by Christobel Rajesh

Created on: January 26, 2008

Burns are caused by a transfer of energy from a heat source to the body which may be through conduction or electromagnetic radiation. Anybody is prone to get a burn injury anytime. Young children and elderly persons are particularly at high risk for burn injury. Burns are categorized by thermal, radiation or chemical injuries.

Pathophysiology of burns: Whatever the type of injury may be, the effect of burns over the skin and vicera are the same. Tissue destruction occurs from coagulation, protein denaturation or ionization of cellular contents. Each system will respond differently depending upon the area involved and they are treated accordingly.

The severity or the depth of the injury depends upon
1. The temperature of the burning agent
2. The duration of contact with the burning agent

Burn care is planned depending upon the extent and depth of the injury, and then proceeding with the three phases of burn care which are the emergent/resusciative phase, acute/intermediate phase and the rehabilitative phase.

Recognizing different degrees of skin burns: Burns are classified according to the depth of tissue destruction and are identified as
1. Superficial partial-thickness injuries (first degree)
2. Deep partial-thickness injuries (second degree)
3. Full thickness injuries (third degree)

1. Superficial partial-thickness injuries (first degree): The epidermis of the skin is destroyed or completely injured and a portion of the dermis may be injured. The wound is very painful and appears red and dry. The skin blanches with pressure. There is some amount of tingling sensation that is felt. The skin is supersensitive (hyperesthesia) and the pain is soothed by cooling. It looks like a sunburn or it may be blistered. A minimal edema will be noticed in some people, many do not present with edema. The skin over the blister peels on its own or can be removed in a sterile way and there is complete recovery within a week.

2. Deep partial-thickness injuries (second degree): This involves complete destruction of the epidermis and the upper layers of the dermis, and slight injury to the deeper layers of the dermis. The wound is painful, hyperesthetic and is very sensitive to cold air. The color appears to be mottled red and exudes fluid. The area is blistered and has surrounding edema. Blanching of the burned tissue is followed by capillary refill which denotes that there is blood supply to those areas involved. The hair follicles over the area remains intact. They are healed in 2 to 3

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