3rd degree burn healing time7/26/2023 The thermal injury was caused by heat at 150 ☌ for 15 s. The analysis of the temperature of the burn wound was performed by Strużyna et al. Figure 2 presents the effect of burn wound cooling on burn wound temperature. Cooling by means of decreasing the temperature of the skin reduces the extent of the injury, protects the basal membranes, and reduces scarring. Burn wound cooling has been known since Galen and was popularized by Sorensen in the 1960s. Burn wound cooling improves removal of heat from tissues and prevents deepening of the burn wound. The skin consists primarily of water, which conducts heat 20 times faster than air. Directly after the burn occurs, the heat absorbed by the superficial layers of the skin is transferred deeper into the muscles and skin, as it is into the surrounding air. In thermal burns, heat energy is accumulated in the skin during the first 15 min and can be transferred to deeper layers or spread by means of different mechanisms, including convection, evaporation, or penetration. Immediately after the thermal injury occurs, the burn wound is only potential, as the disruption of tissues is not instantaneous. The skin serves an anatomical barrier for pathogens, protects internal organs from damage, maintains a balance between the system and the environment, controls water, and plays role in thermoregulation. Deep burns involve a deeper layer of the reticular dermis, or the entire dermis ( Figure 1). Superficial partial-thickness burns extend into the superficial portion of the dermis. Superficial burns involve only the epidermis. Most peripherally, there is a zone of inflammation/hyperemia where pro-inflammatory factors induced in response to trauma cause erythema and oedema. It is an area of the skin with blood circulation impairment and risk of conversion to a full-thickness burn. The stasis zone surrounds the coagulation zone. In the central areas of the burn wound, the coagulation zone, capillary circulation is blocked, and death of cells is observed. This injury initiates metabolic and molecular lesions that can lead to tissue necrosis and eschar formation. The definition of a burn wound is an injury to the integrity of the skin and subcutaneous tissues caused by heat (flames, fluids, solid objects), extreme cold, electricity, chemicals, or radiation. The skin serves as an anatomical barrier against pathogens and protects internal organs from damage from the external environment, maintains a balance between the system and the environment by controlling evaporation, and plays a role in thermoregulation. Hydrogels are a new dressing type that are still in development. Numerous experiments on animal models proved their safety and efficiency. Active dressings may have antimicrobial activity or stimulate wound healing. The active forms may contain ammonium salts, nanocrystal silver, zinc, growth factor, cytokines, or cells, as well as natural agents, such as honey or herbs. ![]() The hydrogel matrix enables incorporating active substances into the dressing. Hydrogels are ideally used during the first hours after injury, but as they do not have antimicrobial properties per se, they might not prevent wound infection. They not only cool the burn wound, but also reduce pain and protect the wound area from contamination and further injuries. ![]() Hydrogels that contain mostly water evacuate the heat cumulating in the skin by evaporation. Hydrogel dressings may be an alternative to cooling burn wounds with streaming water, especially in cases of mass casualty events, lack of clean water, hypothermia, or large extent of burns. Inert hydrogels are of a great importance in burn first aid.
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