The Facts About Burns:
A burn is any injury to tissues of the body caused by heat, electricity, chemicals or radiation. About two million people suffer from burns in the United States each year. Burn injuries are the nation’s third largest cause of accidental death and cause 300,000 serious injuries and 6,000 fatalities each year.
The University of Miami/Jackson Memorial Burn Center offers levels of care from outpatient services to the most advanced levels of critical care medicine. The center treats infants and adults with:
- burn injuries
- electrical burns
- chemical burns
- thermal burns
- contact burns
- scald burns
- severe skin disorders
- difficult or chronic wound problems
- pre-existing medical disorders that could complicate wound management
- pain management
The following are the three types of burn degrees:
- first degree
- second degree
- third degree
First-degree burns affect the outer layer of skin, which is called the epidermis. They are moist, red in color and cause pain, redness and swelling. First-degree burns are partial-thickness burns because of their depth. They will heal spontaneously. A sunburn is an example of a first-degree burn.
Second-degree burns are also partial-thickness burns. The second-degree burn is a serious burn that causes destruction of tissue layers deep into the skin. Second-degree burns involve destruction of both the outer and the underlying layers of skin. It effects all of the epidermal layers and extends into the dermis.
These burns are classified as either superficial or deep.
Superficial burns effect the outermost part of the dermis, which causes pain, is hypersensitive to touch, and usually causes blisters and redness.
Deep burns cause damage to the deepest layers of the dermis. They appear like the superficial burns but usually are dry and white. These burns are usually painful, may take three to four weeks to heal, and may result in thick scarring.
These burns are usually caused by contact with hot liquid and flames. The burned area looks like blisters and the skin is often cherry red or pink. Second-degree burns are usually treated without surgery but sometimes need skin grafting.
The most serious of all burns are third-degree burns, in which all the layers of skin are destroyed. Sometimes third-degree burns also affect underlying tissue. They extend deeper into the skin and destroy all of the epidermis and dermal layers, extending to the subcutaneous layers. This turns the skin brown or black, gives it a leathery appearance, and often causes the skin to separate from the surrounding tissue. The nerve endings are destroyed from the burn and therefore these burns usually are not painful.
Third-degree burns are typically caused by contact with hot liquid, flame or electricity. After being burned, the skin appears white, pearly or leathery. The skin must be replaced either through transplantation or grafting. Treating third-degree burns usually involves debridement, which is the removal of dead skin, and surgical skin grafting.
Types of Burns
The following are common types of burns:
- chemical burns
- electrical burns
- thermal burns
Chemical burns are tissue damage caused by exposure to a strong acid or alkali such as phenol, creosol, mustard gas or phosphorus.
Chemical burns result from the conversion of chemical energy to thermal energy. Emergency treatment includes washing the surface of the wound with large amounts of water to remove the chemical. As long as the chemical is in contact with the skin, the burn usually continues to progress.
An electrical injury occurs when an electrical current from an external source runs through the body as heat. Electrical burns are the result of tissue damage from heat of up to 5,000 degrees Celsius generated by an electric current. The heat causes extensive damage and usually follows the current, but it can damage other structures such as muscle and bone. This electrical current usually flows along the blood vessels and nerves.
This type of electrical current can cause the following three burns:
- contact burn injury
- flash burn
- flame burn
The points of entrance and exit on the skin are burned, along with the muscle and subcutaneous tissues through which the current passes. It is possible that fatal cardiac arrhythmia may result. In this situation contact your local burn center or emergency room immediately.
Thermal burns are the most common types of burns. These often occur from a host of reasons including but not limited to residential fires, automobile accidents, playing with matches, improperly stored gasoline, space heaters, electrical malfunctions, or arson.
Flame burns are often deep burns, causing partial- to full-thickness burns.
Hot liquid burns are not as deep as flame burns, but they can still produce deep burns. Examples of hot liquids which can cause burns include hot water, coffee, grease and hot soup.
Burns from touching hot objects vary in depth, since people’s reflexes cause them to react quickly. These burns can be caused by touching a stove, skillet or grill.
Flash injuries are burns that involve exposed parts of the skin and vary in depth depending on the proximity on the flash and the intensity. Automobile, gas tank and airplane explosions are causes of flash burns.
Sunburns can be extremely painful, but the pain is relieved as the wound is soothed and injury progression is stopped. Sunburns are usually superficial burns or first-degree burns. Although not always fatal, severe sunburns with persisting pain should always be assessed by a specialist.
Symptoms of Burn Injuries
It is important to treat burns immediately after they occur. Some symptoms include, but are not limited to:
- peeling skin
- red skin
- white or charred skin
Pain is not an indicator of the severity of a burn. Some of the most serious burns can be painless. Signs of shock are pale and clammy skin, weakness, bluish lips and fingernails, and a decrease in alertness.
Burns can become infected. Watch for increased pain, redness, swelling, drainage from the burn, swollen lymph nodes or red streaks spreading from the burn toward the heart.