Burn - 烧伤
Sunburn：以后要警惕黑色素瘤的发展。
References
浅表烧伤（一度）仅影响表层皮肤。这些烧伤看起来呈粉红色或红色，不会形成水泡，很干燥，并且可能会有些疼痛。通常 5 至 10 天即可愈合，不会留下疤痕。二度烧伤，也称为浅表部分厚度烧伤，影响皮肤深层的外层。水泡很常见，初次看到时可能会残留。水泡打开后，下面的皮肤呈均匀的红色或粉红色，按压时会变成白色。这些烧伤很痛苦。它们通常会在 2 至 3 周内愈合，且疤痕极小。深度二度烧伤涉及皮肤深层的较深部分。与浅表二度烧伤一样，这些烧伤可能有完整的水泡。去除水泡后，下面的皮肤颜色不均匀，按压时会慢慢变白。患有这些烧伤的患者几乎感觉不到疼痛，只有在深压时才会发生这种情况。这些烧伤无需手术即可愈合，但需要更长的时间，并且预计会留下疤痕。
A superficial (first-degree) burn involves the epidermis only. These burns can be pink-to-red, without blistering, are dry, and can be moderately painful. Superficial burns heal without scarring within 5 to 10 days. A second-degree burn, also known as a superficial partial-thickness burn, affects the superficial layer of the dermis. Blisters are common and may still be intact when first evaluated. Once the blister is unroofed, the underlying wound bed is homogeneously red or pink and will blanch with pressure. These burns are painful. Healing typically occurs within 2 to 3 weeks with minimal scarring. A deep partial-thickness burn involves the deeper reticular dermis. Similar to superficial partial-thickness burns, these burns can also present with blisters intact. Once the blisters are debrided, the underlying wound bed is mottled and will sluggishly blanch with pressure. The patient with a partial-thickness burn experiences minimal pain, which may only be present with deep pressure. These burns can heal without surgery, but it takes longer, and scarring is unavoidable.
A superficial (first-degree) burn involves the epidermis only. These burns can be pink-to-red, without blistering, are dry, and can be moderately painful. Superficial burns heal without scarring within 5 to 10 days. A second-degree burn, also known as a superficial partial-thickness burn, affects the superficial layer of the dermis. Blisters are common and may still be intact when first evaluated. Once the blister is unroofed, the underlying wound bed is homogeneously red or pink and will blanch with pressure. These burns are painful. Healing typically occurs within 2 to 3 weeks with minimal scarring. A deep partial-thickness burn involves the deeper reticular dermis. Similar to superficial partial-thickness burns, these burns can also present with blisters intact. Once the blisters are debrided, the underlying wound bed is mottled and will sluggishly blanch with pressure. The patient with a partial-thickness burn experiences minimal pain, which may only be present with deep pressure. These burns can heal without surgery, but it takes longer, and scarring is unavoidable.
大多数烧伤都是轻微的，可以在家中或由当地医疗保健提供者进行治疗，无需住院。然而，本章将专门讨论严重烧伤的立即护理和治疗。 （有关详细信息，请参阅“烧伤、评估和管理”以及“烧伤、热”部分。）
Most burns are small and are treated at home or by local providers as outpatients. This chapter will focus on the initial resuscitation and management of severe burns. (Also see Burns, Evaluation and Management and Burns, Thermal).
Most burns are small and are treated at home or by local providers as outpatients. This chapter will focus on the initial resuscitation and management of severe burns. (Also see Burns, Evaluation and Management and Burns, Thermal).
烧伤常常被忽视，但可能会造成严重伤害甚至死亡。严重烧伤会引发复杂的身体反应，包括免疫反应、代谢变化和休克，这些反应很难治疗，并可能导致多个器官衰竭。
Burn injuries are under-appreciated injuries that are associated with substantial morbidity and mortality. Burn injuries, particularly severe burns, are accompanied by an immune and inflammatory response, metabolic changes and distributive shock that can be challenging to manage and can lead to multiple organ failure.
Burn injuries are under-appreciated injuries that are associated with substantial morbidity and mortality. Burn injuries, particularly severe burns, are accompanied by an immune and inflammatory response, metabolic changes and distributive shock that can be challenging to manage and can lead to multiple organ failure.
仅影响浅表皮肤层的烧伤被称为浅表或一度烧伤。它们呈红色，没有水泡，疼痛通常持续三天左右。
当损伤延伸到某些下面的皮肤层时，就是部分厚度或二度烧伤。水泡经常出现并且通常非常疼痛。愈合可能需要长达八周的时间，并且可能会留下疤痕。
在全层烧伤或三度烧伤中，损伤会延伸到皮肤的所有层。通常没有疼痛，烧伤部位很僵硬。
四度烧伤还涉及更深层次的组织损伤，例如肌肉、肌腱或骨骼。烧伤通常是黑色的，并且经常导致烧伤部分丢失。
○ 治疗 - 非处方药
重要的是不要弄破烧伤部位的水泡。最好只排出水泡中的血清。必须小心，防止纱布或敷料粘在水泡上并将其撕裂或除去。
用干净的绷带覆盖烧伤处以保护受影响的区域。如果水泡已经脱落，应使用外用抗生素或1%磺胺嘧啶银乳膏（Silmazine）。服用非甾体抗炎药、对乙酰氨基酚和非处方抗组胺药来减轻炎症和疼痛。
外用抗生素
#Bacitracin
#Silver sulfadiazine 1% cream
去痛药
#Ibuprofen
#Naproxen
#Acetaminophen
非处方抗组胺药
#Cetirizine [Zytec]
#Diphenhydramine [Benadryl]
#LevoCetirizine [Xyzal]
#Fexofenadine [Allegra]
#Loratadine [Claritin]