Burn injuries are caused by a variety of agents—hot liquids, flame, flash (i.e., explosions), chemicals, electricity and contact with hot objects. The most important classification of burn wounds refers to the extent and depth of the injury. In most cases, the extent and depth of the burn wound are the most significant factors contributing to the seriousness of injury of the burn victim.
EXTENT OF INJURY
The extent of a burn wound is defined as the percentage of total body surface damaged and may be determined by the Rule of Nines. This divides the body into areas of 9% or multiples of nine (figure I) and is modified for estimating the extent of burn injury in children (figure II).
DEPTH OF INJURY
The depth of a burn injury refers to the amount of skin, and on some occasions other tissue, damaged or destroyed. Skin has two layers, the superficial epidermis and the deeper dermis that overlies subcutaneous tissue. Burn injuries are defined as Superficial (1st Degree), Partial Thickness (2nd Degree) and Full Thickness (3rd Degree).
Superficial Burn (1st Degree Burn)
112 degrees F
- minor damage of the epidermis
- red, tender, dry, no blisters
- i.e., sunburn, heals in three to six days
Partial Thickness Burn (2nd Degree Burn)
140 degrees F
- impacts epidermis and dermis
- blisters are thick walled and sometimes ruptured
- color is mixed red and white
- painful, especially if pressure is applied
- heals in three to six weeks, potential scarring, may require hospital admission, surgery
Full Thickness Burn (3rd Degree Burn)
158 degrees F
- destruction of epidermis and dermis
- high risk of infection, loss of temperature control
- skin appears white, black, gray, leathery and charred, dry
- requires hospital admission, surgery
- months, years to heal
All burns should be treated with concern. It is important to keep in mind the golden rule of burn management: If someone has a burn on their body exceeding the size of the palm of their own hand, where blisters are present, burns to the genitalia, face or to any flexion point, this person should seek medical attention. All electrical burns require medical attention.