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ABC of wound healing: Burns

BMJ 2006; 333 doi: https://doi.org/10.1136/sbmj.0609324 (Published 01 September 2006) Cite this as: BMJ 2006;333:0609324
  1. Alex Benson, specialist registrar in plastic surgery1,
  2. William A Dickson, consultant burns and plastic surgeon2,
  3. Dean E Boyce, consultant hand and plastic surgeon
  1. 1Mersey Regional Plastic Surgery Unit, Whiston Hospital, Liverpool
  2. 2Welsh Centre for Burns and Plastic Surgery, Morriston Hospital, Swansea

About 250 000 people are burnt each year in the United Kingdom. Of these, almost 112 000 attend an emergency department, and about 210 die of their injuries. At least 250 000 others attend their general practitioner for treatment of their injury. A burn results in loss of epidermal integrity of the skin; this article discusses the cause and management of various types of burn injury

About 250 000 people are burnt each year in the United Kingdom. Of these, almost 112 000 attend an emergency department, and about 210 die of their injuries. At least 250 000 others attend their general practitioner for treatment of their injury. A burn results in loss of epidermal integrity of the skin; this article discusses the cause and management of various types of burn injury

Mechanisms of burn

Thermal injury

Flame - Accelerants such as petrol, lighter fluid, or natural gas are often involved. The depth of flame burn is typically full or partial thickness.

Scald - 60% of burns in children are from scalds. Intentional injury is rare but should be considered if there are delays in presentation, inconsistencies in history, or an unusual pattern of injury.

Contact - Contact burns often pres- ent as small burns on extremities, but they can be serious in those not able to remove themselves from the source of injury, such as elderly people, children, disabled people, and people incapacitated by drugs, alcohol, fit, or faint.

Flash - Flash burns are usually to the face and upper limbs and are caused by an explosive ignition of a volatile substance. They are often due to use of accelerants to light a fire or gas explosions.

Protocol for managing burn injuries*

A - Airway and cervical spine control

B - Breathing and ventilation

C - Circulation and haemorrhage control

D - Disability

E - Exposure and environmental control …

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