Julius — the little helper for scar therapy

Julius informs

Burns and scalds

Covering an area of about two square meters (20 square feet), the skin is the largest organ of the human body. It performs important tasks, like regulating the temperature, and protecting the organism against injury or intrusion by pathogens. Any damage to the skin can therefore have serious health consequences and, in extreme cases, even be life-threatening. This kind of damage could result from thermal (e.g. hot water or beverages), chemical (e.g. acid in a workplace accident) or physical influences (e.g. cut injuries or surgery). Extensive injuries to the skin are especially dangerous. By this we mean, in particular, burns and scalds, which can often affect large areas of the body and even damage the deep layers of the skin.

In Germany, 12,000 people suffer severe burn injuries each year, of which about 7,000 are children. Up to 1,400 of these cases require intensive care in specialized burn units. When considered on a per capita basis, the annual rate of approx. 600 cases of minor and smaller-sized burns per 100,000 citizens is relatively frequent, whereas severe burns are quite rare at approx. two to five cases. The most frequent causes of burns are household or recreational accidents (60 to 75 percent) and work-related accidents (20 to 30 percent).

One cup of tea can be enough

Five percent of all injuries in infancy and early childhood involve burns or scalds. Toddlers, in particular, often fall victim to this as they explore the household and, for example, pull pots with hot liquids from the stove. That is why most heat-related injuries in children are seen in the head, hand and chest areas. Hot water of 50 °C (120 °F) is already sufficient to damage a child’s skin so seriously that blisters develop. And the content of a hot cup of tea is enough to scald up to 30 per cent of the body surface of a toddler. The degree of exposure to heat (temperature and duration), the thermal conductivity of any fabrics being worn, and the type of first aid measures performed will influence the extent of burning or scalding. The degree of thermal injury is determined by the size of the burnt or scalded area, and the depth of the damage.

How scars are formed – and what can be done about them

Wounds caused by burns or scalding heal according to the same principles as other skin injuries. Superficial first and second degree (IIa) thermal injuries generally heal within 14 days without scarring. Where deeper injury to the skin has occurred, this scar-free spontaneous healing is no longer possible because the regenerative cell layer has been destroyed. In this case the body tries to close the skin defect from the edge of the wound inwards. It does so by forming new tissue, so-called granulation tissue. Once the wound has closed, “overgrowth” of the wound frequently sets in after three to four weeks. The fibrous cords of connective tissue pack together, harden, then shrink, thereby creating a scar.

If the growth of the fibrous connective tissue cells occurs in an uncontrolled manner, hypertrophic (proliferative) scars or keloids may be formed. Such scars are not just a cosmetic problem - the thickening and hardening can also lead to restricted movement, malpositioning of the joint and, in the most severe cases, to immobility of the entire limb. Affected persons also frequently suffer from disturbed sensation and itchiness. When treated correctly, the conversion of the scar tissue – so-called scar maturation – may take up to two years to complete after closure of the wound. To obtain the most aesthetic scar healing possible with no functional deficits, it is necessary to apply a uniform pressure to the affected body areas. This is only achievable by means of so-called compression therapy.

The scar therapy process

For further information about scar therapy, the process involved, and the role that compression garments play in this, see the „Julius informs" area of this website.

Julius informs

Classification of burn severity by depth:

Degree I
Redness and swelling of the skin. This can occur, for example, with a sunburn.

Degree IIa
Redness and swelling of the skin, blister formation, pain. The epidermis is damaged and rises as a thin-walled blister. This type of injury generally heals within two weeks.

Degree IIb
Paleness and swelling of the skin, blister formation, pain. The skin is damaged right down to the deep layers of the dermis. This often requires operative treatment.

Degree III
Leather-like skin areas with white, gray or black discoloring, reduced pain sensation due to destruction of the nerve endings, complete destruction of the epidermis and dermis (necrosis) and damage to the subcutis. Operative treatment is essential.

A few scar basics

There are quite a few technical terms, aren't there.
Here are explanations for the most important terms:

Scar
A scar represents the healed state of a skin injury. The connective tissue of the scar will, at first, be red, fairly inelastic and not very functional. As the scar matures it is possible for shrinking and hardening to occur.

Scar hypertrophy
An excessive production of collagen fibers leads to the irregular formation of connective tissue extending beyond the original wound area.

Keloid
A keloid is an uncontrolled, strong connective tissue growth that extends beyond the wound area into healthy skin. The reduction in skin elasticity can even lead to stiffening of joints.

Atrophic scar
This is what a sunken scar resulting from poor wound healing is called. It results from an inadequate production of connective tissue fibers.

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