Burning questions about burn injuries
Print Edition
SUMMER means an increase in burn patients across the city. A specialist from Ruijin Hospital gives advice on what to do in case of a burn injury. Cai Wenjun reports.
Summer is the peak season for burn injuries in Shanghai. Ruijing Hospital’s department of burns receives an average of 75 burn patients daily during the summer, with a record of 100. About one-third of its burn patients are children.
A burn is an injury to the skin or other organic tissue primarily caused by heat. Burns can also be caused by radiation, radioactivity, electricity, friction or contact with chemicals. Respiratory damage resulting from smoke inhalation is also considered a burn.
The summer increase in burn patients is largely due to people wearing less clothing, which exposes more skin. The most common causes are fires, hot liquids, contact with hot objects and sunburns.
Scalding is caused by hot liquids and most commonly occurs from exposure to hot drinks, high temperature water in baths or showers, cooking oil or steam. Scalding injuries are most common in young children.
Doctor Huan Jingning, director of Ruijin Hospital’s department of burns and plastic surgery, said they can treat children who have fallen into a bath tub full of extremely hot water.
“Such burns are usually very large and can lead to very critical injuries.”
Electrical burns are also common among children, who may use their fingers or metal toys or forks to stick in an electrical outlet due to curiosity. This can cause deep burns in the fingers. In serious cases a child may need the fingers amputated.
Doctors grade burns based on severity.
Burns that affect only the superficial skin are known as first-degree burns, which usually heal within one week without leaving scars. When damage penetrates into some of the underlying layers, it is known as a partial-thickness or superficial second-degree burn. These are the most prevalent burns and often takes two weeks to heal while also leaving some scars.
If the damage reaches the deep underlying layers, it is a deep second-degree burn, which requires three to four weeks to heal. If it becomes infected, it can develop into a third-degree burn and a skin transplant will be needed.
In a full-thickness or third-degree burn, the injury extends to all layers of the skin and reaches tissue like muscles and bones. A skin transplant is a must in such cases.
The size of a burn is measured as a percentage of total body surface area. For most people, the palm of one hand equals 1 percent of their total surface area.
The seriousness of a burn is determined by how big and how deep it is. Large burns can result in an infection, shock and organ damage. A patient can die in such cases if they are not treated in time.
Even a small burn can be life threatening depending on its location. A burn on the neck can lead to swelling, putting pressure on the air tube.
To protect children from bath water burns, parents are advised to use cold water first and then add in hot water. Mix the water thoroughly to ensure an even temperature.
Child-proofing electrical outlets will reduce the risk of electrical burns.
Huan said parents can begin immediate emergency treatment on a child if an accident occurs.
He recommends running cold tap water on the injured area for at least 10 minutes. If the wound is covered by clothing, he says parents need to remove it carefully under tap water.
“It is wrong to use toothpaste, soy sauce and liquid medicine on the wound,” Huan said. “These so-called folk measures can cause an infection or deepen the injury.”
Once the pain resides, parents can cover the wound with a clean towel or gauze and take the child to the hospital immediately for further treatment.
Huan also said anyone with a second-degree burn or worse needs to be treated at a hospital with burn expertise.
Burns are considered critical if they cover 10 percent or more of the body area of a child or senior. Adults with burns on the face and neck or 15 percent of the body are also considered critical cases.
Chen Erzhen, vice president of Ruijin Hospital, said burn injuries are expensive to treat and a serious injury can put families into financial difficulties.
“The cost is about 10,000 yuan for every 1 percentage of burns on the body surface area,” Chen said. “We have received many children with burns from poor families who are not covered by medical insurance and they can’t afford the bill.
“While promoting prevention and treatment of burns, we are also calling for the government and society to help care for poor children with burns,” Chen added. “We have over 7 million yuan (US$1.12 million) in unpaid bills from poor patients with burns. Some of them have had to give up treatment.”
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