A burn surgeon (combustiologist) is a doctor whose main activity is the treatment of severe and extremely severe burns.
What does a specialist do
The activity of a combustiologist is an immediate response to the diagnosis and treatment of various burn lesions of human tissues. All actions of the doctor must be quick and clear. That is why the profession of a burn surgeon is extremely responsible and stressful. But they are in the business of saving lives, because patients with severe and life-threatening burns get to these doctors.
The main responsibilities of the combustiologist are: careful examination of the patient and determination of the complexity of the skin lesion (source of burn, depth of damage and affected area); first aid (anti-shock therapy, treatment of surface tissues, analgesic therapy); surgical intervention (skin transplantation, removal of dead skin areas; monitoring the patient’s condition after surgery; the use of modern methods and technologies in therapy.
Diagnostic measures to determine the depth of the wound – the doctor first examines the site, prescribes certain diagnostic tests, on the basis of which he will determine the degree of sensitivity impairment and the degree of circulatory damage.
You can determine the violation of blood circulation by simple pressure: the zone of hyperemia – when pressed, the hyperemic skin turns pale; stasis zone – after pressing there are no changes in skin color, which demonstrates venous stasis; a zone of complete absence of blood circulation – the presence of wet or dry deep necrosis.
A doctor can work both in a burn center and in a hospital – a “burn department”.
It is worth noting that any procedure up to the dressing of relatively patients with deep skin lesions is performed using anesthesia, since patients feel acute pain at the slightest touch to the wound.
After the surgical intervention or after the surface of the burn dries out a little, the doctor prescribes therapy with the use of medications: gels, powders, creams, antibiotics, etc.
Sometimes, after the treatment of deep wounds, colloid scars remain on the skin, which look unaesthetic, therefore, the doctor may refer the patient to a cosmetic surgeon to correct the defects.
What symptoms to treat
Combustiologist works with all organs and systems of the human body. The burn can be not only skin, it can be a chemical lesion of the larynx, lungs, etc. The competence of a burn surgeon includes the treatment of the following diseases: burn wounds of varying degrees of complexity, shock after a burn, various complications after therapy.
It is recommended to consult a combustiologist in the presence of the following situations:
- the presence of serious burns on exposed parts of the body;
- combination of thermal burn with other diseases;
- with lesions of a combined type – in addition to a burn, there are mechanical, radiation or cryogenic lesions;
- the presence of a state of shock – an accelerated heartbeat, loss of consciousness, chills, a sharp increase in temperature, unstable blood pressure;
- the affected area occupies from 5% percent of the skin;
- in the presence of severe lesions of 3 or 4 degrees.
In any case, if you have any doubts, if you feel unwell after a burn, if you have redness, inflammation, etc., you should consult a doctor. After all, it is better to hear: “There is no reason to panic – everything is in order” than “Where have you been before?”.
The consequences of improper and untimely treatment can be very serious, up to blood poisoning and death, and this must be remembered!
Therapies
To accurately determine the patient’s condition, the doctor prescribes certain tests and diagnostics.
Diagnosis: CT, MRI, X-ray. Analyzes: biochemistry, anesthesia tolerance test, allergic tests, AIDS test, OAM, OAC, caulogram.
Each person should know about the first aid that needs to be provided to the patient at lightning speed:
- stop exposure to the damaging agent;
- conduct anti-shock therapy;
- carry out preventive actions regarding the affected area of the skin (in order to exclude the possibility of infection);
- transport the patient to the burn unit.
During the period of first aid, it is important to remove the damaging factor. For this, a person is covered with clothes, sprinkled with sand, taken out into clean air. If the lesions are of an external nature, the skin must be urgently cooled, ice or cold clean running water will do. If dense blisters have formed on the skin, do not pierce them, but gently treat the skin with alcohol; if the wound is open, only the area around the wound can be treated with alcohol.
Ironed or sterile diapers should be placed on open wounds. Until the moment of delivery to the hospital, the patient should receive a warm and plentiful drink.
Basic principles of therapy: restoration of the patient’s psycho-emotional state; selection of the optimal oxygen regime; restoration of impaired blood circulation; restoration of acid-base balance; correction of water-salt metabolism; restoration of energy metabolism processes; anti-toxic procedures.
In the first weeks, the doctor does not prescribe oils and ointments. The only procedures performed (if there is no need for urgent surgical intervention) are dressings with novocaine and antibiotics. In adults, the bubbles are immediately cut off completely, in children, an incision is made and the fragments are gradually cut off. Every day, the wounds are washed several times with furatsilin or hydrogen peroxide.
During the period of general treatment, infusion therapy is carried out. Infusion volumes are calculated using the following formula: daily infusion volume u2d (patient’s body weight in kilograms * per affected area as a percentage) / 6. Approximately about XNUMX liters per day, the introduction is long and slow.
For the introduction of fluids into the body, different methods are used: intraosseously, into the root of the tongue, into the veins of the legs, into the subclavian vein. Drugs for treatment: blood substitutes, protein hydrolysates; XNUMX% glucose solution, XNUMX% glucose solution, isotonic sodium chloride solution, fresh frozen plasma.
Principles of local treatment: suppression of pain symptoms, irrigation of the affected area with panthenol; antiseptic wound treatment; prevention of lymphatic loss; providing conditions for active restoration of the epithelium.
There are several methods of local treatment: closed, open, mixed and operational.
Closed – the affected area is covered with fibrin films, under which the antibiotic will be carefully injected in the future.
Open – tannins are not used for treatment, it is important to create a crust on open wounds (using medicines and the correct temperature regime).
Mixed – in this case, both open and closed methods are used.
Operative – is used in the presence of deep limited burns (with a total lesion area of u10buXNUMXbnot more than XNUMX percent).