Burns are damages to the body’s tissue caused by a variety of factors – heat, electricity, chemicals, sunlight or radiation. They can be either minor medical conditions or life-threatening in nature. Burns are traditionally classified into three main types:

First-degree burns: only the outer layer of the skin is damaged

Second-degree burns: the outer and immediately following layer of skin are damaged

Third-degree burns: the deepest layer of skin is affected

Causes

Fire

Hot liquid or hot steam

Hot metal, glass or any other hot object

Electrical currents

Radiation from X-rays

Radiation from chemotherapy

Sunlight

Ultraviolet light from a sunlamp or tanning bed

Chemicals: strong acids, paint thinner, gasoline, lye (caustic soda)

Symptoms and signs

Although burns were previously classified as above, according to the thickness of burned skin, the system is now being replaced with a new one much more equipped to determine the necessity of surgical treatment

The classification of a burn injury can change in a matter of a few days

Superficial skin burns:

The first layer of skin is damaged

Painful, red, dry, swollen

Turn white when pressed

Generally heal in 3 to 6 days

No scarring

Examples: non-blistering sunburns

Superficial partial-thickness skin burns:

The top two layers of the skin are damaged

Painful with air movement or air temperature changes

Red, produce fluid (from blisters)

Turn white when pressed

Heal within 7 to 21 days

The area may permanently become darker or lighter in color

The wound usually appears wet or moist

Scarring does not usually take place

Examples: sunburns that form blisters after several hours

Deep-partial thickness skin burns:

Extend beyond the top two layers of skin

Painful with deep pressure

Do not turn white when pressed

Almost always form blisters

Take more than 21 days to heal

Usually develop scars which may be severe in nature

Full-thickness burns:

Damage is extended through all layers of skin, reaching the fat tissue

Skin is completely destroyed

The burned area is not painful

Waxy white to leathery gray or charred black in color

Skin is dry

May damage nerves, causing numbness

Do not turn white if pressed

Cannot heal without surgery

Scarring is severe

Potential difficulty breathing

Potential smoke inhalation

Potential carbon monoxide poisoning

Advice

Major burns medications and wound healing products:

Water-based treatments – ultrasound mist therapy to clean and stimulate tissue healing

Intravenous fluids to prevent dehydration and organ failure

Pain and anxiety medications

Burn creams and ointments – topical products used for keeping the wound moist, reduce pain, prevent infection and speed healing

Various specialty wounds dressings – for creating a moist environment to fight infections and help the healing process

Anti-infection drugs

Tetanus shots

Surgical and other procedures:

Breathing assistance

Tube feeding – in the process of healing burns the body’s metabolic system enters a period of overdrive and may require assistance in providing nutrition – the tube is inserted through the nose and is directly linked to the stomach

Easing blood flow around the wound – if a burn scab (called ‘eschar’) completely affects a limb or goes around the chest, it can cause tightening, cutting off blood circulation – a physician might make incisions in the eschar to relieve pressure

Skin grafts – healthy skin is used as replacement for the scar tissue caused by deep burns

Plastic surgery – to improve appearance of burn scars and increase the flexibility of joints affected by scarring

Small superficial or superficial partial-thickness burns may often be treated at home:

Cleaning the area:

If it is not stuck to the damaged skin, remove any piece of clothing near the affected area

Wash the burned area gently with tap water and soap

Disinfection not necessary

Cooling the area:

Apply a cold compress to the skin or soak the area in cool water

Do not apply ice directly onto the skin

Prevent infections:

Apply aloe vera or an antibiotic cream

Do not apply ointments or other substances

Minor burns may be covered in dressings changed daily or twice per day

Tetanus prevention (physician-performed vaccination)

Avoid scratching the skin

MISCONCEPTIONS
  • Use of ‘home-remedies’ such as: oil, grease, vinegar, butter, cold meat, onion juice, bleach, alcohol is beneficial – they cause more harm, increasing the risk of infection and should be avoided

    If pain is not experienced, the severity of the injury is not high

    Follow-up treatment is optional

Statistics

According to the World Health Organization (Fact Sheet no 365, updated April 2014):

An estimated 265 000 deaths every year are caused by burns – the vast majority occur in low- and middle-income countries

Non-fatal burn injuries are a leading cause of morbidity

Burns occur mainly in the home and workplace

Burns are preventable

Burns are among the leading causes of disability-adjusted life-years (DALYs) lost in low- and middle-income countries

In 2004, nearly 11 million people worldwide were burned severely enough to require medical attention

Did you know?

The skin is made up of:

Epidermis

Dermis

Subcutaneous layer (fat layer)

 

Heat burns due to hot liquids contact are termed ‘scalds’

 

Heat burns due to hot solids contact are termed ‘contact burns’