Burn - 燒傷
Sunburn：以後要警惕黑色素瘤的發展。
References
淺層燒傷（一度）僅影響表層皮膚。這些燒傷看起來呈粉紅色或紅色，不會形成水泡，很乾燥，並且可能會有些疼痛。通常 5 至 10 天即可癒合，不會留下疤痕。二度燒傷，也稱為淺層部分厚度燒傷，影響皮膚深層的外層。水泡很常見，初次看到時可能會殘留。水泡打開後，下面的皮膚呈現均勻的紅色或粉紅色，按壓時會變成白色。這些燒傷很痛苦。它們通常會在 2 至 3 週內癒合，且疤痕極小。深度二度燒傷涉及皮膚深層較深的部分。與淺表二度燒傷一樣，這些燒傷可能有完整的水泡。去除水泡後，底下的皮膚顏色不均勻，按壓時會慢慢變白。患有這些燒傷的患者幾乎感覺不到疼痛，只有在深壓時才會發生這種情況。這些燒傷無需手術即可癒合，但需要更長的時間，並且預計會留下疤痕。
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.
大多數燒傷都是輕微的，可以在家中或由當地醫療保健提供者進行治療，無需住院。然而，本章將專門討論嚴重燒傷的立即護理和治療。 （有關詳細信息，請參閱“燒傷、評估和管理”以及“燒傷、熱”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).
燒傷常常被忽視，但可能造成嚴重傷害甚至死亡。嚴重燒傷會引發複雜的身體反應，包括免疫反應、代謝變化和休克，這些反應很難治療，並可能導致多個器官衰竭。
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.
僅影響淺層皮膚層的燒傷稱為淺層或一度燒傷。它們呈紅色，沒有水泡，疼痛通常持續三天左右。
當損傷延伸到某些下面的皮膚層時，就是部分厚度或二度燒傷。水泡經常出現並且通常非常疼痛。癒合可能需要長達八週的時間，並且可能會留下疤痕。
在全層燒傷或三度燒傷中，損傷會延伸到皮膚的所有層。通常沒有疼痛，燒傷部位很僵硬。
四度燒傷也涉及更深層的組織損傷，例如肌肉、肌腱或骨骼。燒傷通常是黑色的，並且經常導致燒傷部分流失。
○ 治療 - 非處方藥
重要的是不要弄破燒傷部位的水泡。最好只排出水泡中的血清。必須小心，防止紗布或敷料粘在水泡上並將其撕裂或除去。
用乾淨的繃帶覆蓋燒傷處以保護受影響的區域。如果水泡已經脫落，則應使用外用抗生素或1%磺胺嘧啶銀乳膏（Silmazine）。服用非類固醇抗發炎藥、對乙醯氨基酚和非處方抗組織胺來減輕發炎和疼痛。
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]