Burns and Burn Classification
Fasciotomy
A surgical incision through the fascia to relieve tension or pressure
Escharotomy
An incision made into the necrotic tissue resulting from a severe burn
(Severity) Minor
Criteria: Deep partial thickness <15%. Full thickness <2%. No ears, face, hands, etc. Facility: ER/Out pt
(Severity) Moderate
Criteria: Deep partial-thickness 15-25%. Full thickness 2-10%. No hands, feet, face, eyes, ears, perineum. Facility: Hospital/Burn Unit
(Severity) Major
Criteria: partial-thickness >25%. Full thickness >10%. True electrical injuries. Comorbidities. Hands, face, eyes, ears, feet, perineum. Inhalation, fracture or other trauma. Facility: Burn Unit
Full Thickness Burn (Third Degree)
Destroys the entire epidermis & dermis, skin cannot regenerate, all dermal structures destroyed, extensive burn may involve fat, fascia, tendon & bone (Fourth Degree), color: White, yellow, brown, black eschar develops.
Deep Partial Thickness Burn (Second Degree)
Extend deeper into the dermis, some blistering may take place- Not always, wound is dry & red with areas of whiteness in deeper parts, moderate edema develops, heals in 3-6 weeks without surgery - usually develop scarring, skin grafting can reduce healing time
Superficial Partial Thickness Burn (Second Degree)
Heat injury to upper 1/3 of dermis, red, moist, painful, blanch when pressure applied, blisters form d/t plasma leakage from damaged vessels, heal in 10-21 days, no scarring - minor pigment changes may occur
Pediatric Burns
Hot water scalds are most frequent in toddlers, flame-related burns are more common in older children, 10-20% of documented cases of child abuse include burn injuries, children playing with lighters or matches account for 10% of house fires
Superficial Thickness Burn (First Degree)
Only the epidermis involved, best example: sunburn, redness with mild edema, pain and increased sensitivity to heat, dead skin peels after 2-3 days, heal in 3-5 days without scarring
Rule of Nines
Rough estimate of percentage of burned skin, not applicable for kids.
