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Rationale Behandlung von Patienten mit Verbrennungen 1. Grades

Rational treatment of first-degree burns

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Zusammenfassung

Verbrennungen 1. Grades sind der häufigste Typ der Verbrennung. Trotzdem wird diese Verbrennung oft unzureichend behandelt. Die Methoden der Therapie und der Erkrankungsverlauf sind nur wenig dokumentiert, da die Erkrankung meist nicht ernst genommen wird. Verbrennungen 1. Grades werden durch thermische Schädigung oder durch UV-Strahlung (Dermatitis solaris) verursacht. Die Pathophysiologie und das therapeutische Vorgehen sind ähnlich, wenngleich die Schädigungen mit unterschiedlicher Zeitkurve auftreten: sofortige Schädigung durch Kontakt mit heißen Gegenständen, Flüssigkeiten oder Feuer, protrahierte Schädigung bei einer Dermatitis solaris. Nach initialer Kühlung mit Wasser für einige Minuten sind Emulsionen mit einem hohen Anteil von Wasser und einem geringeren Anteil von hautverträglichen Lipiden (O/W-Emulsionen) zur Behandlung einer Verbrennung 1. Grades oder einer Dermatitis solaris am besten geeignet. Wasser führt durch Verdunstungskälte zur Reduktion der Entzündung; Lipide beschleunigen die Reparatur der geschädigten Barriere und verhindern eine Austrocknung. Insbesondere Schaumsprays eignen sich – neben Lotionen – sehr gut zur Behandlung von Verbrennungen 1. Grades, da die Präparate zudem leicht und schmerzfrei aufzutragen sind. Der Einsatz von topischen Kortikosteroiden ist nicht zu empfehlen, da eine Überlegenheit gegenüber dem Vehikel nicht gezeigt wurde.

Abstract

First-degree burns are the most common type of burn, but are often inadequately treated. The methods of treatment and the course of healing are poorly documented owing to the fact that first-degree burns are generally not considered to be a serious injury. First-degree burns can be caused by thermal injury or UV irradiation (sunburn). The pathophysiology and the therapeutic approach are similar, although the damage follows a different time course for each injury – immediate damage after contact with hot objects, liquids or fire, delayed damage after sun exposure. After initial cooling with water, aqueous emulsions with small amounts of well-tolerated lipids (O/W emulsions) are best suited for treating first-degree burns or sunburn. Water evaporates producing cooling and reducing inflammation; the lipids accelerate the repair of the damaged skin barrier and reduce drying. Foam sprays and lotions are ideal because they are easy and painless to apply. The use of topical corticosteroids is not recommended, as superiority to the vehicle has not been shown.

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Danksagung

Herrn Dr. de Bony (Bayer Consumer Care, Basel) danken wir für die Organisation eines internationalen Workshops in London im Jahr 2005 unter dem Titel „Management of First Degree Burns“, der als Grundlage für diesen Artikel diente.

Interessenkonflikt

Der korrespondierende Autor ist Projektleiter in Studien, die von der Firma Bayer Vital, Köln, finanziert wurden. Trotz des möglichen Interessenkonflikts ist der Beitrag unabhängig und produktneutral.

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Authors and Affiliations

  1. Universitäts-Hautklinik, Schittenhelmstraße 7, 24105, Kiel, Deutschland

    E. Proksch & J.-M. Jensen

  2. General Medical Practice, Nueva Andalucia, Spanien

    A. Crichton-Smith

  3. Mount Vernon Hospital, Northwood, United Kingdom

    A. Fowler

  4. Liverpool Pharmaceutical Consultancy, Liverpool, United Kingdom

    J. Clitherow

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  1. E. Proksch
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  2. J.-M. Jensen
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  3. A. Crichton-Smith
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  4. A. Fowler
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  5. J. Clitherow
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Correspondence to E. Proksch.

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Proksch, E., Jensen, JM., Crichton-Smith, A. et al. Rationale Behandlung von Patienten mit Verbrennungen 1. Grades. Hautarzt 58, 604–610 (2007). https://doi.org/10.1007/s00105-007-1364-3

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