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Ask Dr. Dunn: Burns

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By Maren Dunn, D.O. Health Contributor
It’s fire season in Montana, of the indoor variety. With the temperatures falling, families are firing up wood burning stoves and fireplaces to heat their homes. While an effective and efficient heating method, wood fires do pose a few risks. One is burns. A burn is a flesh injury where skin cells and other tissues are destroyed. They can be caused by heat, cold, electricity, radiation, chemicals, light or friction. Adults commonly sustain thermal burns from flames, while children mostly sustain scald burns from hot water or steam. While prevention is the best medicine, it’s important to know what to do if someone becomes burned.
First, it’s important to decide the depth of the burn. In first-degree, or superficial burns, the top layer of skin has been damaged. The skin is usually red and may be swollen or painful. A mild sunburn is a good example. This type can be treated with pain medications like ibuprofen or acetaminophen and topical coolants or creams. As with any burn, immediate treatment consists of cool water or compresses to transfer the heat out of the skin and reduce swelling. Ice is never indicated when treating burns. First-degree burns usually heal in six days without any scarring.
When the skin has blisters, is splotchy and intensely painful, it has sustained a second-degree burn. This type extends into the second layer of skin. If your second-degree burn is larger than three inches in diameter or includes the hands, feet, groin, buttocks or a major joint, you should seek medical attention. Prevention of infection and promoting healing are the two highest priorities with second-degree burns. Therefore, do not rupture intact blisters. This type of burn usually heals in one to three weeks and rarely scars, although pigment changes are common. As with first-degree burns, immediate treatment includes cooling of the burn with water followed by a sterile dressing to keep the air out. If signs of infection such as increased pain, swelling, drainage, redness or oozing occur, seek medical attention immediately.
Third-degree burns are the most serious, cause permanent damage to the tissue and involve all layers of the skin. They can appear waxy white, or charred and black. There is little or no pain, and the skin does not blanch with pressure. There are no blisters. This type must be treated with surgical intervention in order to heal properly. It’s important to note that all types of burns can co-exist within one injury.
Since prevention is the best medicine, make sure to teach your children proper fire safety, wear gloves when tending a fire, and always have a fire extinguisher near your fireplace or wood stove.

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