scald Scald refers to tissue damage caused by hot liquids, steam, etc. In clinical practice, it is generally grouped with other thermal injuries under the term "burns".

A scald is a tissue injury caused by hot liquids, steam, and other hot substances. In clinical terms, scalds are generally grouped together with other heat-induced injuries and referred to as burns.

Based on the depth of the injury, scalds can be categorized into three degrees and four types.

First-degree scald: Affects the epidermal layer.

Superficial second-degree scald: Affects the superficial layer of the dermis, preserving some of the germinal layer.

Deep second-degree scald: Affects the deep layer of the dermis, with remnants of the reticular layer.

Third-degree scald: Involves the entire skin layer, and may extend to deeper structures such as bones and muscles.

Based on severity, scalds can be classified into mild, moderate, severe, and critical categories.

Mild scald: Second-degree scald covering less than 9% of the body.

Moderate scald: Scald covering 10% to 29% of the body, or a third-degree scald covering less than 10%.

Severe scald: Scald covering 30% to 49% of the body, or a third-degree scald covering 10% to 19%, or a scald covering less than 30% but accompanied by one of the following: significant combined injuries, shock, or severe systemic conditions, moderate to severe inhalation injury.

Critical scald: Total area exceeding 50%, or a third-degree scald covering more than 20%.

After a scald, fluid from blood vessels enters the tissue, causing localized swelling. In severe cases, excessive fluid leakage from blood vessels, elevated levels of catecholamines and cortisol in the body, may lead to shock in patients. Additionally, damaged skin and wounds result in the loss of a barrier against bacterial invasion, making scalded skin prone to infection.

First-degree scald:

Localized redness, swelling, slight elevation in skin temperature, no skin breakage, heals within 3-5 days. Skin color in the area may darken temporarily, leaving no scars.

Superficial second-degree scald:

Development of varying-sized blisters, red and painful after blister skin removal, elevated skin temperature, heals in approximately 2 weeks. Temporary changes in skin color may occur in the area, leaving no scars.

Deep second-degree scald:

Formation of small blisters, red and white mixed appearance after blister skin removal, numbness, slightly lower skin temperature, heals in approximately 3-4 weeks if no infection occurs.

Third-degree scald:

Yellowish-brown, waxen, firm scabs, pale, dry, and cool wound surface, loss of sensation.

Fourth-degree scald:

Tissue charring (carbonization), no blood supply.

Mild scald:

Wound disinfection, bandaging;

Use of pain-relief medication for significant pain;

Administration of tetanus antitoxin and antibiotics to prevent tetanus and infection.

Moderate to severe scald:

Monitoring vital signs such as blood pressure, respiration, and checking for inhalation injuries, combined injuries, poisoning, etc.;

Prompt establishment of intravenous access, examination of corresponding hematological indicators;

Administration of fluid replacement therapy, urinary catheterization;

Use of tetanus antitoxin and antibiotics to prevent tetanus and infection;

Assistance with tracheal intubation, oxygen administration, or mechanical ventilation for those experiencing respiratory distress;

Incision and decompression for those with excessively high tension.

For scalds on areas such as hands and feet, which are functionally important, post-treatment care is particularly crucial, and activities to facilitate functional recovery should be encouraged.

Consistently using elastic clothing to compress scar tissue left after scalds can reduce scar hypertrophy.

It is important to be vigilant to prevent scalds from occurring.

Encouragement and companionship are essential for scald patients. First-degree scalds do not leave scars, but more severe scalds may result in scarring. Therefore, attention to the patient's psychological well-being and maintaining an optimistic and positive attitude are crucial.

Several measures can be taken to reduce the occurrence of scalds at home:

Ensure there is always someone present while cooking, and avoid holding children while cooking. Avoid loose-fitting clothing, especially synthetic fabrics, while cooking.

Keep children away from stoves, heaters, and other heat sources.

Unplug the iron when not in use.

Set the water heater temperature to below 120 degrees Fahrenheit (48.9 degrees Celsius).

Place hot liquids out of reach of children.

Check the temperature before feeding or bathing a child.

Avoid using a microwave to heat a baby's bottle.