Antibacterial therapy in the complex treatment and prevention of infectious complications in burns. Treatment of burns with antibiotics: when and how to take

Burns do not always require the use of antibacterial drugs. Many people make the mistake of using these: antibiotics - potent substances with strict indications and contraindications.

Why use antibiotics for burns?

Antibacterial therapy is used in the treatment and prevention of various types of infections. The latter easily enter the body through open wounds. Dead tissue at the site of injury - ideal culture medium for pathogens.

Bacteria interfere with wound healing, contribute to excessive scarring, and sometimes pose a threat to the life of the victim.

However, strong drugs are not always appropriate. Human skin has powerful protective properties and in most cases can deal with infections on its own.

But in some cases, antibiotic therapy is necessary:

1. Deep and large-scale lesions of mucous membranes, skin, internal organs. Loss large area tissues leads to disruption of the metabolic functions of the body, immune protection, in particular anti-infectious;
2. Elderly age;
3. The presence of chronic infections;
4. Diabetes;
5. Lack of burn treatment and, as a result, its complication.

But antibiotics are not used in the following situations:

• deep but limited damage;
• the burn is less than 10% of the body surface;
• 1st degree burns (epidermal).

The doctor, assessing the need for antibiotic therapy, takes into account the following factors:

1. Depth, vastness of the wound;
2. Burn degree;
3. The presence of complications;
4. Age, immune status of the victim;
5. Type, severity of complications;
6. The sensitivity of the patient to antibacterial agents.

What antibiotics are used for burns?

The vast majority of drugs based on silver sulfadiazine are used.

Therapy can be local (external), systemic and, in especially severe cases, combined.

External treatment involves dressings with solutions of iodopyrone and iodovidone 1%. Ointments based on dioxidine and levomycetin are also used.

Systemic therapy involves oral and/or intravenous/intramuscular administration of drugs. Such treatment is carried out only in a hospital under the supervision of doctors.

Systemic therapy is carried out only in the presence of deep wounds, occupying more than 10% of the body area. If the infection is mild, limited to intramuscular injections.

Otherwise, apply intravenous administration medicines. Systemic treatment carried out with the following medicines:

• semi-synthetic penicillins;
• sulbactam and cefoperazone (often a combination);
• aminoglycosides and fluoroquinolones;
• latest generation cephalosporins;
• lincomycin for bone disease;
• « Nystatin" or " Fluconazole» with a fungal infection.

Refusal of antibiotic treatment of burns

Without therapy, the infection will not disappear without a trace. If the doctor prescribed antibiotic therapy, and the patient refused them, the following complications may occur:

• lymphadenitis;
• sepsis;
• myocarditis;
• purulent arthritis;
• lung/bronchial diseases;
• urinary tract infections.

Basically, therapy involves the use of a drug of one type. Several different medicines are prescribed only when there is an infection, it severe course.

Local treatment of burns: basic principles

The funds used are divided into several groups according to the current principle:

Modern means: antibacterial / antiseptic drugs

Ointment "Betadine"

Based on povidone-iodine - a modern alternative to traditional iodine. "Betadine" is a broad-spectrum agent, active against many pathogens. Treatment involves treating the wound thin layer ointment several times a day.

"Katapol"

It includes a copolymer with crotonic acid and benzalkonium chloride in the composition of povidone. Like the previous drug, it is active against many bacteria. Treatment of burns is carried out with an aqueous solution of 1% (dilute a solution of 10% with distilled water). The medicinal solution is impregnated with tampons, napkins and gauze bandages to protect the wound.

Silvederm

Broad spectrum antibacterial drug. For ease of use, it is produced in the form of an aerosol, cream and ointment. The drug belongs to sulfanilamide, the active substance in the composition is sulfadiazine. Antibacterial activity is provided by silver ions.

Healing agents

Solcoseryl

On the this moment it is the most popular remedy for accelerating the regeneration of damaged tissues. In the treatment of burns, two forms of the drug are used: ointment and gel. The healing edges of the wound are treated with ointment, and the gel itself wound surface. Processing is carried out up to 2 times a day. After the wetness has passed, you can use only the ointment.

"Panthenol"

Another popular tissue regeneration stimulant. The composition of the drug includes B vitamins and dexpanthenol. " Panthenol» improves cell regeneration, stimulates metabolic processes in tissues, and also has a slight anti-inflammatory effect. You can use a cream or spray. The cream is easily absorbed, so it is more convenient to use for painful sunburns and light burns. The aerosol is sprayed from a short distance.

Composite medicines

"Argakol"

The drug is in the form of a hydrogel, based on antiseptic substances: catapole, dioxidine, poviargol (silver preparation). " Argakol"- a potent antibacterial agent that can treat not only burns, but also abrasions / cuts.

After treatment, an air- and water-permeable elastic film is formed on the body, which is easily washed off with water.

Aerosol "Amprovizol"

Includes menthol, anestezin, propolis and vitamin D. Thanks to the combination active substances, the drug has a cooling, antiseptic, anti-inflammatory effect, accelerates regeneration. The aerosol is recommended for use in solar / thermal burns of the 1st degree.

Olazol

Positioned as a wound healing agent; combined foam preparation, which includes sea buckthorn oil. " Olazol» is available in aerosol form for ease of use. The agent has an antibacterial and anesthetic effect, and also improves regeneration, accelerates epithelialization and reduces exudation.

For non-infected 2nd degree burns, atraumatic and wet-drying dressings with antiseptic or antibiotic solutions are required. You can also use hydrogel coatings.

Grade 2 lesions can be treated with ointments/emulsions that provide pain relief and bactericidal action(pr. "Agrosulfan", silver sulfazine 1%, "Levosin", "Levomekol").

In this article:

Antibacterial therapy occupies an important place in the complex of measures aimed at eliminating and preventing various infections that develop in burn wounds. Dead tissues present in the area of ​​any burn injury serve as a favorable environment for the reproduction of pathogens.

Why antibiotics are prescribed

Antibiotics for burns are prescribed to suppress the so-called microbial invasion, which not only slows down the wound healing process, but also contributes to excessive scarring, creates certain difficulties in the plastic closure of burn wounds, and also poses a direct threat to the life of the injured person. In the structure of mortality in burn patients, infections account for more than 75%.

Deep and extensive burn lesions, entailing a number of pathological processes and accompanied by burn disease, create additional prerequisites for the generalization of the infectious process and are the reason for prescribing antibiotics. In addition to the loss of a large area of ​​the protective skin, there is a disintegration of the most important metabolic and neurotrophic functions in the body, leading to the destruction of anti-infective protection factors.

Who needs antibiotic therapy

The use of antibacterial drugs for the treatment of victims with burns or, as well as with deep, but limited wounds, the area of ​​\u200b\u200bwhich does not exceed 10% of the body surface, is considered inappropriate. The only exceptions are some patients:

• Elderly people;
• Patients with chronic infections and diabetes;
• Patients admitted to treatment late in pronounced signs infections.

The burn severity levels listed above typically include:

• almost all household thermal burns-, boiling water, household items (, a frying pan, a saucepan, etc.);
• electrical - by current;
• chemical - iodine, brilliant green, mustard, etc.

accompanied by redness of the skin and the appearance.

And even more so, you should not “stuff” the victims of a burn with antibiotics, which can also be obtained in all of the above cases.

Antibiotics for burns are prescribed by the attending physician on the basis of a comprehensive examination of the condition of the victim, if the degree of damage is fourth or 3B degree. It takes into account the following parameters:

• Depth and extent of the lesion;
• The stage of the burn disease;
• The presence of complications;
• Age and immune status of the victim;
• The nature and severity of comorbidities;
• Sensitivity to a particular prescribed drug.

Treatment tactics

Antibacterial therapy aimed at the treatment and prevention of infections is an integral part of the complex of measures prescribed for the development of burn disease. To prevent the occurrence of infectious complications, the treatment of victims begins in the period burn shock and continue with acute burn toxemia and septicotoxemia. Except medications local application and systemic antibiotic therapy, general methods of treatment in an abacterial environment can be used: isolators and beds "Clinitron".

The choice of drug for local antibiotic therapy requires individual approach and depends on the characteristics of the wound process. Most often, silver sulfadiazine preparations, dressings with a 1% solution of iodopyrone and iodovidone, water-soluble ointments based on chloramphenicol or dioxidine are used. Systemic antibiotic therapy is also strictly individual character and is prescribed for patients with deep burns, the area of ​​​​which exceeds 10% of the body surface. With a mild course of the infectious process, they are limited intramuscular injection drugs, in more severe cases resort to intravenous infusions.

Systemic antibiotic therapy is carried out using drugs with a wide spectrum of action: combinations of cefoperazone with sulbactam, semi-synthetic penicillins, III generation cephalosporins, aminoglycosides and fluoroquinolones. For bone lesions, lincomycin is used. If during treatment an anaerobic non-clostridial infection is detected, metronidazole or clindamycin is prescribed, for a fungal infection, nystatin or fluconazole.

Any infectious process, originating in a burn wound, can provoke the development of severe complications: sepsis, pneumonia, tracheobronchitis, purulent arthritis, infections urinary tract, as well as myocarditis, endocarditis, lymphadenitis and lymphangitis.

The main importance in the fight against generalized infection is given to rational antibiotic therapy, which involves weekly microbiological monitoring. In severe cases of the disease, combined antibiotic therapy is used, which involves the simultaneous use of two or three drugs.

The use of antibiotics in complex treatment burn injuries can reduce the severity of various infectious complications that pose a threat to the lives of affected people. What antibiotics to drink for burns? The answer to this question can only be given by a specialist who made an appointment on the basis of a comprehensive examination of the victim.

A burn is damage to human soft tissues as a result of exposure to high temperatures or chemical exposure. Each degree is characterized by its depth of affected tissues, from which specific measures are taken to restore health.

Physicians paid importance and reasons for the injury. But in any case, in the event of a burn, it is necessary to provide first aid to the victim, without waiting for the arrival of the ambulance team.

What is a second degree burn and how long does it take to heal?

Second degree burns are superficial injuries, but still require close attention.

Unlike, affecting only, in this case, there is a deeper damage to the skin, where, in addition to the epidermal layer, it is injured upper layer and disturbed microcirculation.

Usually 2nd degree burns over time heal relatively quickly- up to two weeks and their treatment with a small area of ​​​​damage is possible at home.

If the affected area is more than 1% (“palm of the hand”), you should immediately seek medical help.

This is explained possible reaction of the body to an injury in the form of a burn disease or shock, which are the basis for mandatory hospitalization. Possible infection in the wound and dehydration. Special attention given to children and elderly patients.

Causes

Depending on how the burn was received, the following types are distinguished:

Thermal

Consequence of defeat by fire, boiling water, steam or touching hot objects.

Chemical

The result of exposure to soft tissues of acidic and alkaline solutions.

Electric

It is formed at the entry / exit points of the electric charge.

Ray

When exposed to ultraviolet or ionizing radiation.

Symptoms

The clinical picture of a 2nd degree burn is as follows:

• inflammation and redness of the affected area;
• soreness when touched;
• puffiness;
• blistering.

Blisters form instantly or after a short time. As a result of exfoliation of the upper layer of the epidermis, a cavity is formed, filled with a yellowish transparent liquid - blood plasma from broken capillaries. After a few days, the contents of the blister become cloudy.

Natural tearing may occur, followed by fluid leakage and exposure of bright red wet erosion. The gradually formed wound heals, and after two weeks it acquires a natural skin color.

When you get a sunburn, the skin turns red and becomes painful to the touch.

Somewhat later, it forms many small blisters. To this picture, you can add the symptoms of sunstroke - nausea and fever.

When an infection enters, the affected area acquires a purple hue and becomes hot, there is a discharge of pus.

Diagnostics

2nd degree burns diagnosed by visual inspection. The combustiologist determines the area of ​​the skin lesion, the degree of its swelling and the level of pain. Check for infection.

For burns of mucous membranes respiratory tract is being done X-ray . For large areas, they can prescribe detailed analysis of blood and urine.

After assessing the patient's condition, a conclusion is made and appropriate treatment and prevention of complications are prescribed.

First aid

It turns out before the arrival of the team of doctors.

First of all, it is necessary to eliminate contact with the cause of the burn and cause ambulance, after which the following steps are performed:

• It is required to quickly cool the burnt surface with running cold water (15-17 ° C). The fact is that after receiving a burn, the skin continues to heat up and break down for some time, thereby causing severe pain. Cold water will stop this process, thereby reducing the depth of the skin lesion. constriction blood vessels and a decrease in the sensitivity of nerve endings give the effect of an anesthetic. It is recommended to treat the wound with cold for 20 to 60 minutes - until the skin becomes numb. The water pressure should be low to avoid causing additional pain.
• With a chemical burn, the chemical is first removed with a sterile dry cloth, after which the remnants of the substance are also washed off with running cold water for 20-30 minutes.
• After washing the inflamed surface, a sterile gauze bandage should be applied.
• To relieve pain, you can take any painkillers. Effective pain relief with injections.
• In the absence of vomiting, the victim is given lightly salted water to prevent dehydration.

What not to do when providing first aid:

• tear off tissue adhering to burns;
• apply ice and cotton to the burn;
• use adhesive tape or tightly bandage the wound;
• treat damaged skin with coloring antiseptics - iodine, brilliant green, as well as sour cream and butter;
• open blisters on your own.

If the area of ​​​​skin damage is small, and the resulting blisters are also small, it is permissible to treat the burn at home.

Mandatory hospitalization is subject to adult victims with a lesion area of ​​5%, as well as children under one year old and children with burns with an area of ​​more than 2%. This also includes people with injuries to the face, neck, perineum, respiratory tract, as well as the elderly.

The post-burn recovery process

For second degree burns recovery process takes 12-15 days.

It is important during this period to properly care for the wound, avoiding exposure to traumatic events, as well as infection. Medicines must be chosen correctly local action to accelerate cell regeneration.

If the wound becomes infected, the recovery time can be much longer.

There are three stages in the healing of wounds obtained by a 2nd degree burn:

Purulent-necrotic

Under the wall of the blister, the contents gradually become cloudy, pus forms. The adjacent skin becomes inflamed. The blister begins to swell and large sizes it needs to be opened.

It is recommended that this procedure be performed by a physician. If this is not possible, then the opening of the blister is carried out independently in compliance with the rules of disinfection. To do this, the burn surface is treated with an antiseptic, the puncture is made with a sterile needle. Leaked pus is carefully removed with a clean napkin, and the wound is treated with anti-burn or antibacterial ointment.

After that, a sterile dressing is applied.

At this stage, there is a gradual recovery of the affected cells.

Eliminates inflammation and blisters. A bandage is no longer required, moreover, the contact of the wound with clothing and other surfaces that can rub it is limited.

The surface of the burn is treated regularly wound healing ointments to prevent it from drying out and, as a result, the formation of cracks. It is important to eliminate the risk of re-infection of the wound.

The last phase of wound healing is observed - it is tightened with a new skin cover.

Regenerating ointments are still used to speed up this process.

When caring for a burn wound protection against infection is key by following the rules of antiseptics.

It is not recommended to wet the wound with water. Dressings are changed as they get wet with the procedure for treating the injured surface. At each dressing change, the condition of the skin is assessed and a conclusion is made for further therapy.

Medical treatment

Properly selected treatment will speed up the healing process of a burn wound. For this, a number of drugs or their analogues, both general and local, are used.

All medications must be prescribed by a doctor. It is necessary to strictly observe the dosage and rules for their administration.

Anti-inflammatory drugs

For the treatment of second-degree burns, the main focus is on anti-inflammatory drugs that provide local antibacterial action: Levomekol, Synthomycin emulsion, Furacilin ointment, Gentamicin ointment and many similar ones.

Antiseptics

Miramistin and Chlorhexidine are often used as antiseptics, which have proven themselves in the practice of first aid, as well as a 0.5% dioxidine solution.

To date, moisturizing healing ointments containing Panthenol have gained popularity: Bepanthen, D-panthenol, which help to accelerate the restoration of the skin at the regeneration stage.

Spray

Effective is the use of Panthenol spray, which is applied to the surface of the skin by spraying without physical contact with the wound.

homeopathic remedies

Antihistamines

Permissible application antihistamines helping to relieve swelling and itching of damaged tissues: Suprastin, Zodak, Claritin.

It should be noted that some antihistamines cause drowsiness.

Analgesics

As an anesthetic, any analgesics are most often taken. In case of severe pain, you can drink Ketorol or its analogues.

Injections with painkillers are effective.

vitamins

As an additional treatment, the doctor may prescribe vitamins A (retinol), E (tocopherol) and ascorbic acid responsible for the production of collagen and enhance the regenerative function of the body.

During the treatment of the injured it is important to maintain a water-drinking balance for faster removal of toxins from the body. It is recommended to include foods rich in proteins and carbohydrates in the diet to make up for the loss of energy that accompanies burn injuries.

What to do with bubbles?

Bubbles are first sign second degree burns.

Manipulations with them must be extremely careful and depend primarily on their size.

• If the blisters are small, then proper care after a burn, they gradually disappear on their own.
• When the bubbles are inflated, piercing is required to remove the contents, as well as its shell. In this case, the help of a doctor who will perform the necessary procedure in compliance with all the rules is desirable.
• With a natural tear, it is first necessary to treat the surface of the burn from contamination with an antiseptic, for example, 3% hydrogen peroxide. Then, using sharp sterile scissors, the bladder membrane is cut off and an antibacterial ointment is applied.

It is important after manipulation with blisters, if necessary, consult a doctor in time. Education purulent plaque and an increase in temperature indicates an infection of the wound, in which case general antibiotics are usually prescribed.

Actions for inflammation

Availability inflammatory process indicates the entry of harmful bacteria and viruses into the body. It is characterized by fever, chills, weakness. As a result, the recovery process is delayed, and at the site of the burn a scar may form. In such cases, you can not delay the visit to the doctor, otherwise it is even possible fatal outcome

As a rule, with inflammation in the first place appointed systemic antibiotics in the form of injections or pills. Moisturizing ointments are replaced by antiseptics and ointments with antibacterial action.

In the absence of purulent plaque at the recovery stage the wound is treated with aerosols forming a protective film on the surface that prevents the penetration of harmful microbes.

In each individual case, the treatment regimen and the selection of drugs are carried out taking into account individual characteristics organism.

Burn in a child

If a child has suffered from a burn, it is necessary to provide him with first aid in the same way as indicated above. Data skills every parent should have, because even the most obedient baby is not immune from an accident. When determining the second degree burn should not hesitate to call a doctor who will determine the severity and area of ​​skin lesions and decide on the need for hospitalization.

The principles of treatment of burns in children are the same as for adults, with the only difference being that the dosages of prescribed drugs are determined taking into account the age and weight of the patient, and the treatment procedures are often carried out under the influence of painkillers. Additionally, physiotherapy can also be prescribed to speed up the recovery process.

In no case should you do home treatment of a child without the supervision of a doctor. The slightest negligence can lead to aggravation of the state of health.

A burn is a type of wound that requires close attention and careful handling. Any self-activity in this matter is unacceptable. Timely access to a specialist contributes not only to the rapid restoration of health, but also helps to avoid the risk of complications that are fraught with negative consequences.

If more serious medical preparations in case of burns, their appointment is carried out by the attending physician. Antibiotics for burns can be taken. Antibiotic prescription is based on integrated assessment the patient's condition, taking into account the extent of skin defects, the depth of the burn, the stage of the burn disease, its complications, the condition immune status, as well as the age of the patient and the severity of comorbidity.

Can antibiotics be used for burns?

affected with various burns 2 - 3 steps, also for patients with limited solid burns, occupying a maximum of ten% of the body plane, the appointment of antibiotics, as a rule, seems inappropriate. If we talk about exceptions for taking antibiotics for burns, then they include elderly people who suffer from diabetes, infections that have passed into chronic condition, also victims who did not seek medical help in time.

Other patients are prescribed district bactericidal therapy for burns: dressings with 1% substance of iodovidone or iodopyrone, ointments, which include levomycetin or dioxidine, silver sulfadiazine. The composition of Levomekol's ointment dressing with gentamicin or neobacitracin powder in gram-negative flora proved to be an excellent remedy. The use of artificial coatings containing bactericidal substances is promising. When curing these patients, daily treatment of diseased areas with the substance of iodovidone or iodopyrone will be appropriate and effective.

When to prescribe antibiotics for burns

With the development of a burn in the victims, antibiotics are used for burns. This treatment will be appropriate and effective for large areas of damaged skin. In this case, antibiotics are prescribed to prevent and treat infection after burn wounds and infectious complications that can cause a burn. One of the significant events is considered to be early immunotherapy and immunoprophylaxis.

The most effective is the use of antibiotics for burns. It should be noted that in addition to the use of medicinal substances, in order to cure the patient, it is necessary to use "Clinitron", as well as antibacterial insulators, and more physical ways improving the state of the disease: laser therapy, ultraviolet radiation, ozone therapy and other procedures prescribed by a doctor. All these procedures, after a full course of passage, relieve pain, prevent infection and, as a result, contribute to the restoration of the skin. This therapy with a speedy cure chain is being conducted on 2 fronts: systemic bactericidal therapy and local use of antibiotics.

But write out necessary antibiotics in case of burns, only the attending physician will be able to help you, depending on the degree of damage, as well as your sensitivity to the drug.

Antibiotics for burns should be used if it is necessary to suppress microbial invasion, which slows down the healing process of the burn wound and contributes to excessive scarring. A burn can pose a significant threat to human health.

Antibacterial therapy captures the main positions in the structure of activities that are aimed at cure and prevention. different kind infections progressing in wounds after burns.

Who needs antibiotic therapy

Large-scale damage after a burn entails many serious pathologies. In this case, the burn wound contributes to the development of infection in it, which is the basis for starting antibiotics. As a result of burn wounds, a vast area of ​​skin is lost, the victim has a violation metabolic processes and nerve damage.

The use of antibacterial drugs for the treatment of burns of the 2nd and 3rd degree, as well as serious wounds with an area of ​​\u200b\u200bnot more than 10% of the body surface, is considered unjustified. The only exceptions are the following patients:

• people of retirement age;
• patients with infection or persons with diabetes mellitus;
• people who seek help in the final stages with an actively progressing infection.

For other victims, the doctor prescribes bactericidal therapy for burns, which involves the application of dressings with 1% iodopyrone. In addition, the victim must use ointments containing chloramphenicol or dioxidine. A remarkable effect is given by artificial coatings that contain bactericidal elements. In the treatment of victims, daily treatment of burn sites with the substance of iodovidone or yodopyrone should be carried out.

The attending physician prescribes antibiotics for burn wounds based on the results of a complete medical examination and general condition patient, in addition, the doctor takes into account certain parameters:

• the scale of the lesion and its depth;
• existing complications;
• immunity and age criterion;
• the state of the accompanying pathological processes;
• susceptibility to prescribed drugs.

When to prescribe antibiotics for burns

In the inflammatory process in the burn wound, certain antibiotics are prescribed. This treatment is considered appropriate when large areas of the dermis are damaged. Antibacterial therapy is also necessary for preventive purposes, to remove the infection and heal wounds. These medicines help prevent the development of infectious complications after a burn. Initially, in case of a burn, immunotherapy and immunoprophylaxis should be carried out.

Effective result gives topical application antibiotics. It is important to note that, in addition to the medicinal medicine, you should use the Klinitron anti-burn bed and stay in antibacterial isolation rooms. Positive effect the state of health of the patient will be provided by laser therapy, ozone therapy and ultraviolet irradiation(UFO). These procedures after their complex passage will help reduce discomfort, prevent the infection process and restore the burned skin layer. In general, treatments are divided into the following types:

• systemic bactericidal therapy;
• local use of antibiotics.

You can buy the necessary antibiotics only by prescription, because they differ depending on the level of damage or the degree of sensitivity to a particular drug.

What medications are used to treat burns?

Medications for the treatment of burns are different. Pharmaceutical distributors offer huge assortment burn medications. Such drugs have comfortable shape and help to remove all existing consequences from burns. Naturally, if these are deep burn wounds with the presence of an inflammatory process in them, then in this case it is prescribed antibacterial group drugs, including antibiotics and antiseptics.

An excellent remedy for burns is panthenol, available in the form of an ointment, cream or gel. It is used for minor 1st degree burns in the form of a gel. Panthenol is applied to the affected skin. After applying the gel, a stable foam is formed, which has a light structure. Due to its regenerative abilities, the gel is quickly absorbed into the skin and restores the original skin structure. Panthenol-based ointment is recommended for active healing of wounds on the skin and for the elimination of cracks and other damage from the dermis layer.

Another remedy used for burns is actovegin. Sold as an ointment, gel or cream. With the help of its properties, it provides effective wound healing and protection of the wound from the entry of various kinds of infections into it. The use of ointments or gels is recommended only in the initial burn stages. In the process of wound healing, it is advisable to first apply the gel, and after a certain time, the ointment.

An agent used to eliminate microbes from burns, as well as having an analgesic effect, is called dioxysol. This tool has bactericidal properties. The composition of these drugs includes certain local anesthetics, which can reduce pain.

A burn is considered to be one of the types of household injuries that can happen to absolutely every person. It is necessary to know how to provide first aid in this situation, therefore, funds for any burns should be in the first aid kit of each family. These can be gels, ointments or creams. If the situation is more serious, then it is necessary to use antibiotics, the course and prescription of which must be obtained from the attending physician. After a deep burn, unpleasant scars can remain on the skin. Their presence suggests that an infection got into the skin during the healing of the wound.

Antibacterial drugs

the main objective local drug treatment consists in the fight against the pathogenic microflora of the burn focus.

In order to achieve this goal, various means are used, which have a variety dosage forms. In addition, all drugs have an individual mechanism of action.

Today there are many classifications antimicrobials, distinguished according to the peculiarities of their chemical structure, the time of exposure to the body and other factors. The range of drugs and their plural forms make it difficult to classify them. To date, you can buy a large number of drugs with combined medicinal properties.

Medicines that have antibacterial properties, and there are antibiotics, as well as antiseptics or chemotherapeutic agents. They are used as a means local therapy with burns. According to their individual composition, they can be divided into multiple classes of chemical compounds. It should be noted that local therapy does not only mean substances that have antimicrobial activity. Many of them are used to treat wounds after burns. It is necessary to choose a specific drug that is suitable for the victim, taking into account all the necessary information about the state of the microflora of the burn wound and its susceptibility to certain antibacterial substances. In addition, the selection of drugs should be carried out taking into account the phase of the wound process.

Used therapeutic drug should be appropriate at the stage of the wound process. In the initial stages, it is recommended to use medicinal solutions and combined ointments that have a hydrophilic base. In the 2nd or 3rd stage of the burn, you should additionally use fat-based products.

Therefore, in the earliest possible time after a burn is received, it is advisable right choice the drug required in this situation, and the compliance of the therapeutic effect this tool stages of the burn process. It should be remembered that you should not start any type of burn, because the initial phase of a burn wound is much easier to cure than the final one, while resorting to agents that have an antimicrobial effect.

Antibiotics for Various Degrees of Burns: A Review of Remedies

Preparations

Antibiotics for burns are drugs that are prescribed to heal the affected areas of the skin. They are aimed at suppressing infection in the wound. The spread of microbes slows down the restoration of the integument of the epidermis and leads to the formation of scars, which later remain unchanged.

How to use antibiotics for burns

Antibiotics are recommended only for grade 1-2 burn injuries. This method of treatment is inappropriate for stages 2-3, as well as with deep lesions, the localization of which exceeds 10-15% on the body.

In a hospital, the doctor will determine the stage of thermal damage to the epidermis and will make a comprehensive treatment.

The doctor decides whether to prescribe antibiotics for a 2nd degree burn based on the following factors:

• age;
• chronic diseases (diabetes), infections;
• the extent of thermal damage and the area of ​​localization;
• sensitivity and the presence of an allergy to a particular drug.

Features of use for burns 2 and 3 degrees

Antibiotics for burns of 2 and 3 degrees are allowed to be used if the affected area is small. For home treatment, it is necessary to observe sterility, to prevent infection.

In everyday life, antibiotics are used for burns with boiling water. Unpleasant incidents are common in young children, less often in adolescents.

Antibiotics help strengthen the immune system, fight pathogens. If they are not used, then it is possible to get complications in the form of pneumonia, sepsis, lymphadenitis.

For quick healing of wounds, they take external antibacterial ointments and creams, home tinctures, solutions.

Antibiotics for external use

Topical antibiotics (those that pass through the esophagus) antimicrobial action. Here is a list of the most popular drugs:

1. Ointments containing silver sulfadiazine. These include drugs such as Sulfadiazine, Silvederm, Dermazin.
2. Yodopirone and Yodovidone. They have a strengthening effect on the immune system, most often such solutions are prescribed with a 1% concentration. Apply after sunburn treatment with antiseptic agents such as Furacilin, Miramistin and Chlorhexidine.
3. Ointments Levomekol, Levosin, Clormikol.
4. Drugs that eliminate the source of infection when the burn blisters begin to burst. These include Dioxidin, Streptonitol (contains nitazole) and gentamicin ointment.

All products are suitable for external use at home. Before use, it is necessary to consult a doctor for contraindications and allergic reactions.

Preparations for systemic use

Preparations for internal use have a stronger effect than topical treatments.

With burns, the body's immunity decreases, as a result of which complications appear in the form of nausea and high fever, and scars may not heal for a long time. Antibiotics internal use needed to normalize functions immune system. They are prescribed by a doctor in a compartment with antiseptic ointments and creams.

Medicine offers many drugs in tablet form. We do not recommend taking pills on your own, consult your doctor.

List of the most effective antibiotics for various degrees of thermal and chemical skin lesions:

1. Ceclor, Cefuroxime, Cefazolin. The drugs are non-toxic and practically have no contraindications, they are used in the first and second stages, as well as in case of toxicemia.
2. Bicillin. Kills the root of the infection in the wound due to the main component in the composition - penicillin. Relieves swelling and itching.
3. Amoxicillin and disodium salt, Ampicillin. Prevent the development of sepsis and promote speedy recovery skin on hands and feet.
4. Aminoglycosides, which belong to the second generation, contain a beta-lactam substance. In a pharmacy they are found under the name Unazin and Sulacillin.
5. Cefixime, Cefotaxime, Ceftriaxone. Treat the third stages of burn injuries.
6. Nystatin, Fluconazole. Used for complications after healing, such as fungal infection.
7. Clindamycin and Metronidazole. It is prescribed for an infection that quickly spreads throughout the body.

This is not the whole list of funds that are prescribed for burn injuries. More often, the doctor recommends undergoing course therapy, which consists of taking several drugs. In the third stage of burns, when the wound localization area is too large, hospitalization is advised. home treatment in such cases will be ineffective and life-threatening.

Contraindications

If you act incorrectly with burn injuries, you can cause irreparable harm to health and appearance. To prevent this from happening, consider a few general contraindications:

• it is forbidden to lubricate the wounds with greasy creams or oils;
• it is not recommended to apply ice cubes to burns, this can cause frostbite of tissue integuments;
• it is forbidden to press or independently open blisters on the body;
• prescriptions are not allowed. alternative medicine without a doctor's approval;
• it is forbidden to use external means for the eyes, throat and other mucous membranes;
• It is not recommended to give antibiotics to a child under three years of age.

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Degrees of burns, symptoms and treatment tactics by stages

The burn surface of the 1st degree is treated at home. Does not require complex activities. Sufficient treatment of injury sites with wound healing ointments, compresses from anti-inflammatory herbs.

At grade 2, blisters filled with fluid appear. If improperly processed, they become infected, become a source of a long-term non-healing defect.

Treatment of 3, 4 degrees is carried out by surgeons. Doctors open dense blisters with preservation of the crust, clean the focus from dead tissues, and carry out antiseptic sanitation.

Gradation by Russian classification allows you to determine the tactics of conducting burns. The basis for classification is the degree of damage to the germ layer of the epidermis, the circulatory system. With the defeat of these anatomical links, self-healing of the skin is impossible. Even after surgical intervention the probability of healing of the defect with a scar, scab remains.

Burn stages:

• 1 degree - superficial lesion with redness, swelling, mild soreness;
• Grade 2 - against the background of hyperemia of the skin, blisters, blisters with yellowish contents appear. When the capillaries are damaged, the internal contents are stained red. The growth layer is preserved, so healing occurs without scarring;
• Grade 3 - the depth of the lesion reaches the germ layer. The skin is destroyed with the formation of a black crust (necrosis);
• Grade 4 - charring of the entire thickness of tissues in the path of the thermal factor. The epidermis, muscles, bone and joint structures are affected.

A similar gradation is applied in the world with some difference in different countries. However, those skilled in the art retain the steps described above as they are convenient for determining treatments.

A qualified doctor will be able to assess the severity of lesions only on the next day after damage to the skin. When there is a distinction between dead and healthy tissues, the severity of the pathology is visible. First aid should be provided immediately after exposure to thermal, solar, chemical factors.

First degree burns: main symptoms

First-degree burns do not damage deep tissues, so the risk of scarring or dangerous complications minimal. Common causes of nosology:

• Short exposure to sunlight
• Touching hot metal;
• Wiring contact.

The danger is extensive first-degree burns due to the risk of dehydration, blood intoxication with toxic products of tissue breakdown. Clinical symptoms: redness, itching, peeling.

The burnt surface heals for several days. Consequences - hyperpigmentation, peeling. Scars do not appear.

Clinical symptoms of second degree burns

Second degree burns are characterized by the formation of blisters of various sizes filled with serous fluid. Bubbles form on the 1-2 day, which makes it difficult to early verify the stage of the disease.

Main reasons:

• Action on the skin of acids, alkalis;
• High electrical voltage;
• Stay in an environment with a high temperature (above 70 degrees Celsius);
• Contact with steam, fire.

Healing of the burn surface of the second degree lasts 2-3 weeks.

Signs of third degree burns

The third degree is divided into 2 varieties: IIIa, IIIb. Morphological changes in pathology proceed in one of the following ways:

1. coagulative necrosis;
2. "Fixation" of changes under the influence of dry heat;
3. wet necrosis.

According to the principle of coagulative necrosis, at the 3rd stage of the burn, damage occurs, obtained under the action of the following reasons:

• contact with fire;
• Touching hot objects;
• Long lasting pair.

The clinical symptoms of the condition are a dark red color of the skin surface with black spots in the area of ​​epithelium death. Around the focus - a zone of hyperpigmentation. Demorcation small shaft can be traced to the end of 1, 2 months. The consequence of such changes is epithelialization due to the growth of the epithelium with a convex edge, granulations. Self-healing is characterized by burns that are no more than 2 cm in diameter. If the penetration of the defect is stopped, dehydration and intoxication are prevented. Only surgical procedures it is possible to clean the lesion, treat the place with antiseptics, and eliminate the violation of microcirculation.

Self-healing of a deep burn surface occurs due to the growth of the edges of the wound inward. The growth layer is affected, so scars form.

Wet necrosis is formed when clothing smolders. Integuments in places of defeat are edematous in the beginning, get white-pink color. The epidermis looks like "rags". After cleansing, granulation is formed, but the lesions often become infected, which prolongs the healing time.

"Fixation" of the skin occurs under the influence infrared radiation. The first three days, when palpated, the integument is cold, pale. Edema and hyperemia develop around the site of injury. Dry scab is formed for 3-4 days. Thereafter morphological changes similar to coagulative necrosis.

Unfortunately, after stages 3a, 3b, the functionality of the affected area is partially lost. The destruction of the musculoskeletal apparatus limits the mobility of the limb. A rough scar prevents stretching of the skin layer. With extensive damage, intoxication of the body occurs with tissue decay products that are absorbed into the blood from the pathological focus. The danger of the condition is determined by the type and concentration of toxins. With extensive damage, death of a person is possible due to reflex shock (irritation of receptors by toxic products).

A 4th degree burn is accompanied by damage not only to the skin, but also to the musculoskeletal system. With pathology, damage to the internal organs occurs. The person is in a state of shock. Treatment of the form is difficult due to the extensive burn surface (more than 60%), severe dehydration, and intoxication. Patients with the fourth stage are treated in the intensive care unit.

To save a life, a person has to difficult transplants internal organs. A disfigured body, limited mobility of the limbs are the consequences of a condition that long time corrected by plastic surgeons. Necrotic changes internal organs are accompanied by suppuration, which increases the risk of sepsis - bacterial infection of the blood.

Modern medicine is engaged in the study of subtle morphological, pathophysiological, biochemical mechanisms that occur in the body during burns. More patients dying from burns III-IV stages, have internal changes that are incompatible with life. If the formation of toxins is prevented in a timely manner, dehydration is prevented, pathological intracellular reactions are stopped, the lethal outcome will not occur. Medicine does not have fast-acting drugs that affect molecular level Therefore, the main method of treatment of deep burn lesions remains surgical.

How does deep necrosis proceed?

Damage muscle tissue accompanied by the release of toxins into the bloodstream that disrupt the functioning of the kidneys and liver. Dark brown skin, a rough scab on the surface are specific manifestations of coagulation tissue death.

Pronounced changes are characterized by the formation of a scab about 1 cm thick, through which the affected muscles and tendons can be traced. When the condition is present, surgeons perform deep excision to prevent intoxication. Often a radical way out is amputation of limbs.

The larger the area of ​​excision, the higher the likelihood of attachment bacterial infection.

Medical aspects of burn treatment

Local changes with a burn of 3a degree:

1. Soft superficial eschar;
2. The color of the skin depends on the provoking factor - gray or white;
3. Vesicles with yellowish serous contents.

Histological examination reveals the following morphological indicators:

• Desquamation of the epithelium;
• Complete necrosis squamous epithelium;
• Disorganization of the papillary layer;
• Swelling of connective tissue fibers;
• Puffiness, congestion of blood vessels;
• Pastosity of adipose tissue.

Subtle morphological changes are accompanied by the following external manifestations:

1. Grayish or black color;
2. Red pink papillae;
3. Granulations on the periphery of the focus;
4. Accumulation of lymphocytes, lymphoid cells on the periphery of the focus;
5. Multiple individual foci of epithelialization;
6. The growth of the epithelium inside the focus of the "flaps".

Clinical studies indicate that with a stage IIIa burn surface, the wound is not a stable formation. It tends to deepen, regardless of the time of occurrence. Activation of necrosis occurs due to vasoconstriction, damage to blood vessels by blood clots, and edema. Prolonged stagnation leads to death hair follicles, skin appendages. In such a situation, a rapid deepening of the necrosis zone is possible.

The reserves of the body are so significant that, according to statistics, about 1/3 of third-degree burns heal on their own (if no more than 60% of the skin is affected). It takes about 3 months to heal the wound. Reparation at the first or second stage occurs in 10-20 days. The difference is in the nature of the changes. The healing of deep necrotic burns is characterized by the formation of rough scars.

The burn surface of the first, second stage heals without scarring. There are no noticeable changes, except for peeling and hyperpigmentation. With small volumes of lesions, the foci heal on their own. Physicians prescribe only symptomatic treatment. Favorable outcome with stage 2 pathology, it is possible with the correct provision of first aid.

Some clinical studies confirm that gross deformities, colloidal scars are formed with the irrational use of ointment dressings.

The main task of local therapy for burn surface II, Stage III- to avoid tissue ischemia in order to limit the zone of necrosis, to prevent its progression. Optimal conditions for local wound healing are created as a result of timely anti-shock therapy in order to fully restore microcirculation.

Deepening of burns of 2-3a degree occurs when using creams against the background of suppuration of the inner layers with a bacterial infection. The condition is accompanied by unstable external symptoms which increase the risk of generalization of the infection. The lesions partially heal. Then they emerge greenish discharge. With extensive lesions of grade 3b-4, the healing process is absent, despite massive treatment. Qualified specialist with a similar picture, an infection will be detected, which will be confirmed by laboratory tests.

For the treatment of thermal, chemical, sunburns, it is more rational to use an etiopathogenetic approach that allows you to optimally determine the tactics of managing a patient and prevent deepening of burns. Scientists are reconsidering the feasibility of using antibiotics for burn wounds in order to reduce the amount surgical interventions.

Antibiotics in the treatment of burns 2-3a degree

For the application of antibiotics (antiseptics), the closed dressing method is optimal. For administration, solutions of furacillin, chlorhexidine, chloracil, ethony, iodovidone, iodonol are recommended. Means have a wide antibacterial spectrum. With purulent melting of tissues, it is better to use iodopyrin (1%), which has a directed action against Pseudomonas aeruginosa, Proteus, and Staphylococcus aureus.

Combined ointments against burns with antibiotics:

• Dioxidine;
• Iodopyrone;
• Sulfamekol;
• Dioxycol;
• Levonorsin;
• Levosin;
• Levomekol.

The composition of the preparations, in addition to antiseptics, is “enriched” with a metabolic regulator, an anesthetic, polyethylene dioxides with a molecular weight of 400, 1500. Based on the results of a morphological assessment of treatment with water-soluble ointments, a decrease in the number of neutrophils is determined, mast cells, microbes in the area of ​​skin lesions. The picture indicates the beginning of the restoration.

Severe dehydrating (prevention of fluid loss), necrolytic, antimicrobial action allows drugs to be an option in the treatment of third-degree burns.

European doctors prefer to use flamazin and sulfamilon to stop all pathological parts of the burn process.

Protective bandages for burns

With extensive border burns of the third stage, an extensive dressing is used:

• Algipor - drug plant origin;
• Epigarde, syncrite - synthetic means;
• Biological dressings (amniotic membrane, collagen preparations).

Of interest are clinical studies on the treatment of burn injuries with a bandage based on pigskin. The drug has a good regenerative property. Morphological study of changes in patients while taking the drug was confirmed positive action. Cytograms indicate consistent change inflammatory type reactions to inflammatory-regenerative in pig skin therapy. True, the duration of treatment and the timing of healing when using xenoskin have not been clarified.

Second degree burns can be treated with amniotic tape. According to various authors, the agent forms a protective sheath over the damaged epithelium, which eliminates the harmful effects of aggressive environmental factors and reduces the number of dressings. The amniotic film does not cause toxic reactions and allergies, but sometimes there are purulent complications.

Suppurations are observed in patients treated with algipore coating. Studies have shown a decrease in the drainage function of the epidermis when using the product.

The above facts indicate the impossibility of creating an ideal burn dressing without consequences with a good healing effect.

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Burn - tissue damage caused by thermal factors, chemicals, electric current, sunlight or radiation.

A first-degree burn affects only the outer layer of the skin (epidermis). A second-degree burn affects both the epidermis and the underlying skin layers. With a third-degree burn, the entire skin is damaged or destroyed; in addition, all underlying tissues are damaged. The burnt area swells, blisters form on it due to the leakage of plasma through the walls of damaged blood vessels.

There are the following types of burns: 1. Thermal; 2. Chemical;

3. Radiation, including sunburn, - as a result of ultraviolet and other types of radiation.

Factors contributing to getting radiation burns: 1. Excessive exposure to direct sunlight. 2. Light, low-pigmented skin. 3. The use of photosensitizing drugs (sulfonamides; tetracycline antibiotics, etc.).

4. Exposure to industrial sources ultraviolet radiation.

Symptoms requiring referral to a doctor. 1. In case of thermal and chemical burns: - charring of the skin - III degree burn (possibly no pain); - formation of blisters on a large area of ​​the skin (more than 5 cm in diameter); - any burn on an infant or small child;

Chemical burn of the pharynx, larynx, esophagus.

2. When sunburn: - confusion of consciousness; - dry mouth, decreased or absent urination; - sunken eyes; - wrinkled or saggy skin; - temperature above 39 °С; - formation of blisters on a large area of ​​the skin (more than 5 cm in diameter);

Strong pain.

Treatment of burn wounds.

[[First aid for burns]]

Locally for burns, it is recommended to cool the burned area, eliminate its contact with clothing, anti-inflammatory creams and ointments. As a general measure, the introduction a large number liquids (2-4 ml for each percent of the burnt surface), painkillers. In severe cases, shown antishock therapy, prompt removal necrotic tissues; measures that promote skin regeneration; skin graft; vitamins that stimulate healing.

The specifics of the treatment of burn wounds

Local treatment of burn wounds depends on their type and has some differences. Deep, borderline or superficial - they are all treated differently.

Uninfected II degree burns: apply atraumatic dressings, hydrogel coatings, as well as wet-drying dressings with antibiotic or antiseptic solutions. For the treatment of these burns, emulsions and ointments with bactericidal and analgesic effects are also used. In particular, argosulfan, 1% silver sulfazine, levomekol and levosin are used.

Extensive IIIA degree burns: methods of drying the burn surface are used using preparations containing iodine, in particular iodopyrone, iodovidone and water-soluble ointments (dioxidine ointment, levomekol). Moreover, ointments are recommended to be used in combination with atraumatic mesh dressings, such as waxopran, parapran or branolind H. In the case of abundant wound discharge, it is preferable to use branolind H dressings, since they have a sufficient cell size. The combination of film dressings with preparations based on silver salts is optimal.

A good effect is also given by the use of Ebermin ointment, which has the ability to accelerate the healing of burns, especially II and III degrees, and the drug argosulfan. The latter, being a product containing 2% silver sulfathiazole and made in the form of a cream, has high efficiency for major pathogenic microorganisms detected during burns in an infected wound.

Deep burns of IIIB - IV degree: treatment is aimed at the rapid formation of a dry burn scab, as well as at preventing the deepening of burn wounds and their infection. For this purpose, preparations containing iodine (iodopyrone or iodovidone), as well as ointments based on water-soluble polyethylene glycol, are used.

To accelerate the cleansing of burn wounds, it is possible to use proteolytic enzymes such as trypsin, chymotrypsin, proteolitin and streptokinase. You can also use dressings based on daltextrypsin. After cleansing the burn surface from dead areas, it is recommended to use water-soluble ointments containing antibacterial drugs. It is also recommended to alternate them with antiseptic solutions and modern synthetic dressings.

Local conservative treatment This type of burn is actually done to prepare the victim for a free skin graft. Surgery burns are performed by skin transplantation in specialized clinics around the world, for example here.

BUT general treatment in this case, it includes the introduction of antibiotics, if necessary, vitamins, blood products, as well as blood substitutes and serum of burn convalescents and antihistamine drugs.

Leader's recommendations. 1. Moisten the burnt area with cold water. 2. Lubricate the burnt surface with an anti-inflammatory cream (once). 3. Do not break the integrity of the formed blisters, i.e. do not pierce or open them. 4. Apply a sterile bandage to areas where there are penetrating skin lesions. 5. For shallow and non-extensive burns, apply drying ointments and pastes to weeping areas. 6. To accelerate healing, enrich the diet with vitamins C, B, especially A and E (inside and outward in the form of an ointment, which helps to avoid the formation of scars). 7. Do not use oils, ointments, aerosols and creams that cause local anesthesia, as they can slow down healing or cause an allergic reaction. 8. Protect the burnt area from exposure to the sun, hot water, irritants.

9. In sunny weather, use protective creams, ointments, wear a hat and Sunglasses.

Over-the-counter drugs for burns. 1. Inside painkillers: paracetamol, acetylsalicylic acid, ibuprofen, naproxen.

2. Ointments, creams, pastes, gels are used externally) - hydrocartisone, zinc, ichthyol, kamagel. Sunburn is treated with Betamethasone (Celestoderm).

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