A burn is an injury to the tissues of the body caused by heat, electricity, chemicals, radiation or friction. most burns affect not only the skin but the burns extend to deeper, areas that may involve injury to the blood vessels, muscles and even the bones.
Burns are classified based on extent of injury and depth, these classifications also allow for proper triage and treatment of burn injuries. Burns involving large surface areas may be fatal and is usually complicated by shock, respiratory distress, electrolyte imbalance, renal failure and multi-organ damage.
The classification of burns has evolved from the traditional classification based on degree of injury to the modified classification of burn thickness which is currently used as guide for surgical intervention. the traditional classification classified burns as first-, second-, third- or fourth-degree.
The modern classification currently uses the following nomenclature:
Superficial thickness (first-degree burn)Partial thickness – superficial (second-degree burn)Partial thickness – deep (third-degree burn)Full-thickness (fourth-degree burn)
This current classification is also used as a basis and guide for surgical intervention since partial-thickness and full-thickness burns may require skin grafting.
Superficial thickness burns are limited to redness and pain on the affected area. only the epidermis or the outermost layer of the skin is affected in this type of burn. Sunburn is classified as a first-degree burn or a superficial thickness burn.
Blistering of the skin is characteristic of a partial-thickness – superficial burn, associated with redness of the affected area due to the involvement of the dermis and the deep dermis.
Partial-thickness – deep burns include injuries extending to the subcutaneous tissue while full-thickness burns involve deeper tissues such as muscles and bones. This type of burn usually requires skin grafting.
It is important in the management of burn and fluid replacement to calculate the percentage affected by partial and full-thickness burns in terms of total body surface area (TBSA). a quick and rough estimate of the TBSA may be done using the “rule of nines” among adults and children above 14 years old.
Treatment of burns includes pain management, fluid resuscitation and wound care. Children with burns of at least 10% or 15% in adults warrants admission to a burn unit for proper monitoring and fluid replacement to avoid life threatening complications such as shock, renal failure and wound infection.
Treating 2nd & 3rd Degree Burns