A burn is a type of injury to flesh caused by heat, electricity, chemicals, light, radiation or friction.

Most burns affect only the skin (epidermal tissue). Rarely, deeper tissues, such as muscle, bone, and blood vessels can also be injured.

Names

Layers involved

Appearance

Texture

Sensation

Time to healing

Complication s

First degree

Epidermis

Redness (erythema)

Dry

Painful

1wk or less

Increased risk to develop skin cancer later in life

Second degree (superficial partial thicknes)

Extends into superficial (papillary) dermis

Red with clear blister . Blanches Moist with pressure

Painful

2-3wks

Local infection/ cellulitis

Names

Layers involved

Appearan ce

Texture

Sensation

Time to healing Weeks may progress to third degree

Complicat ions Scarring, contractu res (may require excision and skin grafting) Scarring, contractu res, amputati on Amputati on, significan t functional impairme nt, possible gangrene,

Second degree (deep partial thickness)

Extends into deep (reticular) dermis

Red-andwhite with bloody Moist blisters. Less blanching . Stiff and Dry, white/bro leathery wn

Painful

Third degree (full thickness)

Extends through entire dermis

Painless

Requires excision

Fourth degree

Extends through skin, subc utaneous tissue an d into underlyin

Black; charred with eschar

Dry

Painless

Requires excision

1.Chemical Most chemicals that cause chemical burns are strong acids or bases. Chemical burns can be caused by corrosive chemical compounds such as sulfuric acid and sodium hydroxide .Hydrofluoric acid can cause damage down to the bone and its burns are sometimes not immediately evident.Chemical burns can be either first, second, or third degree burns, depending on duration of contact, strength of the substance, and other factors.

2. Electrical Electrical burns are caused by either an electric shock or an uncontrolled short circuit (a burn from a hot, electrified heating element is not considered an electrical burn). Common occurrences of electrical burns include workplace injuries, taser wounds, or being defibrillated or cardioverted without a conductive gel. Lightning is also a rare cause of electrical burns.

Radiation

Radiation burns are caused by protracted exposure to UV light (as from the sun), tanning booths, radiation therapy (in people undergoing cancer therapy), sunlamps, radioactive fallout, and X-rays. By far the most common burn associated with radiation is sun exposure, specifically two wavelength ranges of light UVA, and UVB, the latter being more dangerous. Tanning booths also emit these wavelengths and may cause similar damage to the skin such as irritation, redness, swelling, and inflammation. More severe cases of sun burn result in what is known as sun poisoning or "heatstroke". Microwave burns are caused by the thermal effects of microwave radiation.

Scalding Scalding (from the Latin word calidus, meaning hot) is caused by hot liquids (water or oil) or gases (steam), most commonly occurring from exposure to high temperature tap water in baths or showers or spilled hot drinks.A so-called immersion scald is created when an extremity is held under the surface of hot water, and is a common form of burn seen in child abuse.A blister is a "bubble" in the skin filled with serous fluid as part of the body's reaction to the heat and the subsequent inflammatory reaction. The blister "roof" is dead and the blister fluid contains toxic inflammatory mediators. Scald burns are more common in children, especially "spill scalds" from hot drinks and bath water scalds.

Inhalational injury

Steam, smoke, and high temperatures can cause inhalational injury to the airway and/or lungs

Wound care

Debridement cleaning and then dressings are important aspects of wound care. The wound should then be regularly re-evaluated until it is healed.In the management of first and second degree burns little quality evidence exists to determine which type of dressing should be used.

Intravenous fluids

Antibiotics Intravenous antibiotics may improve survival in those with large and severe burns. However due to the poor quality of the evidence, routine use is not currently recommended

Analgesics A number of different options are used for pain management. These include simple analgesics (such as ibuprofen and acetaminophen) and narcotics. A local anesthetic may help in managing pain of minor first-degree and second-degree burns.

Surgery Wounds requiring surgical closure with skin grafts or flaps should be dealt with as early as possible. Circumferential burns of digits, limbs or the chest may need urgent surgical release of the burnt skin (escharotomy) to prevent problems with distal circulation or ventilation.