How Burns are Classified and Treated

Nucleus Medical Media

1 Aug 202304:31

Summary

TLDRThis 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.

Outlines

00:00

🔥 Understanding Burn Injuries and Their Treatment

This paragraph delves into the anatomy of the skin and the various types of burns that can occur. It explains that burns are tissue injuries caused by factors such as heat, chemicals, electricity, radiation, extreme cold, or friction. The skin is composed of three layers: the epidermis, dermis, and hypodermis. Burns are classified based on their severity and the layers affected: superficial, partial thickness, and full thickness. Superficial burns affect only the epidermis, causing redness and pain. Partial thickness burns can be either superficial or deep, with the latter destroying most of the dermis and some nerve endings and appendages. Full thickness burns are the most severe, affecting all layers and requiring surgical intervention. The paragraph also discusses how burns are evaluated by the percentage of body surface area they cover, using the rule of nines. It highlights the physiological response to severe burns, which can lead to hypovolemic shock and burn shock, affecting blood supply and potentially causing tissue and organ death. Treatment strategies include restoring fluid balance, wound care to prevent infection, and various procedures for different burn severities, such as cleansing and dressing for superficial burns, debridement for partial thickness burns, and excision and grafting for full thickness burns.

Mindmap

Keywords

💡Epidermis

The epidermis is the outermost layer of the skin, serving as the body's first line of defense against environmental factors. In the context of the video, superficial burns affect only the epidermis, causing redness and pain. This layer is crucial for understanding the varying degrees of burn severity, as more severe burns penetrate deeper into the skin layers.

💡Dermis

The dermis is the middle layer of the skin, containing connective tissue, blood vessels, and nerves. It plays a vital role in sensation and temperature regulation. The script mentions partial thickness burns that can affect either the superficial or deep dermis, leading to blistering and intense pain, illustrating the importance of the dermis in burn injuries.

💡Hypodermis/Subcutaneous

The hypodermis, also known as the subcutaneous layer, is the deepest layer of the skin, primarily composed of adipose tissue. It provides insulation and cushioning. Full thickness burns can damage this layer, resulting in a white, dry, and charred appearance, as mentioned in the script, indicating severe tissue damage requiring surgical intervention.

💡Burns

Burns are tissue injuries caused by various agents such as heat, chemicals, electricity, radiation, or extreme cold. The video script discusses different types of burns, emphasizing the disruption they cause to the skin's structure and function, which is central to understanding burn treatment and recovery.

💡Superficial Burns

Superficial burns are those that affect only the epidermis, causing redness and pain. They are an important concept in the video as they represent the mildest form of burn injury and are the starting point for discussing the severity spectrum of burns.

💡Partial Thickness Burns

Partial thickness burns involve damage to both the epidermis and parts of the dermis. The video script describes them as either superficial or deep, with superficial partial thickness burns causing immediate blistering and pain. This term helps to differentiate the severity and treatment approach for different burn injuries.

💡Full Thickness Burns

Full thickness burns are severe injuries that destroy the entire epidermis and dermis, and may also affect the hypodermis. The script indicates that these burns result in a lack of sensation and require surgical intervention, highlighting their critical nature and the complexity of their treatment.

💡Rule of Nines

The rule of nines is a method for estimating the percentage of body surface area affected by burns. The video script mentions this as a quick estimation technique, which is essential for assessing the severity of burns and planning appropriate treatment.

💡Hypovolemic Shock

Hypovolemic shock is a life-threatening condition resulting from severe burns where there is a significant loss of fluid from the bloodstream. The video script describes how this leads to a decrease in blood volume, causing a cascade of physiological responses that can be fatal if not treated.

💡Wound Care

Wound care is a critical aspect of burn treatment, as highlighted in the video script. It involves cleaning, covering, and monitoring burns to prevent infection and promote healing. Proper wound care is essential for recovery and minimizing complications from burns.

💡Debridement

Debridement is the surgical removal of dead or damaged tissue from a wound. The script discusses its importance in treating deep partial thickness burns, where it is necessary to prepare the wound bed for healing or skin grafting. This process is crucial for preventing infection and promoting regeneration.

💡Skin Graft

A skin graft is a surgical procedure where healthy skin is transplanted to a burn wound to aid healing. The video script mentions skin grafts in the context of treating deep partial thickness burns, emphasizing their role in restoring function and appearance to damaged areas of the skin.

Highlights

The skin has three main layers: the epidermis, dermis, and hypodermis.

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

Superficial burns affect only the epidermis, causing redness and pain.

Partial thickness burns can be either superficial or deep, involving different layers of the skin.

Superficial partial thickness burns involve the epidermis and upper dermis, causing blistering and intense pain.

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

Full thickness burns destroy the entire epidermis, dermis, and portions of the hypodermis, resulting in a white, brown, dry, and charred area without sensation.

Burns can be evaluated by the percentage of body surface area they cover, using the rule of nines.

Severe burns can lead to hypovolemic shock due to increased capillary permeability.

Burn shock occurs when lowered intravascular volume increases blood viscosity and vascular resistance.

Burn treatment aims to restore fluid balance through intravenous fluids, electrolytes, and proteins.

Wound care is crucial in reducing complications by preventing infection and promoting healing.

Analgesics are used to control pain and inflammation in superficial burns.

Superficial partial thickness burns are treated with cleansing, sterile dressing, and regular monitoring for infection.

Deep partial thickness burns require debridement to a healthy level and maintaining a clean and moist wound bed for epithelial regeneration.

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