Case 2

Patient K., 35 years old. Surface dermal burns by flame of the II degree. The first hours after the injury. The patient has a distinct pain syndrome. Tumbled epidermal blisters, significant exudation from the wounds. Burn wound is covered with hydrogel bandage with novocaine.

The epidermal blister's scraps were removed. The bottom of the wound is mainly dermis surface layers, and sometimes the deep layers of epidermis. The epidermal blister removal with its moist chamber leads to the wound's bottom drying and subsequent necrosis formation. During the first day after injury the wound's bottom is covered with hydrogel bandages with novocaine and Bentonite to prevent drying. The bandage change is made without pain during the hydrogel bandages use. There is a secretion from the wound of a serous nature. The pedal edema is not observed.
Peripheral inflammation is not expressed.

The 4th and 5th days - the bandage was fixed on the wound, well-molded, takes the surface shape. The wound's content is serous, moderate. The wound is kept in a moist environment, therefore necrosis is not formed. The wound was not deepened. The bandage is not being changed. The hydrogel bandages with methyluracil are on the wound, which promote rapid epithelization and keep the wound in a moist environment.

The 8th-9th days after injury. The bandage was fixed on the wound. There is a slight serous discharge from the wound. There is no pedal edema. There is no purulent inflammation. There is an active epithelization of a surface dermal burn of the 2nd degree under a hydrogel wound bandaging from the wound edges and bottom. The 11th day after injury. Complete self-epithelization. The "young" epidermis covers the wound surface. The burn wound treatment was performed according to the following algorithm: during the first day after the trauma, hydrogel bandages with novocaine were applied, within 3-4 days after the injury - bandage with furacilin, during 5-7 days after injury - bandage with Bentonite, during 8-11 days after injury - bandage with methyluracil.

Case 2

 Patient M., 5 years old. Epidermal-dermal burn with boiling water of the front of the body, expressed exudation from the wounds. The epidermis surface layers are absent. Severe pain syndrome. The wounds were closed with hydrogel bandages with novocaine in the burn center (in 40 minutes after injury). The pain has gone.

The bottom of the wound has epidermis deep layers and dermis viable layers. Significant exudation. The wound content is serous. The thermal damage zone is covered by wound hydrogel bandages with Bentonite, which are fixed with a plaster and a bandage for reliable protection from infection and for cleaning from the exsudate and maintaining the wound in a moist environment.
The 4th-5th days after injury. The upper layers of the fixing gauze bandage are dry. The bottom of the wound is moderately swollen. The wound content has the serous color. Peripheral inflammation is not observed. The wound is treated with an antiseptic solution of betadine. A large area of the wound surface has been covered with hydrogel bandages containing furacilin in order to prevent infection.
The 7th-8th days after injury. The wound content is serous in an insignificant amount. Dermal necrosis was not formed. The wound is being kept in a moist environment.
The 10th day. Active epithelization in wounds. The patient is discharged for ambulatory treatment. Edema has decreased. There is no peripheral inflammation. Wound surfaces are covered with hydrogel bandages with caolin clay (Kremnium). The bandaging is made every 2 days.

Case 3

Patient F, 45 years old. The dermal burn of the 2a-2b degree of the left hip with an area of 3% of the body's surface. Epidermis is absent. The dermis is present at the wound bottom. The dermis surface layers are not viable. The surface necrosis is formed. The right half of the wound will be covered with wound bandage with caolin clay (Kremnium) and the second half of the wound - a moisture-proof bandage with an antiseptic solution. A hydrogel bandage with a caolin clay (Kremnium) is on the right half of the wound.
The third day is the exudation phase. The distinct exudation from the burn wound area can be observed. The wound bandage with caolin clay (Kremnium) has an increased volume and weight in 2 days. The wound bandage change has been performed. A hydrogel bandage with a caolin clay (Kremnium) is applied. The wound is in a humid chamber under a hydrogel bandage, the bottom is not dried. The bandage transparency gives a visual control over exsudate at the wound bottom.
The wound is being kept in a moderately moist state under wound bandage (left half of the wound - shown by the arrow). The right half of the wound is covered with wet bandages with an antiseptic betadine. Moisture-drying bandage is drying the wound (right half of the wound). Unfortunately, at the same time, necrosis deepening is observed.

The bandages with caolin clay (Kremnium) were removed in 6 days, and hydrogel bandages with furacilin were applied, which were replaced three times every 2 days. The surface aseptic necrosis has occurred under wound bandage. The wound bandages were actively absorbing the molten surface dermis necrosis, purulent inflammation of this part of the wound has not occurred. The 14th-17th days after injury. The surface necrosis has completely been removed from the right half of the wound. The dermis viable layers are present at the wound bottom. Multiple epithelization islets occur. A small amount of serous exsudate is secreted from the wound bottom. The part of the wound is covered with hydrogel bandage with methyluracil.
There were remnants of necrosis with purulent discharge on the right side of the wound. The wound was cleaned with antiseptic octenisept and closed with bandage with Miramistin hyperosmolar antibacterial ointment. At the 18th day after injury, complete satisfactory epithelization was observed under the wound bandage.
On the right half of the wound, which was treated under moisture-drying bandages with water and hyperosmolar antiseptics, the numerous hemorrhages were observed, an immature epidermis, which was easily injured.

Case 4

Patient S. 4 years old. Deep dermal burn of the right shoulder. There is a discharge from the wound of purulent-serous nature. At the wound bottom - granulation tissue. The wound was cleaned with betadine solution and dried with a sterile napkin. A hydrogel bandage with caolin clay (Kremnium) was applied.

The next bandage was applied in two days. The amount of wounded content has decreased. There was no pain syndrome during bandage change.

There was an active boundary epithelization. The hydrogel bandages with methyluracil was used to stimulate epithelization. Bandaging was performed every other day. An active epidermis islands growth was observed under the bandage. The number of wounded content has decreased. The discharge from the wound of a serous nature was observed. There was no pain syndrome during the bandaging. The skin irritation around the wound under the bandage was not observed.

The wound bandages change took place after 48 hours.
The wound was in a humid chamber, the wound content amount was moderate. The wound content is serous. The islands' fusion in the wound center and active edge epithelization was observed.
The full epithelization was achieved at the 26th day without skin transplantation performing.

Conclusions:
The patients with epidermis and surface dermal burns, in the first hours after the injury, have severe pain syndrome. At this stage, hydrogel bandages with novocaine or lidocaine are used for pain relief and reliable wound protection from infection.
On the 2nd-3rd days after the injury - the hydrogel bandages with furacilin are applied to protect against possible infection as an antimicrobial and anti-inflammatory medicine.
While dealing with infected burns, the wound should be treated with an antiseptic and closed by the hydrogel bandage with dimexidum, which may stay on the wound during 24-48 hours and contributes antiseptic penetration into the wound's depth.
The hydrogel bandages with Bentonite use is indicated, which soak up to 100% of its weight and can remain on the wounds for 48 hours, during the first and second phases of the wound process, in the presence of significant exudation.
Bentonite bandages, in addition to the antiseptic properties presence, work in the wound as sorbents.
At the second and third wound process phases, it is advisable to apply a hydrogel bandage with a caolin clay (Kremnium) for necrosis cleaning from the wound surface and wound deflection absorb.
The hydrogel bandages with methyluracil, which contribute the epidermis regeneration should be used in dermal surface burns, in 8-10 days after injury (in the epithelization phase).
While dealing with dermal deep burns, the use of hydrogel bandages with methyluracil in the third wound process phase promotes active boundary epithelization, horizontal epidermis cells migration along the wound and epithelium islets' growth, which, in case of local burns, prevents the need for skin transplantation.