Integumentary: Burns: Degree of Burn

Question 1

First Degree:

Epidermal Burn

Answer 1

• Epidermis Only
• Pink/red appearance with no blistering/Dry surface
• Minimal edema
• Tenderness and delayed pain

Question 2

First Degree:
Epidermal Burn:
Healing/Scarring

Answer 2

• Spontaneous healing will take place in 3-7 days

- No scarring

Question 3

Second Degree:

Superficial partial thickness Burn

Answer 3

• Epidermis+upper layers of the dermis
• Bright pink/red appearance
• Blanching with brisk capillary refill
• Blisters present
• Moist surface with weeping present
• Moderate Edema
• Painful/sensitive to touch/temperature changes

Question 4

Second Degree:
Superficial partial thickness Burn:
Healing/Scarring

Answer 4

• Spontaneous healing typically 7-21 days

- Minimal or no scarring; discoloration

Question 5

Second Degree:

Deep partial thickness burn

Answer 5

• Severe damage to epidermis and dermis with injury to nerves 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

Question 6

Second Degree:
Deep partial thickness burn:
Healing/scarring

Answer 6

• Healing is slow and occurs through scar formation and re-epithelialization.
• Excessive scarring will occur without preventive treatment.

Question 7

Third Degree:

Full Thickness Burn

Answer 7

• Complete destruction of epidermis, dermis, and subcutaneous tissues, may extend into muscle.
• White coloration, charred tan or black
• No blanching with poor distal circulation.
• Parchment like dry leathery surface, lowered area.
• Little pain, nerve endings are destroyed

Question 8

Third Degree:
Full Thickness Burn
Healing/Scarring

Answer 8

• Removal of eschar and skin grafting are necessary due to destruction of dermal and epidermal tissue.
• Risk of infection is increased.
• Hypertrophic scarring and wound contracture are likely to develop without preventative measures.

Question 9

Fourth Degree:

Subdermal Burn

Answer 9

• Complete destruction of the epidermis and dermis with involvement of subcutaneous tissues and muscle.
• Charred appearance
• Destruction of vascular system which may lead to additional necrosis
• Additional complications with electrical burns: Ventricular fibrillation, acute kidney damage, spinal cord damage.

Question 10

Fourth Degree:
Subdermal Burn
Healing/Scarring

Answer 10

• Heals with skin grafting and scarring.
• Requires extensive surgery.
• Amputation may be necessary.