scalding

The scald

Scalds are relatively common in the home environment. They mostly arise during kitchen work and here especially when pouring off hot or even boiling water (e.g. poured pasta water, etc.).

A distinction is made between scalds from hot water and from steam. The latter can cause more severe injuries to the skin, as water vapor is considerably hotter than heated water. Scalds occur from a temperature of 45 degrees Celsius. Only the upper layer of the skin is affected. In addition to severe pain, reddening and possibly swelling of the corresponding skin area can also be observed.

The first measures should always be to cool the area. First of all, items of clothing must be removed from the relevant skin area. In the case of scalds that do not leave the skin open, you can put cooling tap water or ice packs on the area. It is important that the cooling should be started within the first few minutes after the scald.

After 10 minutes at the latest, the cooling should be interrupted and the skin inspected. If necessary, the cooling can take place again. Depending on how large the area is or where it can be found, a doctor should be consulted after or during the cooling. Are large areas of the skin or important organs such as If the eyes are affected by the scald, a doctor should always be consulted immediately.

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Degree of scalding

Degrees of combustion

Our skin is made up of many layers. From the outside in, these are essentially the Epidermis (epidermis), Dermis (Dermis) and the Subcutis (Subcutaneous tissue) with the fatty tissue. The dermis are also indispensable for the regeneration of the skin. Severe damage to this skin layer usually results in scarring.

Depending on the skin layers involved in the scald, it can be divided into different degrees of severity.

  • Grade 1: There is only reddening and slight swelling of the skin; only the epidermis is affected. The skin is painfully irritated, but the scald heals within days to weeks without permanent damage.
  • Grade 2: Both the epidermis and the dermis are affected. A visible blistering with a red-white background takes place; the patient feels severe pain. At Grade 2a finds a complete cure, at Grade 2b the formation of a scar takes place. It takes a few weeks for the injury to heal completely.
  • Grade 3: A third-degree burn or burn is represented by black and white blisters or even necrosis (dead tissue) marked. The patient still feels no pain, since nerve endings were destroyed along with the dermis and subcutis. Scar-free healing is not possible.
  • Grade 4: In the case of very severe scalds, not only layers of the skin but also underlying muscles, tendons, bones and joints were damaged. Again, the scald is painless.A fourth-degree burn usually requires a skin graft.

A more detailed assessment of burns is based on the burned area of ​​the skin:

Even a second or third degree burn leads to an affected body surface of about 10% in adults (corresponds roughly to the area of ​​an arm) or 5% for children (corresponds roughly to the area of ​​half an arm) to severe water loss due to unhindered evaporation. A life-threatening one hypovolemic shock can be the result.
With the so-called rule of nine, the burn area in adults can be roughly estimated. The arms and head each take up 9% of the body surface. The skin of the legs covers about 2 x 9 (18)% of the body, the skin of the trunk about 4 x 9 (36)%. The rule of nine loses its validity for children due to the different body proportions. However, the general rule of thumb is that the palm of the patient (including the fingers) is about 1% of the body surface.

Treatment of a scald

First of all, scalds should be treated with 20 ° cold water.

The most important treatment for burns and scalds is to cool the scalded skin immediately after the heat source has been removed. This can best be done using about 20C ° cool, germ-free water (best tap water) happen. Ice, on the other hand, should not be used as there is a risk of freezing the skin. Studies regarding the wound healing effect of cooling on scalds and burns are rather vague. However, a pain relieving effect is assured and justification enough for cooling.

On the scalded skin clothing or other objects should not be removed yourself and should be left on the patient's body until specialist personnel arrive. An exposed burn wound should be covered, if possible, with sterile, non-fluff wound dressings after cooling. These should be applied loosely. Ideally, a wound pad coated with aluminum is used for this.
Dressing sets specially designed for burns usually contain such wound dressings. It is generally advisable, but especially with children in the household, to always have sets of this kind close at hand in the medicine cabinet.

Applying home remedies such as:

  • Flour
  • oil
  • Salt or
  • Hand creams

should definitely be avoided, as infection and further damage to the skin can result. Even special ointments and gels should only be applied, if at all, after consultation with the family doctor or a pharmacist and are therefore not part of first aid measures.

Depending on the severity and extent of the scald, a doctor should be consulted for further treatment. First-degree burns are easy to treat yourself; if you have severe scalds, it is recommended to see your doctor or the emergency room.

Anti-scald ointments

In addition to cooling, cooling or pain relieving ointments are often used for scalds. However, their application is not entirely undisputed.
In most cases, fresh scalds should be treated dry. For this purpose, simple wound dressings are loosely attached. Applying ointment to the scalded skin is counterproductive here and should definitely be avoided.

Normal skin creams in particular are not very helpful for moderate scalds. Even special wound creams should only be used when the inflammation has largely healed and wound healing has started. To be on the safe side, ask the pharmacist or family doctor whether and to what extent ointments can be helpful in the event of a slight burn.

Home remedies for a scald

Light and small burns can be treated well by yourself. The focus is on cooling of the affected area a few minutes, but a maximum of 15 minutes after the heat source has been removed immediately.
The primary aim of this is to relieve pain, but at the same time it prevents the burn from spreading through hot tissue parts. For this, it is best to use cool, but not cold, tap water. The ideal temperature will be around 20 C ° (so room temperature) specified. In any case, however, the water should be sterile in order to avoid infections. The use of ice should be avoided as it carries the risk of frostbite.

Note: We definitely advise against using home remedies such as skin creams, powders or even flour, oil or salt.

Such substances lead to dehydration and in the worst case to inflammation of the skin, which is already susceptible to infections. Once the scald has been cooled, the best measure is to apply a loose bandage to the affected skin. A wound compress coated with aluminum is best suited for this. If the wound begins to heal, special wound creams can be helpful.

If the pain is severe or persistent, it is recommended to take painkillers such as ibuprofen or paracetamol according to the package insert.

Scalding in the toddler

Children have a very lively urge to explore. Since they are still quite clumsy at the same time, tearing off hot liquid containers from the stove and table is very common and in many cases leads to scalding.
At around 70%, scalds make up the majority of all burns. It is important to note that, compared to adults, scalds and burns are much more dangerous in children. In adults, for example, a second-degree scald can be life-threatening with a scalded body surface from around 10%, in children, however, from around 5%. The easiest way to estimate the extent of the burn in children is to use the rule of thumb that the small patient's palm (including the fingers) is approximately 1% of the body surface area.

The treatment of scalds in young children is otherwise the same as in adults. Immediately after removing the heat source, sufficient cooling (ideally with tap water at a temperature of around 20C °, but not with ice) respectively. If possible, the wound should be covered with sterile drapes. The opening of burn blisters, as well as the application of home remedies such as oil, flour or the like on the wound should be avoided. Burned clothing or other objects left on the skin should only be removed by qualified personnel and should remain on the child's body until they arrive.

Large burns or scalds of the second or higher degree should always be clarified by a doctor in children. Infants and toddlers should always be presented to the clinic if they have burns.

combustion

It happens a little less often but still often Burns in the household. In most cases, these are not hot liquids, but rather Candles, heating stoves, heating coils of the stove, Gas flames by the stove, hot fat or Hot water bottles left on for too long involved.

The combustion depends on the affected depth and the size of the area in 4 degrees of severity assigned.

While Grade 1 just a light one Swelling and redness causes the skin and corresponds to sunburn, it happens in Grade 2 already to Blistering. In this case it is not possible to say with certainty whether the skin can heal without scars. Grade 1 and 2 are characterized by severe pain.

Painless is already Grade 3because the nerve endings are already destroyed and can no longer pass the pain on.

Grade 4 is the most severe form of burn. This leads to the involvement of those lying under the skin Fascia and bones. To determine the burn area, look at the individually affected body regions. In adults, an involved head or neck corresponds to 9% of the skin, the torso 36%, the arms 18%, the legs 36% and the genitals 1%. In children and infants, the distribution pattern is shown somewhat differently.

In principle, immediate cooling is also useful in the case of burns. Here, too, it is important to begin with remove burnt clothing. Is it a burn? Grade 1 or 2, can be done in the same way as with scalding. At Grade 3 and 4 a sterile cover should be applied first. Open skin areas are extremely susceptible to infection. You should pay attention to this right from the start. Ice packs can be placed on the sterile pad. Depending on the degree or the extent to which it is spreading, an emergency doctor must be notified immediately, as transport to a special clinic may have to take place. Every summer there are numerous BBQ accidentsin which alcohol or other flammable liquids are inadvertently poured into the grill and burns caused by flashes are accepted. Even at Christmas time, injuries occur again and again Christmas tree or Advent wreath fires or through Fireworks.

If in doubt, always consult a doctor in the case of burns. The situation is particularly urgent when pain no longer occurs after a severe burn or when tissue lying under the skin becomes visible. In extreme cases, burning clothes occur. In this case, a second helper should put out the fire with the help of a blanket. The situation becomes difficult when the person concerned tries to run away in a panic. As long as the clothes are on fire, the burn rate and spread will progress very quickly.