling and inflammation are all the symptoms of a first degree burn. As a first degree burn heals, dry skin and peeling takes place. As the skin peels, the symptoms and signs disappear as the burn only manifests on the top most skin layer. It usually takes a week or little more for a first degree burn to heal without any scarring. If the burnt area affects over three inches of skin, or is on the face, then a doctor should be consulted. Home care generally suffices for a first degree burn. Healing time accelerates with rapid treatment of the burn.
Second-degree burns: They are serious as the extent of damage is deeper than the topmost layer of the skin. The skin becomes extremely sore with the formation of red blisters. The blisters might pop open and as time passes, the wound may develop a scab. Proper bandaging is required to reduce chances of an infection. Home remedies should be avoided. The burns usually heal within three weeks.
Third-degree burns: They are the most severe. They extend through each layer of the skin. They might not cause any pain due to the severity of burn as the nerves might get damaged. There might be extreme scarring if corrective surgery isn t done.

Burns - Understanding Its Degrees!

Burn surgery is very common these days. Burn surgery is usually done on people who suffer from major burns. Reconstructive burn surgery is usually required in the last stages when the initial burns have healed to a certain extent. Usually reconstructive burn surgeries are done on patients who have suffered from huge accidents and have burnt their face, neck and hands to a great extent. Patients requiring this surgery usually become unrecognizable after an accident.

When is reconstructive burn surgery recommended?

If you have been involved in a household accident and the scars have not healed completely. Surgery might not totally heal the face, but it can improve your basic functions like breathing, smelling, seeing or tasting (if most of your senses are burnt and disfigured).
Reconstructive burn surgery is also very useful for acid attack victims. Sometimes, burns are not only caused by fire, but it is also caused by chemicals and acidic substances which are worse and can completely burn and disfigure your face. When hydrochloric acid, nitric acid and sulfuric acid come in contact with your skin it seeps into the skin and burns off your nose, cartilage and sometimes even causes blindness. It disfigures your face completely, reconstructive burn surgery can do miracles, though it cannot bring back your previous features and skin texture, but it does make you look more recognizable.
After a burn, facial scarring occurs which leads to the loss of eyelids, hair, nose and lips. In this case burn surgery is required.
How to take care of yourself after a burn surgery?

Regular stretching should be done, especially if the areas of your burn include your hands, legs, joints, etc. Do as much as activities as possible like getting dressed and grooming yourself. It will also make you more self-reliant and give you confidence.
Depression is very common after a burn surgery. A reconstructive burn surgery will not magically make you look the way you used to. A lot of sittings is required and remember, appearance and looks do not matter much. The wounds will fade away with time.
Itching is also very common after a burn surgery. If this problem persists, you should consult your doctor for a moisturizer.
Avoid sun exposure. Don t go out in the sun, because the U.V rays are extremely harmful and can singe your already sensitive skin; you can also get skin cancer.
Custom pressure garments should be worn to protect your skin.

Reconstructive Burn Surgery - How Can You Take Care Of It?

Wounds and bruises are both injuries. However, they differ widely in terms of the causing factors, the nature of the injury, the pain they cause and the kind of treatment they require. The following are a few of the myriad ways in which the two injuries differ from each other:

1. A wound causes quick damage - the skin tissue is cut or punctured while a bruise (also called a closed wound) is where the skin is not torn. 

2. A wound is usually caused by a sharp object but bruises are the results of blunt force or trauma.

3. A wound almost certainly bleeds due to ruptured tissue and blood vessels. Blunt injury also damages the blood capillaries of the skin and causes blood to accumulate under the skin tissue, creating a dark patch of skin. Blood vessels can also break due to lifting of heavy objects or overexertion of muscles.

4. A wound carries the risk of infection because the skin is open but a bruise does not get infected.

5. A wound has a burning or stinging sensation but a bruise is characterized by swelling and a blunt throbbing pain.

6. A wound can be healed by antiseptic and antibiotic medication. Large wounds need to be closed by stitching them up to avoid severe infection. On the other hand, a bruise usually heals by itself. A cold compress and pain killers may be used to ease discomfort. Heat can be applied to the injured spot to normalize the blood flow and dissolve the blood clot.

7. A wound can lead to complications like bacterial infections or the healing might be delayed by chronic diseases like diabetes. In case of a bruise, it usually does not cause complications but if there's a blunt injury to sensitive areas like the head, the tailbone or the eyes, medical attention is advised.

8. Wounds and bruises can also be differentiated on the basis of their subtypes. The different types of wounds are:

a. Incision (sharp objects cutting the dermis layer of skin)
b. Abrasion (the epithelial tissue is scraped off)
c. Avulsion (a body structure is torn off)
d. Penetration (a sharp object causes an entry and an exit wound)
e. Puncture (only an entry wound caused by a sharp object)

The different types of bruises are:
a. Hematoma (blood pools under the skin)
b. Purpura (tiny spots of blood on the inside of the mouth)
c. Contusion (similar to hematoma and caused by external trauma)
d. Crush injury (caused due to a large amount of force on the body part for a long time)

Wounds VS Bruises

While injuries of any form can be painful, burn injuries are one of the worst to suffer from. While cuts and bruises can be temporarily assuaged with a proper dressing, burns are quite different in this regard. With burns, the damaged tissues will stay on the body and may cause continuous pain. Thus, burn injuries are difficult to treat and they require different strategies for pain management as well.

Treatment methods available for treating pain arising due to burn injuries

Apply an anesthetic cream or aloevera gel to soothe the burnt skin. Avoid exposing the skin to air as that will cause painful sensations.
Loose gauze or antibiotic ointment must be used to protect the influenced area.
Soak the burnt area wound in cold water for about five minutes or more.
If the burn escalates or affects a widespread area, seek medical attention immediately.
Pain management factors for burn injuries:

Relaxation: During the phase of recovery, burn injuries put immense stress on your body and continue for a long period. Muscle tension is caused by stress that increases pain. Some relaxation techniques are proven to be beneficial to reduce the stress on body.
Coping with your pain: Different people have different ways to cope with physical discomfort. Look out for situational aspects which are currently under your control and take it positively. The  what ifs  or wishing that the burn didn t occur in the first place will not help with your current situation. You should focus on things what you can control like self-rehabilitation, doing your daily exercises, physical therapy treatment or following a doctor s suggestion of pain management strategies. This will help you cope with your pain to a greater extent.
Sleep medications: If your normal sleep routine is hampered, consult your physician for safe sleep medications. Proper sleep is very important for the healing process and even more so in the case of burn related injuries.
Antidepressants: Some people may not be suffering from depression, but they might still need antidepressants for relief and sound sleep. A health care provider might prescribe antidepressants as a way to deal with acute pain from burn injuries.
Increase the pace of your activities: If you want to rebuild your health and stamina and get back in form soon, focus on the regular physical and mental activities. Exercise regularly, but don t push yourself too much. Increase your physical activities gradually over time. Unless and until you are fully comfortable, don t strain yourself too much. Occupational and physical therapists can help you with an appropriate activity program.

Burn Injuries - 5 Ways to Manage Its Pain

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