Combustion - the damage of the tissues which have arisen from local thermal (thermal), chemical, electric or radiative influence. Most often in a clinical practice there are thermal combustions. The degree and prevalence of a local thermal combustion define during the moment of survey of the victim. The overheating of tissues above 52°С leads to irreversible coagulative coagulation of fibers of tissues. Gravity of damage depends on height of temperature, duration of influence, extensiveness of a lesion and localization of a combustion. Especially serious combustions the flame, the fused metal causes, steam under the pressure, boiling oil, hot gas. There are combustions of arms, legs, eyes is more often.

The general consequences of combustions. At rather limited combustions rise in temperature is marked. Quite often there is a shock: at the combustions of 1 degree amazing more of 30 % of a surface of a body; 2 - 4 degrees - more than 10 %. The burn shock develops in 1-2 hours after a combustion. The strong pain, thirst, integuments acyanotic, temperature of not amazed sites is lowered. Later some hours consciousness confused, can develop clonic cramps and a delirium. A vomiting and diarrhea - bad prognostic attributes. Depression of a diuresis is often marked; a collapse. If treatment is not spent, patients quite often perish at the first 12-48 o'clock from an acute cardiovascular failure. The burn shock is caused by neurovascular reflexes (a pain, pavor) with emission of catecholamins; thermal damage of capillaries to a zone of a combustion leads to an output of albumins in a tissue. Matter also development at combustions of Histaminum and other mediators of an inflammation. By third day of the phenomenon of a shock are usually stoped. The acute burn intoxication begins after a phase of a shock at serious combustions (a heat, a tachycardia, depression of appetite, a slow adhesion of burn wounds); it is caused by an absorption of products of disintegration of the burnt tissues. Duration of the period of 4-12 days. At a pyesis the septicopyemia which can lead to a burn attrition develops.

Local consequences of combustions. Combustions divide into 4 degrees: 1 degree (erythema) - an erubescence, puffiness and a pain. The inflammatory phenomena remit in 3-6 days, leaving only an ecdysis of a skin; 2 degree (formation of bubbles) - a strong pain with intensive reddening, amotio of a false skin with formation of the bubbles filled by transparent or slightly muddy liquid. Damages of deep layers of a skin are not present, and if the infection has not joined, in a week layers of a skin without formation of cicatrix are restored all. Full convalescence comes in 10-15 days. In case of a becoming infected convalescence is sharply tightened, the adhesion goes a second intention; 3 degree: the necrosis grasps a depth of a skin up to a layer (the independent cuticularization is possible); a necrosis of all depth of a skin (the independent adhesion is possible only at small combustions due to a regional cuticularization). The dense scab under which there are damaged tissues is formed. The adhesion goes a second intention with formation of rasping cicatrix; 4 degree: arises at influence on a tissue very much heats (a flame, the fused metal). These are fires at failures on motor transport, planes, accidents on shafts more often. There is a damage of muscles, tendons, bones. If are amazed the top or bottom extremity, well-timed ablation can salvage a life of the victim only.