Burn - 燒傷
Sunburn：以後要警惕黑色素瘤的發展。
relevance score : -100.0%
References淺層燒傷（一度）僅影響表層皮膚，外觀呈粉紅色或紅色，不會形成水泡，且較乾燥，可能伴有輕微疼痛。通常於 5 至 10 天內癒合，不會留下疤痕。 二度燒傷，又稱淺層部分厚度燒傷，累及皮膚較深的外層。常見水泡，初期可能仍保留。水泡破裂後，底層皮膚呈均勻的紅色或粉紅色，按壓時會變白，且疼痛明顯。此類燒傷多在 2 至 3 週內癒合，疤痕極小。 深度二度燒傷則波及皮膚較深的層次。與淺表二度燒傷相似，常有完整的水泡。去除水泡後，底層皮膚顏色不均，按壓時會逐漸變白。患者對此類燒傷的疼痛感較低，僅在深度壓迫時才會感到疼痛。此類燒傷可自行癒合，無需手術，但需要較長時間，且通常會留下疤痕。
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.
大多數燒傷屬於輕度，可在家中或由當地醫療保健提供者處理，無需住院。然而，本章將專門討論嚴重燒傷的即時護理與治療。（有關詳細資訊，請參閱「燒傷、評估和管理」以及「燒傷、熱」章節。）
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).
燒傷常被忽視，卻可能造成嚴重傷害甚至死亡。嚴重的燒傷會引發複雜的身體反應，包括免疫反應、代謝變化與休克，這些情況難以治療，且可能導致多器官衰竭。
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.
僅影響淺層皮膚的燒傷稱為淺層或一度燒傷，呈紅色，無水泡，疼痛通常持續約三天。
當損傷延伸至較深的皮膚層時，稱為部分厚度或二度燒傷。常會形成水泡，且疼痛明顯。癒合可能需長達八週，且可能留下疤痕。
全層燒傷或三度燒傷則波及皮膚所有層，通常無疼痛感，受傷部位會變得僵硬。
四度燒傷涉及更深層組織，如肌肉、肌腱或骨骼，燒傷部位常呈黑色，且常伴隨組織壞死。
○ 治療 - 非處方藥
重要的是避免弄破水泡，最好僅讓水泡內的血清自然排出。必須小心防止紗布或敷料黏在水泡上而導致撕裂或脫落。
可用乾淨的繃帶覆蓋燒傷部位，以保護受損區域。若水泡已自行破裂，應使用外用抗生素或 1% 磺胺嘧啶銀乳膏（Silmazine）。可服用非類固醇抗發炎藥（NSAIDs）、對乙醯氨基酚（acetaminophen）及非處方抗組織胺，以減輕發炎與疼痛。
外用抗生素
#Bacitracin
#Silver sulfadiazine 1% cream
去痛藥
#Ibuprofen
#Naproxen
#Acetaminophen
非處方抗組織胺藥
#Cetirizine [Zytec]
#Diphenhydramine [Benadryl]
#LevoCetirizine [Xyzal]
#Fexofenadine [Allegra]
#Loratadine [Claritin]