Value of Hormone Measurements in Gynaecology

Abstract

A burnt patient often has a problem before being burnt. Such injuries occur to the accident-prone: deprived children; the stressed or careless; epileptics, drug addicts, alcoholics, psychotics; the elderly; and those already sick. A burn is a serious injury, no matter how localized, and it affects the psychological, social, financial and often the medical status of the whole family. The manner of burning is directly related to the extent, depth and distribution of the injury. A detailed history taken as soon as possible after the injury from patient or observers will give vital clues as to the likely cause of the problem. Scalds are the commonest burn. They are often of limited extent and depth, and heal quickly with insignificant scarring. They may be extensive and deep, with all the metabolic problems particular to a major burn. The injury is usually confined to skin unless superheated steam has been inhaled when there may be a pulmonary injury. The heat of the liquid and how soon it cooled or was removed are facts which, if recorded, give guidance in the diagnosis of depth of injury. Flame burns are hot and invariably destroy the full thickness of part of the burnt area. If these burns are due to ignited clothing, the front of the body, neck and face and palms of the hands are burnt; if they are due to a burning building, hot or irritating gases may add a heat or chemical pulmonary burn. Head or internal injuries or fractures of limbs or spine, are common in those who have jumped or fallen from windows. Electrical burns at mains voltage are always 'full-thickness' burns. Damage is propagated along vessels and nerves since this plane constitutes the line of least electrical resistance. High tension electricity causes damage to skin at entry and exit sites, and extensive damage to muscle between the two points. Flash burns from explosion of inflammable gases or vapours or the discharge of electricity are always partial thickness, so long as clothing has not been ignited. Healing occurs in ten days. Contact burns are usually restricted to one surface (unless a hot press is involved), are of limited extent, but may be associated with a crush injury. Chemical burns, often the result of an assault, are usually of limited extent and confined to skin, unless the agenthas been swallowed or the patient has been accidentally immersed. Patients unconscious at the time of burning more commonly suffer deeper burns. A burn is infinitely variable and is an injury which affects all ages and complicates a variety of physical and psychological conditions. The primary effect is upon the surface of the body, but the metabolic effects of the injury and the treatment that follows it affect all systems to an amazing degree.