A burn is defined as a traumatic injury the outer layer of the skin and its underlying tissues. There are several types of burns chemical, electrical and burns caused by a heat source such as fire.
Burns that are caused by electricity are the most typically the most severe because they are deep within the underlying tissues. Electricity also causes damage throughout the entire course of the body from the entrance point to the exit point of the electricity.
Chemical burns cause typically cause damage to not only the outer skin layers from the initial contact but without proper removal the chemical can continue to burn through the skin layers and damaging underlying tissues until it has been neutralized. Some chemicals can eat through virtually anything they come in contact with, destroying everything in its path.
Heat burns can cause just as much damage as chemicals but can also be fatal by other means as well. Heat such as fire depending on the intensity of the blaze can burn the esophagus from inhalation. Heat burns or burns caused by fire start by burning the outer layers of the skin, however if the person is trapped by the heat source the burn can virtually engulf the entire body causing massive fatal injury.
There are many zones to burns and determining the depth of a burn is sometimes difficult.
Superficial or first degree burns are characterized by burns that involve the outermost layer of the skin called the epidermis. First degree burns are painful and cause pink or red swelling however the pain usually subsides fairly quickly and leaving no scarring to the skin. The majority burns are first degree burns.
Second degree burns or superficial partial thickness burns affect the epidermis and dermis layers causing painful blisters. Second degree burns are characterized by pink to red mottled skin, blistering and fluid exuding. The burn depending on how big it is usually takes up to two weeks to heal and usually results in pigment changes to the skin or blanching. Although most second degree burns result in no scarring they do however require medical attention usually to keep from the burn from getting infected.
Deep partial thickness burns are essentially a higher grade burn typically characterized as being somewhere between a second and third degree burn. The deep partial burn causes patchy red to white skin changes, wet or waxy appearance once dry and the majority of time may cause scarring and in some cases require skin grafts. This is a very painful burn and requires proper medical attention to keep the burn from being infected and possible debridement. Deep partial thickness burns can take 3 weeks or more to heal.
Full thickness burns or third degree burns are burns that destroy all layers of the skin and subsequently can become painless after the nerves are severely damaged. The tissue is charred causing a brown or black leathery covering known as “eschar” and if not debrided this type of burn injury can lead to sepsis. The burn causes severe disfigurement or scarring. Skin grafts are necessary because the skin cells are no longer able to regenerate. Third degree burns can affect the epidermis, dermis and subcutaneous tissues.
Full thickness burns that continue are known as fourth degree burns and they typically destroy everything including fat, muscle and even bone. The fourth degree burn is usually characterized by black damage to the body affected, severe disfigurement and scarring and in extreme cases a need for amputation if limited to a limb. This type of severe burn can be fatal.
Severity of burns are determined by not only the zones and depth but the percentage of the burn itself as it pertains to coverage on the body. This percentage is called the “Rule of Nines” and is a quick rule of thumb to estimating how much skin surface the burn involves. The palm size amounts to approximately 1% of a person’s total body surface area, therefore think of the entire arm as approximately 9%, a leg as 18% or double and a torso as 18% anteriorly and 18% posteriorly, etc. Add the percentage amounts accordingly and you have an approximate percentage of burn coverage to the body.
Every type of burn needs medical attention however proper immediate medical attention for severe burns is essential and can save the person’s life.