Severity of burn injury is determined by the depth of skin damage (degrees of burns) and the size of the wound. Burns are divided into 4 categories:
- First-degree burn. This type is minor burn, affecting only the outer layer of the skin (epidermis). It might cause mild redness and pain. It is usually self-limiting. First-degree burn usually needs a week healing time, without scarring. The example of this type of burn is overexposure to the sun (sunburns)
- Superficial second-degree burn. This type of burn affects both the epidermis and the superficial layer of the dermis which is the second layer of skin. Blisters may develop and pain can be severe. It may cause white or splotchy skin. If treated appropriately, burns can be cured within 2-3 weeks and scar rarely occurs.
- Deep second-degree burn. This type of burn affects the epidermis and the deeper layer of the dermis, making it more difficult to treat. It usually requires longer healing time and it can cause scarring.
- Third-degree burn. This burn damages the entire layers of the skin and reaches to the fat layer beneath the skin. Third-degree burn can destroy nerves, causing numbness and less pain. Burned areas may turn to be white. The skin may look leathery or cover with necrotic tissue. Third-degree burn has a high risk of infection. Treatments are complicated. It is usually treated with skin grafts by surgical removal the injured skin and replacing it with healthy skin from an uninjured area of the body (skin grafting). However, if it is a small burn, it can be self-limiting and scarring after burns usually develops.
The size of burns can be estimated as the percentage of body surface area burned by using the rule of palm. The palm of the patient who is burned is about 1% of the body. Another method is called the rule of nines. In this method, the body is divided into sections of 9%, each arm is equal to 9% of body surface area and each leg is equal to 18% of body surface area. The treatment of burns depends on the severity and location of skin damage. Deep or widespread burns often need immediate medical attention. Some patients with severe burns need treatment at specialized burn centers and several months for follow-up care.
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