Classification of Burns
Location of Burn
Extent of Burn in Percent of TBSA
Depth of Burn
Zone of Burn Injury
Full- Thickness
3rd Degree
2nd Degree
4th Degree
1st Degree
Superficial partial-thickness burn
erythema, blanching on pressure, no vesicles to blisters
painful and mild swelling
Involves epidermis
heals in 10-14 days
Deep partial-thickness burn
epidermis and dermis involvement
the burn site appears red, blistered, and may be swollen and painful
usually requires skin grafting
heals via contraction and granulation tissue formation
hair follicles and sweat glands destroyed
scarring and hypo-pigmentation
destroys the epidermis and dermis and may go into the subcutaneous
there is no sensation in the area since the nerve endings are destroyed
the burn site may appear white or charred
must have skin grafting, flap, or amputation
epidermis and dermis plus damage the underlying bones, muscles, and tendons
Rule of 9
Lund and Browder
Quick, more commonly utilized (especially for adults)
More accurate, gives consideration for age and portions (used especially in children).
Zone of Stasis
Zone of Hyperemia
Zone of Coagulation
the actual tissue burned resulting in a coagulated protein
like cooked eggs, irreversible damage
decreased tissue perfusion due to poor blood flow and edema
area of damaged blood vessels
cells are at risk for necrosis in the next few hours or days
dehydration and infection these cells as well
at risk = the depth of burn could increase over the first few days
good wound care and hydration are required to prevent infection and minimize damage to these cells
tissue is not actually burned but is inflamed
vasodilation results increased blood flow that aides in the healing
outer edge of the burn
increased WBCs and nutrients
this is the least damaged area of tissue
Hands/Feet/Joints/Eyes
Ears/Nose/Perineum/Buttocks
Face/Neck/Chest
Circumferential
interfere with breathing/airway
function
infection
causes problems distal to burn
burns to the face & neck are circumferential burns to the check/back may interfere with breathing as a result of mechanical obstruction secondary to edema or leathery, devitalized burn tissue.
these burns may also signal the possibility of smoke or inhalation injury
area of concern because they make self care veery difficult and may jeopardize future function
burns to the hands and feet are challenging to manage because of superficial vascular and nerve supply systems that need to be protected while the burn heals
burns to the ears and the nose are at the risk for infection as the skin is very thin and the underlying skeleton is frequently exposed
burns to the buttocks or perineum are at high risk for infection (*urine or feces)