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Burns

Definition

A burn is damage to the skin and sometimes to the underlying tissues. Burns are categorized according to the depth and extent of the damage to the skin:
Classification of Skin Burns
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Causes

Burns can be caused by:

Risk Factors

Burns are more common in males, and in those aged under 4 years. Other factors that may increase the chance of burns include:

Symptoms

Burn symptoms and signs vary depending on the type of burn.

Superficial Burn

  • Burned area turns red and is painful
  • The area blanches (turns white) when you press on it
  • The area may swell, but it is dry and there is no blistering

Superficial Partial-Thickness Burn

  • Blisters
  • The area is moist, red, and weeping
  • The area blanches (turns white) when you press on it
  • Painful to air and temperature

Deep Partial-Thickness Burn

  • Blisters, usually loose and easily unroofed
  • The area can be wet or waxy dry
  • The skin color can vary from patchy, to cheesy white, to red
  • The area does not blanch (turn white) with pressure
  • May or may not be painful, can perceive pressure

Full-Thickness Burn

  • Skin can appear waxy white, leathery gray, or charred and blackened
  • May not be painful if nerves have been damaged, the only sensation may be deep pressure

Diagnosis

The doctor will ask how the burn occurred and will examine the burned area.
Treatment will depend on the cause of the burn, how deep the burn is, and how much of the body the burn covers. Doctors have methods and charts to estimate the total percentage of body surface area (TBSA) affected by the injury. This estimate is age dependent. For example, the head represents a larger percentage of surface area in a baby than in an adult.

Treatment

Quick treatment is important and can lessen the damage to the tissues. First aid for minor burns may involve:
Once a minor burn is completely cooled, you can consider using a fragrance-free lotion or moisturizer to prevent drying and make the area more comfortable.
For more serious burns, like deep partial-thickness or full-thickness burns, seek medical attention or call emergency medical services. Until an emergency unit arrives:

Hospitalization

A doctor will decide if hospitalization is necessary based on many factors. These include age, the cause of the burn, and the extent and depth of the burn. Reasons to hospitalize a person who has more than a minor burn may include:
  • Age: younger than five years or older than 55 years
  • Suspected child abuse
  • Very small, deep burns on the hands, face, eyes, feet, or perineum (groin/genital area)
  • Extensive burn: using TBSA and age charts
  • Burns that may require complicated dressing changes, elevation, or continued physician observation
  • High-voltage injury or burn
  • Suspected or known inhalation injury
  • Circumferential burn
  • Other medical problems that predispose a person to infection, such as:

Medical Treatment for Major Burns

If the burn is serious, the following treatments may be administered in a hospital:
  • Oxygen to help with breathing
  • Intubation
  • IV fluids to replace those lost from the burn
  • Skin graft
  • Splints—placed on joints to help maintain mobility
  • Physical therapy, in the case of large burns

Prevention

Most burns are the result of accidents. To help reduce the chance of burns:

RESOURCES

American Burn Association http://www.ameriburn.org

National Library of Medicine - National Institutes of Health http://www.nlm.nih.gov

CANADIAN RESOURCES

Canadian Burn Survivors Community http://canadianburnsurvivors.ca

Health Canada http://www.hc-sc.gc.ca

References

Behrman R, Kliegman R, et al. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, PA: Saunders; 2007.

Beers MH. The Merck Manual of Medical Information. 2nd ed. London, England: Simon and Schuster, Inc; 2003.

First aid for burns. American Academy of Pediatrics Healthy Children website. Available at: http://www.healthychildren.org/English/safety-prevention/all-around/Pages/First-Aid-For-Burns.aspx. Updated September 2, 2014. Accessed November 3, 2014.

Goldman L, Ausiello D, eds Cecil Textbook of Internal Medicine. 23rd ed. Philadelphia, PA: Saunders; 2008.

Major burns. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated October 24, 2014. Accessed November 3, 2014.

Marx J, Hockberger R, et al. Rosen's Emergency Medicine. 7th ed. St. Louis, MO: Mosby; 2009.

Minor burns. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated April 29, 2014. Accessed November 3, 2014.

Protect the ones you love: burns. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/SafeChild/Fact%5FSheets/Burns-Fact-Sheet-a.pdf. Accessed November 3, 2014.

Topical treatment and dressing of burns. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated April 29, 2014. Accessed November 3, 2014.

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