the skin contains three main layers the
epidermis
dermis
and hypodermis or subcutaneous burns are
tissue injuries caused by heat chemicals
electricity radiation extreme cold or
friction that disrupt the Skin's
framework and function
superficial Burns affect the epidermis
only causing
erythema or redness and pain
partial thickness burns are either
superficial or deep
superficial partial thickness Burns
involve the epidermis and the upper or
papillary dermis
causing immediate blistering and intense
pain and sensitivity
deep partial thickness burns destroy the
papillary dermis epidermis and most of
the lower or reticular dermis sparing
some cutaneous nerve endings capillaries
and dermal appendages
fold thickness burns destroy the entire
epidermis dermis and portions of the
hypodermis the burned area is white
brown dry and charred has no sensation
and cannot heal without surgical
intervention
Burns can also be evaluated by
determining the percentage of body
surface area they cover this percentage
can be estimated quickly using the rule
of nines a formula in which each body
part is assigned a value of nine percent
or a multiple of nine
severe burns involving a large surface
area
increase capillary permeability and lead
to two stages of shock
in hypovolemic shock water
electrolytes and plasma proteins leak
from the bloodstream into interstitial
spaces creating widespread edema
in Burn shock the lowered intravascular
volume increases blood viscosity and
Vascular resistance
to compensate the heart rate speeds up
as a result organs and tissues do not
receive adequate blood supply resulting
in tissue and organ death from a lack of
oxygen
burn treatment aims to restore fluid
balance through administration of
intravenous fluids electrolytes and
proteins which increases intravascular
volume
wound care reduces complications by
preventing infection and promoting
healing of damaged tissues
analgesics control the pain and
inflammation of superficial Burns
superficial partial thickness burns are
cleansed covered with a sterile dressing
and monitored regularly for infection
in deep partial thickness Burns dead
skin or escar is routinely detached or
debrided to a healthy level the wound
bed is kept clean and moist to allow
epithelial regeneration and to accept
transplanted tissue called a skin graft
fold thickness burns are excised and
regularly debrided to prevent ischemia
and infection and to create a viable
base for grafting