Determining the seriousness of a burn

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Determining the seriousness of a burn

The seriousness of a burn is determined by:

• The depth of the burn (first-, second-, third-, or fourth-degree).
  • First-degree burns are burns of the first layer of skin. See an illustration of a first-degree burn .
  • Second-degree burns. There are two types of second-degree burns:
    • Superficial partial-thickness burns injure the first and second layers of skin. See an illustration of this type of second-degree burn .
    • Deep partial-thickness burns injure deeper skin layers. See an illustration of this type of deep second-degree burn .
  • Third-degree burns (full-thickness burns) injure all the skin layers and tissue under the skin. See an illustration of a third-degree burn .
  • Fourth-degree burns extend through the skin to injure muscle, ligaments, tendons, nerves, blood vessels, and bones. These burns always require medical treatment.
• The size of the burn.
• The cause (thermal, electrical, chemical, radiation, or friction).
• The part of the body where the burn occurred.
• The age and health of the burn victim.
• Other injuries.

Minor burns

Minor burns include:

• Second-degree burns covering:
  • Less than 15% of the body of a person between ages 10 and 50.
  • Less than 10% of the body of a person younger than 10 or older than 50.
• Third-degree burns covering less than 2% of the body.

Moderate burns

Moderate burns include:

• Second-degree burns covering:
  • 15% to 25% of the body of a person between ages 10 and 50.
  • 10% to 20% of the body of a person younger than 10 or older than 50.
• Third-degree burns covering 2% to 10% of the body.

All moderate burns require a visit to a doctor. Some of these burns may be treated at home by carefully following your doctor's instructions. Infection is a concern in moderate burns. It is important to watch for signs of infection. Some moderate burns may require hospital admission and specialized burn care.

Major burns

All major burns will require immediate evaluation by a doctor for treatment and prevention of complications. Major burns include:

• Second-degree burns covering:
  • More than 25% of the body of a person between ages 10 and 50.
  • More than 20% of the body of a person younger than 10 or older than 50.
• Third-degree burns covering more than 10% of the body for all age groups.
• Burns involving the face, hands, feet, or genital area.
• Burns crossing major joints.
• Burns that go completely around (encircle) the chest or a limb.
• Burns complicated by smoke inhalation injury.
• Electrical burns that cause burns to the skin.
• Burns with other injuries, such as fractures.
• Burns to the very young or very old.
• Burn injuries to a person with medical conditions, such as diabetes, peripheral arterial disease, or an impaired immune system.

A second- or third-degree burn—even a small burn—on the face, eyelids, ears, hands, feet, genital area, or over a joint is more serious for several reasons, such as an increased risk of infection and complications from scarring. Scarring is more likely to cause a problem in these areas.

• The body tries to heal burns by pulling together the skin around the burned area. When scar tissue forms, it can change the look or affect the function of the burned area. For example, a severe burn on your hand might affect the function of the fingers and limit your ability to use your hands.
• Scarring on the face might cause a misshapen appearance that would require cosmetic surgery to correct it. Large burn areas might need skin graft surgery.

Major burns may require you to stay in the hospital and receive specialized burn care.

What to think about

It is important to watch for signs of infection during the healing of any burn.

Credits

Last updated:	February 02, 2007
Author:	Susan Van Houten, RN, BSN, MBA
Reviewed By:	William M. Green, MD - Emergency Medicine, H. Michael O'Connor, MD - Emergency Medicine
Editors:	Sydney Youngerman-Cole, RN, BSN, RNC, Tracy Landauer