BURN

Dr. Abhishek Karn

Dept. of Forensic Medicine
& Toxicology
 Definition
A burn is an injury which is caused by
application of heat/chemical
substances to the external/internal
surfaces of the body, which causes
destruction of tissue.

Microscopically
Epithelial cells are elongated and
flattened & stain more deeply with
haemotoxylin.
 Minimum temperature for producing
a burn is 440C for 5-6 hours.
At650C, 2 seconds are sufficient to
produce burns.
Full
thickness destruction of skin
occurs within seconds above 700C.
1) Fire
2) Heated substance
3) Corrosive
4) Explosive
5) X-rays
6) UV rays
7) Electricity
8) Lightning
 Dupuytrens classification(six degrees)
Wilsons classification (3 groups)
i. Epidermal- (1,2 Dupuytrens)
ii. Dermo-epidermal- (3,4 Dupuytrens)
iii. Dermal/Deep- (5-6 Dupuytrens)

Modern classification
i. Superficial- (1,2,3 Dupuytrens)
ii. Deep (4,5,6 Dupuytrens)
Epidermal
Involves the epidermis
Characterized by reddening
Tenderness and Pain
Increased warmth
Blistering due to capillary dilatation &
transudation of fluid into the t/s
Singeing of hair
Usually heals in ~ 7 days
Dermo-epidermal
Damage extends through the epidermis and
involves the dermis.
Not enough to interfere with regeneration of
the epithelium
Moist, shiny appearance
Salmon pink to red color
Most painful
Usually heal in ~7-21 days
Contraction of scar t/s
Dermal/Deep
Both epidermis and dermis are destroyed
along with SQ t/s, m/s & even bone
Thick, dry appearance
Pearly gray or charred black color
Painless
Cannot heal and require grafting
1. Superficial-
depth of lesion does not
extend beyond part of thickness of
the true skin.

2. Deep-
all burn injuries involving
the whole thickness of the true skin
or deeper tissue.
 Erythema(redness) immediate
Vesication 2-3 hrs.
Pus, slough 36-72 hrs.
Fall of superficial slough 1 week
Fall of deep slough 2 weeks.
 Granulation tissue begins to cover
the area and a scar is formed after
several weeks or even months
depending upon the amount of
suppuration, sloughing depth and
extent of the burn.
1. Extent of surface area of body
involved
2. Degree of heat
3. Duration of exposure
4. Depth of the burn injury
5. Site of injury
6. Age of the victim
7. Sex of the victim
 Rule of Nines

Palm Rule
A. Primary causes of death
i. Neurogenic Shock
ii. Suffocation
iii. Accident/Injuries

B. Secondary causes of death

i. Secondary Shock
ii. Toxemia
iii. Sepsis
1. Identity of the deceased?
Remnant of clothing or any other article
X-ray examination of entire body
Forensic odontology

2. What is the actual cause of death?

i. Whether the burn injuries were ante-mortem in
nature?
ii. If so, whether those injuries were sufficient to cause
death?
iii. If so, whether signs of precise cause or causes of
death were present on the body?
iv. If there were any other finding or findings in the
body to suggest any other cause of death?
 Antemortem Postmortem
Burns Burns
Erythema Present Absent
surrounding
the burnt area
Blister Contains Thin clear fluid
serous fluid
rich in protein
+ chloride,
Vital Present Absent
reaction
Carboxy Hb Elevated < 10%
(Cherry-red blood) (>10%)
Soot Present Absent
particles in
Base red and dry hard and
inflammed yellow
Enzymes Increased No such increase
Serotonin,
Histamine,
Esterase, Acid
Phosphatases,
Alkaline
Phosphatases
 Injury which results from
the application of liquid
above 600C or from steam.

The destruction doesnt extend as

deeply as in burns.

Water at 700C can cause full thickness

scalds of the skin in 1 sec. of contact.
 Redness appears at once
& blistering takes place
within a few minutes.

There is no singeing of the hair or

blackening or charring of the skin.

Sticky liquids eg. syrup, oils & tar causes

more severe scalds than hot water.
 Scars of scalds are much thinner than
those of deep burns & causes less
contraction & disfigurement.

Inhalation of steam may cause

thermal injury to the respiratory
tract, producing death by asphyxia
due to obstruction of the airway by
the oedematous mucous membrane.
THANK YOU