Local changes in burn injury

I degree burns are characterized by phenomena of aseptic inflammation most superficial layers of the skin, often barely reaching her papillary layer, pain and slight swelling of the surrounding tissue. In the basis of these phenomena lies persistent arterial blood with vihodnie from blood vessels into surrounding tissue insignificant number of plasma and blood cells.
C. N. Evdakov found with burns of I degree of morphological changes in the germinal layer of the epidermis in the form of granular regeneration of epithelial cells.
Moritz and ham, studying superficial burns in pigs were found swelling of the nuclei of epithelial cells of the epidermis and numerous vacuolation of their protoplasm.
The affected areas and formed a small swelling, wool vsyerossiiskaya, and depigmentirovannah skin is well expressed hyperemia. In the future, the dead layers of skin peel.
The II degree burns characterized by persistent expansion of blood vessels, a sharp increase in their porosity and vpotevanie significant number of the liquid part of blood into the surrounding tissue.
Animals serous exudate diffuse permeates the entire thickness of the skin, subcutaneous tissue and underlying tissues, forming extensive edema, which gradually descended into the lower parts of the body (dewlap, the lower part of the chest, abdomen and extremities). Maximum development swelling reach in 24-48 hours. after thermal injury.
Ham has established that in pigs main place of plasmocracy are the capillaries located around hair follicles, sebaceous and sweat glands.
Often serous exudate vuotiaat on the surface of the skin, especially on the border of the burn, in the form of sticky yellowish-pink color drops "dew"that music industry form a loose brown. On parts of the body with gentle skin (in the area of the facial part of the head, neck, groin, genitals, udder, knee folds, flexor surfaces of the joints) exudate may accumulate between horn and malpighiales layers (due to the existing loose connection between them), forming various sizes bubbles. The resulting bubbles contain transparent, slightly pinkish color, opalescent fluid. At the opening of the bladder exudate quickly becomes cloudy and turns into a jelly-like mass. The liquid accumulated in places of swelling and blisters on the chemical composition is very similar to the plasma and contains: protein from 3 to 6% (divided into albumin - 35-42%, alpha-globulin - 11-24%, beta-globulin - 20-22% and gamma-globulin - 23-31%), residual nitrogen from 14 to 32 mg, sugar from 25 to 70 mg%, chlorides from 480 to 530 mg% and formed blood elements.
Some authors indicate that burns of II degree of the upper third of hair follicles completely blackened dead tissue, and in the deeper sections observed pikes and vacuolization of cores. Such changes are detected in the epithelium of the sweat glands.
N. E. Heckler and I. B. Pruzhany found on place of burning degenerative changes in the nervous until their necrosis.
As a rule, at the place burn to 15-20 days of the necrotic tissue is rejected. Healing occurs by, epithelization due to the preserved parts of the epidermis.
The burn of the III degree arise from exposure to high temperature and is characterized by lesions of the entire thickness of the skin is a total loss of hair follicles, sweat and sebaceous glands. To this extent, characterized by the gradual spread of necrosis of tissues in depth, which can partly be explained by the sharp compression of the nerve endings and cells viphavadi the exudate, developing a stasis and thrombosis of vessels, in violation of neuroregulation and trophic processes in the tissues. All this leads to deep infringements of exchange processes, leading to cell death.

Fig. 2. Bull in 3 hours after burn 25% II + III right side of the body. On the ground burn of the III degree leather collected in the rough folds-"bumps".
The skin on the burn becomes dense, fixed, not sensitive to painful stimuli and at movement of the animal is going to rough folds-"flute" (Fig. 2). When pressed in the area of the burn revealed signs of a strong pain. Later 15-40 minutes after burn develop swelling of subcutaneous tissue, first on the affected area and on its circumference, and then gradually extends to the underlying parts of the body, reaching the maximum development for 3-4 days.
O. K. Khmelnitsky and ham indicate that on the affected area for burns III degree all surface network of blood vessels is not functioning, and plasmodia is due to the sharp expansion vessels located in the deep layers of subcutaneous fat. On 7-1 5th day on the burnt place cracking of the skin (clinically captured the beginning of exclusion dead skin and underlying tissue), of which appears after the first serous, and then purulent exudate. Without the active surgical intervention, in the presence of extensive burns, cleaning of the affected area from the dead tissue is very slow and ends only 50-60 and even to 80 days. After the rejection of dead tissue is formed extensive poorly-granulating surface.
Several authors indicate that burns III degree, the likelihood of epithelial elements in the thickness of the skin is very small. Therefore the healing of these lesions is the same as in normal extensive traumatic skin defects, - Andrey a cohesive power, due to fibrous degeneration of granulation tissue and epithelization from the edges. Fibrous degeneration of granulations prevents epithelization. Therefore, extensive surface of burns heal very slowly, by type atonic ulcers.
In the heart of burn wounds granulation ageing fast and epithelization stops. This leads to a proliferation of massive fixed bumpy keloid scar, often with ulcerative surface in the center. Such wounded surface for a very long time (1.5-2 years and more) did not show inclinations to heal and lead to long intoxication, pathological irritation of the nervous system and loss of protein. The presence of an unhealed ulcer surface within 1-1,5 years sometimes leads to rebirth scars in tumors. Formed with extensive burns, scars, and even covered the epidermal tissue, usually very rude, still, easily injured, crack and izyaslau.
The IV degree burns are formed by prolonged exposure to very high temperatures and are accompanied by charring body part or all of the body (leg, head, ears and so on). When this degree burn, the skin at the affected area becomes wrinkled, dry very dense crust; the same pattern is sometimes observed in more deep superficial tissues.
It is established experimentally that prolonged exposure to high temperature on the limited areas of the skin horses is not always the case charring of the skin, however, and in these cases always develop necrosis lower fabrics. Immediately after the defeat on the burned areas are formed of different depth and magnitude of the crack (especially deep cracks are at a burn in the joints, knee folds, groin, udder and so on), which is yellowish-bloody fat-like after.