Classification of burns

DR A VAN DER MERWE

Anatomy of the skin
 Classification of
burn injuries

Classification of burns
According to According to
depth area

Classic Wallace rule of

classification nines

New Lund-Browder
classification chart

Palmar surface
method
 Classic New Appearance and Course and Treatment
S Classification Classification Symptoms
Fist degree Superficial Erythematous Exfoliation
E (epidermis) thickness Dry, mildly swollen Heals spontaneously in 1 week
Blanches with pressure No scarring
V Second degree Superficial
Painful
Blistering Reepithelization in 7 – 20 days
E (dermis) partial
thickness
Moist, weeping
Blanches with pressure
R Painful
Red
I Deep partial No blisters (not always)
Reepithelization in weeks to
months
T thickness Wet or waxy dry
Yellow/white color
Skin grafting may speed
recovery

Y/ Less painful
At risk for conversion to
Associated with scarring

D full thickness because of

marginal blood supply

E
Third degree (all Full thickness White waxy to leathery Reepithelization does not occur
of dermis and gray to charred black Requires skin grafting
epidermis) Insensate to pain Associated with scarring
P Does not blanch to
pressure
T Fourth degree Black (eschar) May require amputation or
(extends to Exposed bones, extensive deep debridement
H muscle, bone,
tendon)
ligaments, tendons
Classify this
burn
Classification of burns
First degree burns/ superficial thickness burns
Classification of burns
Second degree burns Second degree burns
◦ Superficial partial thickness ◦ Deep partial thickness
Classification of burns
Third degree burns/ Full thickness
Classification of burns
Fourth degree burns
 Classification of burns
Wallace rule of nines

Quick for large burns

Adults vs Children chart
 Classification of burns
Lund-Browder Chart

Most accurate
Adults & Children
 Classification of burns
Palmar surface method

Smaller burns
Not accurate in >15% TBSA burns
Calculate TBSA burns
Using Wallace rule of nines
27% 4,5
Calculate TBSA burns
Using the Lund-Browder chart
13,5 %
3 ½ (3 2/4)

3 ½ (3 2/4)

1¾

1¾

3½

1¾
References
◦ Total Burn Care, 4th edition (David N. Herndon)
◦ The Essential Burn Unit Handbook, 2nd edition (Jeffrey J. Roth; William B. Hughes)
◦ Handbook of burns Volume 1: Acute Burn Care (Jeschke, Marc G.)
◦ Images:
◦ Courtesy of Google Images
◦ Color Atlas of Burn Care (David N. Herndon)