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Introduction

Severity of Burns

The damage caused by burns depends on the degree (depth) and extent of the burn. This will depend on temperature and type of the heat source and the duration of contact. Higher the temperature of the heat source and longer the time of contact, more the severity of the burn.


First degree burns are superficial burn in which the outermost layer of the skin, called the epidermis is injured. These burns are painful and do not need any treatment, and have complete recovery.


Second degree burns (partial thickness burns) occurs when the heat damages the epidermis (outermost layer of the skin) & dermis (inner layer of the skin) sparing skin appendages. They are painful and present with blisters. There are ulceration, burn wound infection and dehydration. Nerve endings in the dermis are injured causing severe pain. It heals spontaneously.


Third degree burns (full thickness burns) occur when both the epidermis and the dermis (first and second layers of the skin) are damaged completely. There is no pain in the affected area. Escher formation may lead to vascular impairment, compatorment syndrome, and ischemic necrosis of the muscles. Deep burns heal by fibrosis leading to post-burn contracture & Marjolin’s ulcer (a type of skin cancer) formation. They require skin grafting.

 

Fourth Degree Burn: Burn injury involving total destruction of the skin, subcutaneous tissue, fascia, muscles, & bones.

 

Any burn involving more than 10% of the body surface area needs admission in a Burn unit. Burns in children even smaller involvement may need referral. Inhalation burns always need urgent treatment.

 

IMCH has a well established Burn Unit which is running with its competent Surgeons, Physician and Nursing staff. The unit is capable of providing extensive services to the burn patients. The unit offers resuscitation and burn wound management, and can provide surgical services for complications of burn