Types of Burns
There are three types of burns that can result from a variety of mechanisms. Types of burns include first, second and third degree burns. These burns may also be referred to as superficial, partial and full-thickness burns. Types of burns may also be classified according to the mechanism of burn injury.
These types of burns cause superficial erythema (redness) and swelling and may be quite painful. The skin will blanch upon pressure. These types of burns involve only the outermost layer of skin, or the epidermis. Treatment generally involves cooling the burn with running water or the application of cool cloths and application of an over-the-counter burn ointment or a soothing agent, such as aloe cream or gel. These types of burns heal quickly and do not result in scarring. A physician should be consulted if superficial burns are extensive, especially in children or the elderly.
Partial-thickness burns affect both the epidermis and the dermis to varying degrees. Superficial partial-thickness burns do not involve the full thickness of the dermis, while deep partial-thickness burns may involve the dermis more extensively. Depending on how much of the dermis is affected, these types of burns may result in scarring and may require skin grafting to heal. It may be difficult to determine whether a burn affects the dermis superficially or more deeply; the difference lies partially in healing time, as superficial partial-thickness burns will heal more quickly, often in less than 3 weeks. These types of burns will cause blisters. Blisters should never be punctured but should be left intact, as rupturing them may increase the risk of infection. These types of burns may cause permanent disfigurement. They may also be quite painful, as nerves are intact and undamaged.
Full-thickness burns extend down into the hypodermis, or subcutaneous tissue. These types of burns may affect underlying bone, nerves, tendons and other structures. These burns in themselves are generally not painful; however, there may be surrounding areas of partial-thickness burns that are painful. These burns will require surgery to close and may result in permanent disfigurement and disability, especially if they occur over a joint. The risk for complications, especially infection, is very high and these types of burns may be life-threatening if they are extensive. These types of burns should be cared for in specialized burn centers.
Mechanism of Burn Injury
Burns may be caused by several different mechanisms, each with their own complications:
- Scalds- these types of burns result when skin comes into contact with hot liquids (spilled liquids or food, hot bathwater)
- Contact burns- these burns result from contact of the skin with hot items, including flames
- Chemical burns- these burns result from contact of the skin with chemicals, or by ingestion of chemicals
- Electrical burns- these types of burns result when a person comes into contact with a source of electrical energy; includes burns caused by electrocution and lightning strike
- Radiation burns- these types of burns result from contact with a source of radiation; may include overexposure i.e. sunburn
Burns may be classified according to the tissue damaged (first, second or third degree) and also according to the mechanism of burn injury. Knowing the types of burns allows health professionals to tailor their treatment accordingly and predict which patients require more specialized care, as well as which patients are more at risk for complications.