Burns are a type of traumatic injury caused by thermal, electrical, chemical, or electromagnetic energy. Smoking and open flame are the leading causes of burn injury for older adults, while scalding is the leading cause of burn injury for children. Both infants and the elderly are at the greatest risk for burn injury.
A burn injury usually results from an energy transfer to the body. There are many types of burns caused by thermal, radiation, chemical, or electrical contact:
- thermal burns - burns due to external heat sources which raise the temperature of the skin and tissues and cause tissue cell death or charring. Hot metals, scalding liquids, steam, and flames, when coming in contact with the skin, can cause thermal burns.
- radiation burns - burns due to prolonged exposure to ultraviolet rays of the sun, or to other sources of radiation such as x-ray.
- chemical burns - burns due to strong acids, alkalies, detergents, or solvents coming into contact with the skin and/or eyes.
- electrical burns - burns from electrical current, either alternating current (AC) or direct current (DC).
Burns are classified as first-, second-, or third-degree, depending on how deep and severe they penetrate the skin's surface:
- First-degree (superficial partial thickness) burns
First-degree burns affect only the epidermis, or outer layer of skin. The burn site is pink or red in appearance, sore and tender, but not blistered. First-degree burns will heal without treatment. Long-term tissue damage is rare and usually consists of an increase or decrease in the skin color. Example; mild sunburn.
- Second-degree (partial thickness) burns
Second-degree burns involve the epidermis and part of the dermis layer of skin. Skin is a blistered, reddened, swollen, weeping wet surface, and is sensitive to air. Unless it is a deep second degree burn, the wound will heal by itself. Only part of the skin layers has been damaged. Example; a flash fire, hot liquid splashed on skin.
- Third-degree (full thickness) burns
Third-degree burns destroy the epidermis and dermis. The burn site appears white, black or charred with a leather-like appearance. While the site will be swollen, there is no sensation in the area since the nerve endings are destroyed. The full thickness of the skin has been burned and there may also be destruction of the underlying tissue, bones, muscles, and tendons. Regeneration of skin is not possible in third-degree burns and these areas must be grafted. Example; flame, electricity, chemicals, frostbite.
A severe burn can be a seriously devastating injury - not only physically but emotionally - and not only to the burn victim, but to the entire family. Persons with severe burns may be left with a loss of certain physical capabilities, disfigurement, a loss of mobility, scarring, infection, nightmares or flashbacks from the traumatizing event, loss of a limb, and/or loss of a friend or family member and possessions in the fire. In addition, severe burns are capable of penetrating deep skin layers, causing muscle or tissue damage, virtually affecting every system of the body.
Specific treatment for burns will be determined by your physician based on:
- your age, overall health, and medical history
- type, classification, location, and severity of the burn
- your tolerance for specific medications, procedures, or therapies
- expectations for the course of the burn injury
- your opinion or preference
Treatment may include:
- wound care
- intravenous (IV) fluids and electrolytes
- pain management
- physical therapy
- occupational therapy
- skin grafting
- functional and cosmetic reconstruction