The vast majority of burn injuries happen in the home. They are caused by a variety of sources including heat, chemicals, electricity, friction and radiation. Fire injuries are most common, followed by scalding, contact with a hot object, and electrical injuries. To understand different kinds of burns, it is helpful to know about skin.
Skin is the largest organ of the body. The average adult has 18 square feet of skin which accounts for 16 percent of the total body weight.
- Acts as a physical barrier for you to the outside world.
- Protects you against infection and injury.
- Provides for a water tight barrier.
- Helps regulate body temperature.
- Contains glands that lubricate and moisturize your skin.
- Undergoes constant repair and regeneration.
Lacerations, abrasions or burns alter the skin's ability to protect and buffer you from your surroundings.
Anatomy of the skin
1. The epidermis is the thin top layer of the skin.
2. The dermis is the thicker under-layer. It contains the sweat glands, hair follicles and nerve endings that feel pain.
3. The subcutaneous tissue (or hypodermis) is the next layer. This fat layer helps the body to maintain temperature. Underneath the subcutaneous layer is muscle and bone.
The depth of a burn injury depends on the temperature of the burning substance, the duration of contact, and the skin depth in the area burned.
First Degree Burns
A first degree burn is damage is to the first layer of skin (epidermis). It is pink, red, dry and painful. An example of first degree burn is sunburn. If the burn is kept clean it will usually heal over a week or two. Some peeling will occur and there is no scarring.
Second Degree Burns
A second degree burn is deeper. This burn may occur from a scald, hot grease or contact with a hot substance such as a curling iron. There is damage to the epidermis (top layer) and some damage to the second layer of skin (dermis). There are blisters which may be broken or intact. Skin under the blisters is weepy, pink and painful.
Second degree burns are divided into two categories based upon the depth of the burn. There is a superficial second degree burn and a deep second degree burn.
Superficial second degree burns typically heal with conservative care (no surgery) in one to three weeks. Topical medications are placed on the burn wound. Daily or twice daily wound bandage changes are the norm. New epidermis grows in one to three weeks.
Deep second degree burns (or partial thickness burns) appears more pale than red. The skin is drier and the sensation of that skin tends to be diminished. Sometimes these burns will need operative grafting for repair. Often this decision cannot be made in the first few days and a short course of conservative treatment (topical medications) will be tried.
Third Degree Burns
In a third degree burn, all layers of the skin are destroyed. Blisters may be present and color of the skin varies (red, pale pink, white and tan). These burns require skin grafting.
Recognizing Burn Severity
||How Much Damage
||How It Looks & Feels
||How It Heals
||How It Might Happen
||Part of the 1st layer (epidermis)
||Pink, red, dry and painful
||Some peeling over a week; no scarring
||Sunburn or steam
||Some damage to second layer (dermis)
||Blisters are present(should be removed); skin under blisters is weepy pink and painful
||New epidermis grows in 1 to 3 weeks
||Hot water, tea, coffee, flash fires, soups, hot foods
||All of the skin is destroyed
||Blisters may be present; color varies (red, pale pink, white or tan)
||Needs skin grafting unless very small
||Grease scalds, electricity, roofing tar, flames, hot coals