Burn Treatment in Ankara, Turkey

Burn treatment is a multi-layered care process that starts with repairing skin damage and extends to maintaining the body’s overall balance. The methods used are tailored to the individual, depending on the burn depth (degree) and total affected area. This process includes emergency first aid, wound care and dressings, life-saving fluid resuscitation in severe cases, and infection prevention. In advanced burns, surgical removal of dead tissue and skin grafting may be performed to speed healing and prevent loss of function. The ultimate goal is full recovery with minimal permanent scarring.

You can contact Prof. Dr. Ebru Soy, one of the doctors performing Burn Treatment in Ankara, to get information about Burn Treatment prices, the process, and the hospital where Burn Treatment is performed.

What Should Be Prioritized First in a Burn Emergency?

When facing a major burn, the wound itself may look alarming, but the first response must focus on more urgent, life-saving priorities. In trauma care, there is a standard step-by-step approach used to assess and manage the most lethal problems first. This sequence is also the gold standard for burn patients and is followed in order using the ABCDE approach. The goal is to identify and address the most life-threatening issue as early as possible.

• A (Airway): The first and most critical step is checking whether the patient can breathe. In people with facial burns, smoke inhalation, or burns sustained in an enclosed space, the airway may also be injured. Swelling can rapidly block the windpipe and cause suffocation. Symptoms such as hoarseness, coughing, or noisy breathing must be taken very seriously. If an additional trauma (such as an explosion or a fall from height) is suspected, the neck should be stabilized with a cervical collar due to possible spinal injury.
• B (Breathing): After ensuring the airway is open, assess whether the patient is breathing adequately. Observe the chest movement. In deep burns that wrap around the chest, burned skin can lose elasticity and act like a tight corset, restricting chest expansion and making breathing impossible. High-flow oxygen is also essential to help clear toxic gases such as carbon monoxide from the body.
• C (Circulation): At this stage, evaluate circulation by checking blood pressure and pulse. A severe drop in blood pressure immediately after a burn is more likely due to another hidden injury such as internal bleeding rather than the burn itself. Burn shock from fluid loss develops more gradually over the following hours. In large burns, rapid fluid loss begins, so as soon as the patient reaches medical care, two large IV lines should be placed and fluid resuscitation started.
• D (Disability): Quickly assess the patient’s level of consciousness. Confusion or loss of consciousness can result from lack of oxygen, low blood pressure, toxic gas exposure, or an accompanying head injury. Each possibility must be considered carefully.
• E (Exposure): Heat can continue damaging skin as long as clothing remains in place. All clothing, jewelry, and metal objects should be removed immediately to stop ongoing burning and to expose the full burn area and any other injuries. However, once the patient is undressed, there is a serious risk of hypothermia (dangerously low body temperature). After the examination, cover the patient with clean, dry blankets, keep the environment warm, and warm IV fluids when possible.

What Should First Aid for a Burn Wound Look Like?

Correct first aid within the first three hours after a burn can prevent deepening of the injury, reduce pain, and improve healing. The most important step is cooling the burned area under running tap water for at least 20 minutes at approximately 15°C. This helps stop heat from continuing to damage deeper skin layers.

There are also important “don’ts”:

Avoid ice or ice-cold water: Ice can cause sudden constriction of blood vessels, reduce blood flow, and worsen tissue damage.

Do not apply toothpaste, yogurt, tomato paste, or similar substances: These increase infection risk, complicate cleaning, and prevent accurate assessment of burn depth.

Do not apply wet cloths to large burns: For burns covering more than 5% of the body, prolonged wet dressings can cause rapid heat loss and hypothermia—especially dangerous in children and the elderly.

After cooling, loosely cover the area with a clean cloth or non-adherent material such as plastic wrap, and seek medical care promptly.

How Can Burn Depth Be Recognized, and Why Does It Matter?

Burn depth is the key factor that determines whether the wound can heal on its own, whether it will scar, and whether surgery will be necessary. Burns are classified based on how deeply they extend into the skin, and this classification forms the foundation of treatment planning.

First-Degree (Superficial) Burn: Affects only the outermost skin layer (epidermis).

• Appearance: Red, dry, tight skin
• Pain: Painful
• Blisters: No fluid-filled blisters
• Healing: Usually heals in 5–10 days without scarring
• Example: Mild sunburn

Second-Degree (Partial-Thickness) Burn: Affects the epidermis and part of the dermis. These burns are divided into superficial and deep forms depending on how much dermis is involved.

Superficial Second-Degree Burn:

• Appearance: Pink-red, moist/wet, with fluid-filled blisters
• Pain: Very painful due to exposed nerve endings
• Healing: Usually heals in 2–3 weeks with proper care and minimal scarring

Deep Second-Degree Burn:

• Appearance: Mottled red and white, often paler and drier; blanching (whitening with pressure) is slow or absent
• Pain: Less painful because many nerve endings are damaged; patient often reports pressure sensation
• Healing: Takes longer than 3 weeks and almost always heals with thick, raised scarring (hypertrophic scar), so surgery is often needed

Third-Degree (Full-Thickness) Burn: Destroys all skin layers (epidermis and dermis) and may extend into underlying fat tissue.

• Appearance: White, leathery, brown, or black; dry and non-elastic
• Pain: No pain because nerve endings are destroyed
• Healing: Cannot heal on its own; requires surgical removal of dead tissue and skin grafting

Distinguishing superficial from deep second-degree burns is especially critical. A well-known principle in burn care is the “21-day rule”: if a burn wound does not heal on its own within three weeks, it is likely to heal with severe scarring and functional limitation. Therefore, in deep second-degree burns, early surgical excision and grafting often provide the best functional and cosmetic outcomes.

Why and How Is Burn Size Calculated?

Calculating what percentage of the body surface area is burned is one of the most critical steps in treatment. It determines how much fluid the patient needs, whether transfer to a specialized burn center is required, and how high the life-threatening risk is. Only second- and third-degree burns are included in this calculation; first-degree redness is not counted.

Several methods are used:

• Rule of Nines (Wallace Rule): Commonly used for rapid estimation in adults during emergencies. Certain body regions are assigned values of 9% or multiples of 9%. For example, one entire arm is 9%, one entire leg is 18%, the head is 9%, the front of the torso is 18%, and the back is 18%. This method is not reliable in children because body proportions differ.
• Palmar Method: The patient’s palm (with fingers together) is approximately 1% of total body surface area. Useful for estimating small or scattered burns.
• Lund–Browder Chart: Considered the most accurate method, especially in children. Body region percentages are adjusted by age. It is standard in burn centers.

Even if the Rule of Nines is used initially for speed, hospitalized patients should be re-evaluated with the Lund–Browder chart for a more accurate calculation, because even small errors can lead to incorrect fluid dosing.

Why Do Major Burns Cause Fluid Loss, and How Is It Treated?

A burn covering more than 20% of body surface area becomes a systemic condition affecting the entire body. The body mounts a severe inflammatory response that increases capillary permeability. These tiny vessels become “leaky,” allowing plasma and proteins to escape into the tissues.

This happens not only in burned areas but also in unburned tissue. As a result, blood volume drops, blood becomes more concentrated, cardiac output decreases, and tissues receive insufficient blood flow. This is known as burn shock. Without rapid fluid replacement, serious complications such as kidney failure can develop.

Preventing and treating this shock is done through fluid resuscitation, aiming to restore adequate organ perfusion.

• Parkland Formula: A commonly used starting point to estimate the fluid needed in the first 24 hours based on body weight and burn percentage.
• How It’s Given: Half of the calculated total is delivered within the first 8 hours from the time of injury, and the remaining half over the following 16 hours. This timing is critical because capillary leak is greatest early on.
• Goal-Directed Therapy: Formulas are only a starting guide. Modern burn care relies on adjusting fluid rate continuously based on patient response. The most reliable indicator is urine output. In adults, the target is about 0.5 mL/kg/hour (e.g., roughly 35–50 mL/hour for a 70 kg patient). IV fluid rates are increased or decreased to meet this target.

Are Chemical and Electrical Burns Different?

Although most burns are caused by heat (thermal burns), chemical exposure and electrical current can cause highly specific and potentially dangerous burn injuries that require special approaches.

Chemical Burns: Caused by strong acids or alkalis. Severity depends on the chemical type, concentration, and contact time.

• Acid Burns: Acids coagulate proteins (coagulation necrosis), creating a hard, dry scab (eschar). This scab can act as a partial barrier and may limit deeper penetration.
• Alkali Burns: Alkalis (e.g., drain cleaners, cement) cause liquefaction necrosis, essentially dissolving tissue. They penetrate deeper and can continue damaging tissue even after contact ends, making them often more dangerous.
• Treatment: The most urgent step is prolonged irrigation with copious running water. Acid burns often require at least 30–60 minutes; alkali burns may require hours. If the chemical is in powder form, it should be brushed off completely before adding water. Do not attempt to “neutralize” with another chemical, as the reaction can generate heat and worsen injury.

Electrical Burns: Occur when current passes through the body and often involve far more internal damage than what is visible on the skin. Small entry/exit wounds can be only the “tip of the iceberg.” The main injury often occurs in muscles, nerves, and organs along the current path.

• Mechanism: Electrical energy converts to heat in tissues, causing deep “cooking-like” injury. High-resistance tissues such as bone heat strongly and can burn surrounding muscle.
• Complications: Myoglobin released from damaged muscle can clog kidneys and cause acute kidney failure. Violent muscle contractions can cause fractures or dislocations. Dangerous heart rhythm problems are also a major risk.
• Treatment: Electrical burn patients often need much more fluid to maintain high urine output to help clear myoglobin. The urine output goal is about double that of thermal burns (approximately 75–100 mL/hour). Severe swelling may reduce limb circulation (compartment syndrome) and require emergency surgery (fasciotomy) to relieve pressure.

Why and How Are Deep Burns Operated On?

Deep second-degree and third-degree burns are wounds where the skin loses its ability to regenerate. The dead tissue (eschar) can lead to serious problems if left in place. First, it is an excellent medium for bacteria and increases the risk of life-threatening infection. Second, it triggers ongoing inflammation that delays healing.

For these reasons, a core principle of modern burn surgery is early excision (removal of dead tissue) and coverage with skin grafts. This approach improves survival, lowers infection rates, shortens hospital stays, and produces better functional outcomes.

Two common excision techniques are:

• Tangential Excision: The most common method. Using a special tool (dermatome), the surgeon shaves away thin layers of dead burn tissue until healthy, bleeding tissue is reached—aiming to preserve as much dermis as possible. It often yields better cosmetic results but can involve significant bleeding.
• Fascial Excision: Used for very deep or extensive burns. All skin and subcutaneous fat are removed down to the fascia overlying muscle in a single layer. It is faster and less bloody, but long-term cosmetic outcomes can be worse and may increase issues such as limb swelling (lymphedema).

After excision, the open wound must be covered. The ideal coverage is the patient’s own skin (autograft). A thin layer of skin is harvested from an unburned area (often thigh or back) and grafted to the burn wound. The donor site typically heals on its own within 7–14 days. For very large burns, harvested skin can be expanded using meshing techniques to cover a larger surface area.

How Can Scarring and Movement Limitation Be Prevented After Burns?

After a burn wound heals, the long-term phase is just as important as acute care. Deep burns almost always leave scars, but scar quality is strongly influenced by treatment and rehabilitation. Uncontrolled healing may cause hypertrophic scars—raised, red, itchy, firm scars. When scars cross joints, they can tighten over time and create contractures, which severely restrict movement.

Preventing and managing these outcomes requires a multidisciplinary approach. Treatment begins as soon as the wound closes and can continue for 1–2 years. Key methods include:

• Pressure Garments: Custom elastic garments apply consistent pressure to prevent scars from thickening, hardening, and becoming overly red. Typically recommended up to 23 hours per day.
• Silicone Sheets/Gels: Help regulate moisture and collagen production, improving scar softness and smoothness.
• Massage and Moisturizing: Regular massage with moisturizing creams improves flexibility, reduces itch, and softens stiffness.
• Physiotherapy and Exercise: The most critical component for preventing functional loss. Stretching and range-of-motion exercises help prevent contractures.
• Splinting: Especially for hands and armpits, static or dynamic splints maintain proper joint position and reduce contracture development.