Quick and Dirty Guide to Burn Classification
Burn depth is measured in degrees of severity from superficial to full-thickness
Superficial burns are pink and slightly swollen from edema. The associated pain is minimal and will often subside as the burn cools. These burns do not blister and affect the epidermis layer only.
Partial Thickness Burns
- Partial thickness burns may be superficial or deep. Superficial partial-thickness burns are painful, red, blistered, moist and more edematous than a first-degree burn.
- Deep partial-thickness burns appear both white and red. They will have a lack of hair to the area and may or may not be painful.
- Partial-thickness burns affect some amount of the dermis, which contains lymph vessels, small blood vessels, sweat glands, collagen bundles, fibroblasts and nerves.
Full Thickness Burns
Full thickness burns involve the nerves that supply the skin. Therefore, they aren't painful. Color ranges from white to black, and the skin will be dry and leathery. Full-thickness burns extend through the dermis and tend to cause hemolysis, worsening the patient’s condition.
Severe Full Thickness Burns
Severe full thickness burns (Fourth-degree) burns extend through subcutaneous fatty tissue, which is responsible for maintaining heat, into muscles, larger blood vessels and often bone tissue. This causes rhabdomyolysis and puts the patient at great risk for renal failure, limb loss and death.
Circumferential full thickness burns represent an additional problem, the stiffening of the skin along with internal edema cut off, venous blood and lymph flow creates a tourniquet effect. Blocked venous and lymphatic flow impedes recovery, and the swelling will ultimately cause nerve compression and the blockage of arterial flow.
In burns encompassing the torso, chest expansion will become restricted. These patients require rapid, safe transport for escharotomy to restore circulation and to maintain adequate tidal volume.