Types and Severity of Burns
– Superficial (first-degree) burns affect the epidermis, appear red without blisters, and are painful. They heal well in 5-10 days.
– Superficial partial thickness (second-degree) burns extend into the superficial dermis, have redness with clear blisters, and are very painful. They heal in 2-3 weeks with a risk of local infection but no scarring.
– Deep partial thickness (second-degree) burns extend into the deep dermis, appear yellow or white with less blanching, and may blister. They are fairly dry and cause pressure and discomfort. Healing can take 3-8 weeks and may result in scarring and contractures.
– Full thickness (third-degree) burns extend through the entire dermis, appear stiff and white/brown with no blanching, and feel leathery. They are painless and healing is prolonged and incomplete, often requiring treatment. Scarring, contractures, and amputation may occur.
– Fourth-degree burns extend through the entire skin and into underlying fat, muscle, and bone. They appear black and charred with dry texture and no pain. These burns do not heal and require excision. Significant functional impairment, amputation, and even death can occur.
Signs and Symptoms of Burns
– Superficial burns cause pain lasting two or three days and result in peeling of the skin.
– Severe burns may cause discomfort or pressure instead of pain.
– Severe burns can appear pink, white, or black, while superficial burns are typically red.
– Burns around the mouth or singed hair inside the nose may indicate airway burns.
– Worrisome signs include shortness of breath, hoarseness, and stridor or wheezing.
– Itchiness is common during healing, affecting up to 90% of adults and nearly all children.
– Numbness or tingling may persist after an electrical injury.
– Burns can also cause emotional and psychological distress.
Causes of Burns
– Burns can be caused by thermal sources (heat-related), chemical exposure, electrical accidents, and radiation.
– In the United States, the most common causes of burns are fire or flame, scalds, hot objects, electricity, and chemicals.
– 69% of burn injuries occur at home or in the workplace.
– Domestic kitchens pose risks of burns from stoves, flames, and hot liquids.
– Workplace risks include fire, chemical burns, and electric burns.
Prevention and Treatment of Burns
– Burns are generally preventable.
– Treatment depends on the severity of the burn.
– Superficial burns may only require simple pain medication.
– Major burns may necessitate prolonged treatment in specialized burn centers.
– Cooling with tap water can help relieve pain and minimize damage, but prolonged cooling may lead to low body temperature.
– Partial-thickness burns may require cleaning with soap and water and dressing.
– Management of blisters is uncertain, but small blisters may be left intact while large ones may be drained.
– Full-thickness burns usually require surgical treatments like skin grafting.
– Extensive burns often require large amounts of intravenous fluid due to fluid leakage and tissue swelling.
– Infection is a common complication of burns, and tetanus toxoid should be given if not up to date.
Epidemiology and Outcomes of Burns
– In 2015, fire and heat caused 67 million injuries worldwide, leading to 2.9 million hospitalizations and 176,000 deaths.
– Burns related to open cooking fires or unsafe cook stoves are more common among women in many parts of the world.
– Unsafe workplace conditions contribute to burns more frequently in men.
– Most burn-related deaths occur in the developing world, particularly in Southeast Asia.
– Treatment advancements since 1960 have improved outcomes, especially in children and young adults.
– In the United States, approximately 96% of those admitted to a burn center survive their injuries.
– The size of the burn and the age of the person affected influence the long-term outcome. Source: https://en.wikipedia.org/wiki/Burn
A burn is an injury to skin, or other tissues, caused by heat, cold, electricity, chemicals, friction, or ultraviolet radiation (like sunburn). Most burns are due to heat from hot liquids (called scalding), solids, or fire. Burns occur mainly in the home or the workplace. In the home, risks are associated with domestic kitchens, including stoves, flames, and hot liquids. In the workplace, risks are associated with fire and chemical and electric burns. Alcoholism and smoking are other risk factors. Burns can also occur as a result of self-harm or violence between people (assault).
| Burn | |
|---|---|
 | |
| Second-degree burn of the hand | |
| Specialty | Dermatology Critical care medicine, plastic surgery |
| Symptoms | First degree: Red without blisters Second degree: Blisters and pain Third degree: Area stiff and not painful Fourth degree: Bone and tendon loss |
| Complications | Infection |
| Duration | Days to weeks |
| Types | First degree, Second degree, Third degree, Fourth degree |
| Causes | Heat, cold, electricity, chemicals, friction, radiation |
| Risk factors | Open cooking fires, unsafe cook stoves, smoking, alcoholism, dangerous work environment |
| Treatment | Depends on the severity |
| Medication | Pain medication, intravenous fluids, tetanus toxoid |
| Frequency | 67 million (2015) |
| Deaths | 176,000 (2015) |
Burns that affect only the superficial skin layers are known as superficial or first-degree burns. They appear red without blisters and pain typically lasts around three days. When the injury extends into some of the underlying skin layer, it is a partial-thickness or second-degree burn. Blisters are frequently present and they are often very painful. Healing can require up to eight weeks and scarring may occur. In a full-thickness or third-degree burn, the injury extends to all layers of the skin. Often there is no pain and the burnt area is stiff. Healing typically does not occur on its own. A fourth-degree burn additionally involves injury to deeper tissues, such as muscle, tendons, or bone. The burn is often black and frequently leads to loss of the burned part.
Burns are generally preventable. Treatment depends on the severity of the burn. Superficial burns may be managed with little more than simple pain medication, while major burns may require prolonged treatment in specialized burn centers. Cooling with tap water may help pain and decrease damage; however, prolonged cooling may result in low body temperature. Partial-thickness burns may require cleaning with soap and water, followed by dressings. It is not clear how to manage blisters, but it is probably reasonable to leave them intact if small and drain them if large. Full-thickness burns usually require surgical treatments, such as skin grafting. Extensive burns often require large amounts of intravenous fluid, due to capillary fluid leakage and tissue swelling. The most common complications of burns involve infection. Tetanus toxoid should be given if not up to date.
In 2015, fire and heat resulted in 67 million injuries. This resulted in about 2.9 million hospitalizations and 176,000 deaths. Among women in much of the world, burns are most commonly related to the use of open cooking fires or unsafe cook stoves. Among men, they are more likely a result of unsafe workplace conditions. Most deaths due to burns occur in the developing world, particularly in Southeast Asia. While large burns can be fatal, treatments developed since 1960 have improved outcomes, especially in children and young adults. In the United States, approximately 96% of those admitted to a burn center survive their injuries. The long-term outcome is related to the size of burn and the age of the person affected.
