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Kakabadze Ann
DEFINITION
A burn is a type of injury of skin or other tissues caused
by heat, electricity, chemicals, friction or radiation.
Reminder of Anatomy
Electrical burns
Electrical burns may cause serious injury that is not readily
apparent. Often the entry and exit points for the electrical shock
may not be easily found.
Electricity flows more easily through tissues in the body that are
designed to deal with electricity. Nerves and muscles are
"wired" for this task and often are damaged. If significant
muscle damage occurs, muscle fibers and chemicals can be
released into the bloodstream causing electrolyte disturbances
and kidney failure.
Electrical burn
Chemical burns
Burns can also occur when chemicals are spilled onto
the body and generate a reaction that creates heat.
Chemical burns may be classified by their pH or acidity.
Chemical burn
Radiation burns
Radiation burns may be caused by protracted
exposure to ultraviolet light (such as from the sun,
tanning booths or arc welding) or from ionizing
radiation (such as from radiation therapy, X-rays
or radioactive fallout). Sun exposure is the most
common cause of radiation burns and the most
common cause of superficial burns overall.
There is significant variation in how easily people
sunburn based on their skin type.
CLASSIFICATION
Based upon their depth, burns are classified as follows:
First degree burn: superficial, causes local inflammation of
the skin (can be caused by sunburns)
Signs:
Pain
Redness
Mild swelling
CLASSIFICATION
Second degree burn: deeper, affecting epidermis and part of
the dermis.
Signs:
Pain
Redness
Swelling
CLASSIFICATION
Superficial second degree burns affect the entire epidermis
and upper third of the dermis, including papillary layer of the
dermis. It may leave slightly rough and weak scars.
CLASSIFICATION
Third degree burn: causes most damage, extending through
every layer of skin. The damage can even reach the
bloodstream, major organs, and bones, which can lead to
death
Signs:
Difficulty breathing
In addition to the depth of the burn, the total area of the burn is
significant. Burns are measured as a percentage of total body area
affected.
The "rule of nines" is often used. This calculation is based upon the
fact that the surface area of the following parts of an adult body
each correspond to approximately 9% of total (and the total body
area of 100% is achieved):
Head = 9%
Chest = 18%
Abdomen =18%
Groin = 1%
If more than 15%-20% of the body is involved in a burn, significant fluid may be
lost. Shock may occur if inadequate fluid is not provided intravenously. As the
percentage of burn surface area increases, the risk of death increases as well.
Patients with burns involving less than 20% of their body should do well, but those
with burns involving greater than 50% have a significant mortality risk, depending
upon a variety of factors, including underlying medical conditions and age.
Any questions?