Types of Burn Injuries

Treatment of Burns and Skin Injuries at Columbia St. Mary's Regional Burn Center

Columbia St. Mary's Regional Burn Center is capable of treating every kind of burn, regardless of its size or severity. The Center has been taking care of burn patients for over 50 years and has a wealth of experience about the special care burn wounds require. Because of this expertise with burn injuries, the Center also treats patients with other large wounds to the skin as well as patients suffering from smoke inhalation.

We are one of only two Burn Centers in the state of Wisconsin verified by the American Burn Association in the care for burn-injured adults. This verification process provides confirmation that a burn center has demonstrated its commitment to providing the highest quality of care for burns.

Specialized burn centers such as Columbia St. Mary's have experience specific to managing burn wounds, burn pain and all of the unique care that a burn patient requires. Some patients can be evaluated, have their wounds treated, learn about burn care, have their pain controlled then go home in a day or two. Other patients may suffer very large burns and receive care at the Regional Burn Center for several weeks, or even a few months.

Types of Burn Injuries:

• Thermal Burns: Can be caused by flame, heat or a chemical reaction. Types of burns that can occur are:
  • Flame Burns: Flames cause a direct heat and burn injury to the skin and sometimes deeper tissues
  • Heat: In some instances during a house fire or other structure fire, the heat can be come so intense that it can cause a burn injury
  • Contact: Coming in contact with a hot object like a stove can also cause a thermal burn
• Chemical Burns: These burns most often occur in industrial settings; however, they can also be caused by common household cleaners and swimming pool chemicals. Many times, chemical burns do not appear serious at first, but become worse as the chemicals continue to react with the exposed tissue.
• Scald Burns: Scalds are produced by hot liquids such as water or cooking oil. These are the most common burns seen in children. Elderly persons are also at risk especially when their sensitivity to heat or cold is diminished.
• Electrical Burns: In addition to the actual burn, electricity can cause serious internal injuries that are not immediately visible to emergency personnel or other healthcare providers. Electrical burns can cause everything from heart attack and neurological damage to broken bones and ruptured ear drums. Electrical current can cause either a flash of flame or electrocution. Electrocution injuries are always much worse than they appear. With electrocution, even a small dime-sized burn can place a person at risk for loosing a limb.

Classification of Burn Injuries:

Normal Skin Layers

• First Degree Burn: This is also called a superficial burn injury. It looks like a typical sunburn injury: a bit pink, a bit sore and may make the victim feel a bit dehydrated. Only the very outer layer of skin (epidermis) has been damaged. The deeper skin structures are still intact. It DOESN’T look like an open wound. Sunburn or tanning beds are usually the cause of a first degree burn. First degree burns usually heal in a few days. Medical care is usually not required unless it involves most of the body and you’re dehydrated, or are having problems with pain control. Consult your doctor if you’re concerned.
  
  When someone suffers a first degree burn they should:
  • Drink plenty of fluids
  • Apply lotion to dry skin areas as they are healing
• Second Degree Burn: This is also called a partial thickness burn injury. It’s called a partial thickness injury, because in addition to the outer skin layer (epidermis), part of the inner skin layer (dermis) has also been damaged. Second degree burns are bright red (like the color of red meat), moist, and painful to the touch. Many times they will also blister and look like an open wound. They generally take two to three weeks to heal.
  
  Other information about second degree burns:
  • Seek medical care if it is a large wound. Consult a doctor if you’re concerned.
  • If the area is deep, sometimes skin grafting may be required.
  • In very young or elderly patients, a second degree burn (like a scald) can convert to a deeper and more serious burn.
  • Second degree burns become more serious when combined with other health problems.
  • Second degree burns to more than 10% of the body should be treated at a specialized burn center.
• Third Degree Burn: This is also called a full thickness burn injury. It’s called a full thickness burn injury, because besides the outer skin layer, (epidermis), the full inner skin layer (epidermis) has also been damaged. The color of third degree burns may vary: They look like an open wound that may be dark red (like the color of red wine), white, brown and leathery or charred in appearance. They are less painful to the touch because the nerve endings have been damaged. Seek medical care for any third degree burn.
  
  Other information about third degree burns:
  • Generally, surgery will be required for skin grafting unless it is a very small area.
  • In the very young or with elderly patients, or those with other health problems or trauma, any burn can make the injury more serious.
  • Third degree burns should be treated at a specialized burn center.
• Burns that require specialized care in a burn facility:
  • Second degree burns affecting more than 10% of the body surface.
  • Any third degree burn requires immediate medical care.
  • Burns over sensitive areas like joints, face, head, neck, genitals or hands, or where joint function or cosmetic outcome could be compromised.
  • Electrical (including lightening), chemical burns or inhalation injuries.
  • Patients who also have serious health problems beside the burn injury.
  • Patients who have trauma and burns should be evaluated by the physician. If the trauma is the greater threat to life, treatment initially at a trauma center is needed.
  • Burn children need specialized burn care in facilities that have equipment and personnel trained to deal with the special needs of children.

Other Injuries Treated at Columbia St. Mary’s Regional Burn Center

Smoke Inhalation

The leading cause of death in fires is smoke inhalation, not burns from flames. Mild smoke inhalation usually responds to oxygen given by emergency personnel. If the injured person can’t breathe on their own without use of a respirator (ventilator), this is a severe inhalation injury. In severe inhalation injuries, there is a significant risk of death.

Smoke inhalation injuries can be caused by toxins in the smoke, or burns in the face and airways from the heat of the smoke. Toxins in smoke include carbon monoxide and cyanide.

The best way to treat severe smoke inhalation injuries is to prevent them from happening in the first place. Always use care with flammable materials. Have furnaces checked regularly. Change batteries regularly in your smoke detectors. Consider the use of a carbon monoxide detector in your home.

Frostbite

Frostbite is another type of thermal burn. Frostbite involves the freezing of tissue, when ice crystals form in or on the tissue leading to damaged skin and muscle. Frostbite can happen in cold weather, but especially in weather that is both cold and wet.

• Areas most sensitive to frostbite are fingers, toes, your nose and ears.
• Seek immediate medical care for frostbite to prevent further permanent damage to sensitive tissues.
• Avoid frostbite by dressing properly for the weather. If you’re not very mobile, keep a cell phone with you during cold weather.

Exfoliative Disorders (Skin slough disorders): Some medical problems or drug allergies can cause a large area of skin to peel away (slough). These skin disorders often appear like a second degree burn. Blisters are a cause for concern, especially when the medical problem might be a drug allergy reaction. Blisters usually form before the skin begins to peel away. Catching the problem early is very important. These reactions can be so extensive that other tissues are affected. Sore eyes or mouth could also be a concern.

Examples of exfoliative disorders or major skin disorders:

• Steven’s Johnson Syndrome
• TEN: Toxic Epidermal Necrolysis
• Erythema Multiforme
• SSSS: Staphylococcal scalded skin syndrome
• Fournier’s Gangrene
• DRESS Syndrome: Drug Reaction with Eosinophila and Systemic Symptoms
• Necrotizing Fasciitis

Consult your physician immediately for medical care. If the cause of the problem is an allergic drug reaction, stopping the drug as soon as possible is important. Developing blisters, eye irritation or other severe problems can be a serious health problem.

Other Injuries

There are other wounds that may look similar to a burn injury but are caused by other trauma or medical problems. Because the staff of Columbia St. Mary’s Regional Burn Center has extensive expertise in caring for very large burns, they also have experience caring for patients with other wounds.

To learn more about Columbia St. Mary’s Regional Burn Center, order a copy of our FREE DVD by clicking here. To schedule a community education talk, learn more about our support groups, or to speak to a member of our staff regarding a patient referral or other matter please call (414) 291-1680.