Burn Staging

Question 1

Superficial 1st Degree Burns

Answer 1

• damage to epidermis only (sunburn)
• Characteristics
  
  • erythema
  • slight edema
  • tenderness
  • no blistering
• some peeling of skin will occur with spontaneous healing in 2-5 days

Question 2

Superficial Partial Thickness 2nd Degree Burns

Answer 2

• damage to dermis and epidermis
• Characteristics
  
  • blisters
  • inflammation
  • severe pain
  • healing complete w/o surgery 7-10 days
• minimal scarring with some residual skin color changes

Question 3

Deep Partial Thickness (2nd degree) Burns

Answer 3

• Dermis destroyed w/ injury to hair follicles, nerve endings and sweat glands
• Characteristics
  
  • red or white appearance
  • edema
  • blistering
  • severe pain
• healing taked 3-5 weeks - hypertrophic and keloid scarring are common

Question 4

Full Thickness 3rd Degree Burns

Answer 4

• complete destruction of dermis, epidermis and subcutaneous tissue w/ some muscle damage
• Characteristics
  
  • tissues are white, gray or black w/ a dry surface
  • edema
  • eschar formation
  • insensate or little pain (nerve endings gone)
  • often significant p! in surrounding areas
• Treatment
  
  • surgical removal of eschar (escharotomy) and skin grafting
  • infection and hypertrophic scarring
  • maybe keloid scarring can occur

Question 5

Subdermal 4th Degree Burn

Answer 5

• complete destruction of all tissues + bone and ms
• Characteristics
  
  • skin is charred
  • dry in appearance
  • mummified
  • destruction of vascular system = necrosis
  • prolonged contact w/ flame or hot liquid or electric
• Amputation and muscle paralysis are common
• extensive surgery and rehab required.

Question 6

Epidermal Burn

(First Degree)

Answer 6

• Characteristics
  
  • damage to epidermis only
  • pink or red appearance
  • no blistering (dry surface)
  • minimal edema
  • tenderness, delayed pain
• Healing/scarring
  
  • spontaneous healing 3-7days
  • no scarring

Question 7

Superfiscial Partial-Thickness Burn

(second degree)

Answer 7

• Characteristics
  
  • epidermis and upper layers of dermis damaged
  • bright pink or red appearance
  • blanching with brisk capillary refill
  • blisters, moist surface, weeping
  • moderate edema
  • painful, sensitive, temp changes
• Healing
  
  • spontaneous healing, typically in 7-21 days
  • minimal or no scarring
  • discoloration

Question 8

Deep Partial-Thickness Burn

(second degree)

Answer 8

• Characteristics
  
  • severe damage to epidermis and dermis with injury to nerve endings, hair follicles and sweat glands
  • mixed red or waxy white appearance
  • blanching with slow capillary refill
  • broken blisters, wet surface
  • marked edema
  • sensitive to pressure, but insensitive to light touch or soft pin prick
• Healing
  
  • slow and occurs through scar formation and reepithelialization
  • excessive scarring without preventitive tx

Question 9

Full-Thickness Burn

(third degree)

Answer 9

• Characteristics
  
  • complete destruction of epidermis, dermis & subcutaneous tissues; maybe muscle
  • white (ischemic), charred, tan or black
  • no blanching;
  • poor distal circulation
  • parchment-like dry leathery surface; depressed
  • little pain, nerve endings are destroyed
• Healing
  
  • removal of eschar and skin grafting are necessary due to destruction of dermal and epidermal tissues
  • risk of infection is increased
  • hypertrophic scarring and wound contracture are likely to develop without preventitive measures
    *

Question 10

Subdermal Burn

(Fourth Degree)

Answer 10

• Characteristics
  
  • complete destruction of epidermis, dermis, with involved subcut, and muscle
  • charred appearance
  • destruction of vascular system may lead to necrosis
  • from electrical burns, proglonged contact with flame
  • additional complications likely with electrical burns:
    
    • v-fib, acute kidney damage, SCI
• Healing
  
  • skin grafting and scarring
  • requires extensive surgery
  • amputation may be necessary