CHEONG, DENOVE, ROWELL & BENNETT
> Injury Definitions

Burns

Burns are usually caused by heat (thermal burns), such as fire, steam, or hot liquids. Burns are also caused by chemicals, radiation, sunlight, and electricity. Thermal and chemical burns usually occur because heat or chemicals contact part of the body's surface, most often the skin. Thus, the skin usually sustains most of the damage. However, severe surface burns may penetrate to deeper body structures, such as fat, muscle, or bone. The depth of injury from a burn is described as first, second, or third degree. First-degree burns are the most shallow, and affect only the top layer of skin (epidermis). Second-degree burns extend into the middle layer of skin (dermis). Third-degree burns involve all three layers of skin (epidermis, dermis, and fat layer), usually destroying the sweat glands, hair follicles, and nerve endings as well. Infection can cause a first degree burn to become a second degree, and a second degree to become a third degree. Treatment depends on the severity of the burn. Superficial minor burns should be treated with cool water and an antibiotic cream. Deep minor burns are treated with antibiotic cream, and may require a skin graft, in which a piece of healthy skin is taken from an unburned area of the person's body, from another living or dead person, or from another species, and sewn over the burned area. Severe, life-threatening burns require immediate care. Large amounts of intravenous fluids are given to treat dehydration and destruction of muscle tissue. Severe burns take a long time to heal, sometimes years. As such, extensive hospitalization is usually required for severe burns.

Surgical treatment of burns usually involves the removal (debridement) of dead tissue, and the grafting of viable skin on the site of the burn. Typically, the skin that is grafted comes from the patient’s body. There are different types of skin grafts that can be performed. Depending upon the severity of the injury, multiple skin grafts may be required.

There are three types of scars associated with burn injuries. A keloid scar is an overgrowth of scar tissue and it is usually red or pink. A hypertrophic scar is a raised scar that is red and thick. A contracture scar is a tightening of the skin and may affect the muscles and tendons.

For related information go to: Chronic Pain Syndrome, Infection and Pain.

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