How Burns are Classified and Treated

Summary

This script discusses the three layers of the skin and the types of burns affecting them. Superficial burns cause redness and pain, while partial thickness burns can be either superficial or deep, leading to blistering and intense pain. Full thickness burns are severe, affecting all layers and requiring surgery. The script also covers burn evaluation, shock stages due to burns, and treatment methods including fluid balance restoration, wound care, and skin grafting.

Takeaways

• 🔥 The skin is composed of three main layers: the epidermis, dermis, and hypodermis (subcutaneous).
• 🌡️ Burns are tissue injuries caused by various factors such as heat, chemicals, electricity, radiation, extreme cold, or friction.
• 🚑 Superficial burns only affect the epidermis, leading to redness, pain, and are treatable without surgery.
• 🌀 Partial thickness burns can be either superficial or deep, with the latter causing blistering, intense pain, and sensitivity.
• 💥 Deep partial thickness burns extend into the lower dermis, sparing some nerve endings and appendages, and require medical intervention.
• 🔍 Full thickness burns destroy all skin layers, resulting in a white, brown, dry, and charred area that cannot heal without surgery.
• 📏 Burns can be assessed by the percentage of body surface area they affect, using the rule of nines for quick estimation.
• 🩸 Severe burns can lead to hypovolemic shock due to increased capillary permeability, causing fluid loss from the bloodstream.
• 🏥 Burn treatment includes restoring fluid balance with intravenous fluids, electrolytes, and proteins, and wound care to prevent infection.
• 🛡️ For superficial partial thickness burns, wound care involves cleansing, sterile dressing, and monitoring for infection.
• 🔪 Deep partial thickness burns require debridement to remove dead skin and promote healthy tissue regeneration and graft acceptance.

Q & A

What are the three main layers of the skin?

The three main layers of the skin are the epidermis, dermis, and hypodermis or subcutaneous.

What causes burns to the skin?

Burns are tissue injuries caused by heat, chemicals, electricity, radiation, extreme cold, or friction.

What is the difference between superficial and partial thickness burns?

Superficial burns affect only the epidermis, causing redness and pain, while partial thickness burns involve the epidermis and upper or papillary dermis, leading to immediate blistering and intense pain and sensitivity.

How do deep partial thickness burns affect the skin?

Deep partial thickness burns destroy the papillary dermis, epidermis, and most of the lower or reticular dermis, sparing some cutaneous nerve endings, capillaries, and dermal appendages.

What are the characteristics of full thickness burns?

Full thickness burns destroy the entire epidermis, dermis, and portions of the hypodermis, resulting in a white, brown, dry, and charred area with no sensation that cannot heal without surgical intervention.

How can the percentage of body surface area affected by burns be estimated?

The percentage of body surface area affected by burns can be estimated using the rule of nines, where each body part is assigned a value of nine percent or a multiple of nine.

What are the two stages of shock that can occur due to severe burns?

The two stages of shock that can occur due to severe burns are hypovolemic shock, where water, electrolytes, and plasma proteins leak from the bloodstream, and burn shock, where lowered intravascular volume increases blood viscosity and vascular resistance.

What is the goal of burn treatment?

The goal of burn treatment is to restore fluid balance through administration of intravenous fluids, electrolytes, and proteins, which increases intravascular volume.

How are superficial partial thickness burns typically managed?

Superficial partial thickness burns are cleansed, covered with a sterile dressing, and monitored regularly for infection.

What treatment is necessary for deep partial thickness burns?

For deep partial thickness burns, dead skin or eschar is routinely detached or debrided to a healthy level, and the wound bed is kept clean and moist to allow epithelial regeneration and to accept transplanted tissue called a skin graft.

How are full thickness burns treated to prepare for grafting?

Full thickness burns are excised and regularly debrided to prevent ischemia and infection, and to create a viable base for grafting.