The first step in burn treatment is to ease the pain and provide a degree of comfort to the patient
Burns are caused due to exposure of human tissue to heat, chemicals or electricity. They are classified as first, second, third and even fourth-degree burns.
First-degree burns are superficial and affect only the outer layer of skin. They can be treated well with suitable home remedies. Sunburn is an example of a first-degree burn. Second-degree burns penetrate through the outer layer of skin called the epidermis and affect part of the lower layer called the dermis. Examples are burns caused by boiling water and steam. Treatment will depend on the extent of tissue damage.
Third-degree burns destroy both the epidermis and the dermis. The tissue looks black and charred; the innermost layers are likely to be affected. They could be life-threatening and may require surgery. If the damage extends to the muscles and bones, the injury is classified as a fourth-degree burn. Fourth-degree burns typically do not cause pain because the nerve endings are damaged. Patients with fourth-degree burns need to be provided with critical care. Some of the Mumbai hospitals that have specialised burn units are Masina Hospital, Airoli Burn Centre and Bhatia Hospital. While Masina Hospital and the Airoli Centre accept patients with less than 20 per cent burn injuries, Bhatia Hospital accepts all burn victims.
Critically ill patients admitted by the latter are attended to by an entire team of healthcare providers including doctors, a nutritionist, plastic surgeons, physiotherapists, psychologists and trained nurses. Each one of these specialists has a role during the various stages of treatment. The psychologist interacts with the patients and guides them during the treatment.
The first step in burn treatment is to ease the pain and provide a degree of comfort to the patient. Pain can be managed in multiple ways, starting from paracetamol, and progressing to skin patches and special epidural anaesthesia.
New technologies that have been developed have greatly enhanced the treatment and management of burn injuries. Newer forms of dressing material have been developed, but they are permeable to bacteria. On the other hand, biological dressings like collagen create a physiological barrier between the wound and the environment and prevent the entry of bacteria. Although the completeness of healing is comparable to that with conventional
dressings, the use of collagen sheets has changed the name of the game in burn treatment. It adds to the comfort of the patient and pre-empts the need for skin grafting. Should skin grafting become necessary, allograft technology is now available. Allograft skin is provided bya donor — as against the patient’s skin — which is used to cover the wound.
It is long-lasting and avoids the risk of infection through frequent dressing changes. KM Hospital and Sion Hospital in Mumbai have skin banks from where these materials can be sourced. Since no patient is refused admission to Bhatia Hospital regardless of the extent of the burn injury, treatment at the hospital has to be of the highest standard. The hospital has a private burn unit with three wards. The facility has a separate connection for dialysis and a dedicated operation theatre.
Patients are given a specialised bed, where they can be weighed without ever having to get up. Operations can
also be performed on the same bed. Each patient has one and only one nurse allocated to them, and that nurse
is the only one allowed to attend to the respective patient. All staff re trained in ICU management and dressings. To prevent the entry of infection, anyone entering the unit must change their clothes and footwear; wear a cap, mask and gown; and wash their hands before touching the patient. But as the saying goes, prevention is better than cure. The best way to avoid the complications of burn injuries is to prevent them from happening. Children
should not be allowed to go near hot water, especially when preparing them for a bath. Lighters and matches should be kept away from flammable substances. All electrical outlets should have proper grounding. Electrical
wiring should be of good quality with no exposed wire. Switches should be in the ‘off’ position before handling
any electrical appliance.
Kitchen stoves should be kept at a safe height, with proper ventilation and exits. These are some of the common precautions that can be taken in day-to-day life. It is better to be safe than sorry, and although they may be a little harsh on the pocket, in the long run, these safety measures will go a long way to give people a good, safe life.