First Aid for Burns
Medical Author: Benjamin C. Wedro, MD, FAAEM
Medical Editors: Melissa Conrad Stöppler, MD and William C. Shiel, Jr., MD, FACP, FACR
Introduction to burns
The skin has an important role to play in the fluid and temperature
regulation of the body. If enough skin area is injured, the ability to maintain
that control can be lost. The skin also acts as a protective barrier against the bacteria and
viruses that inhabit the world outside the body.
The anatomy of the skin is complex, and there are many structures within the
layers of the skin. There are three layers:
- Epidermis, the outer layer of the skin
- Dermis, made up of
collagen and elastic
fibers and where nerves, blood vessels, sweat glands, and hair follicles reside.
- Hypodermis or subcutaneous tissue, where larger blood vessels and nerves
are located. This is the layer of tissue that is most important in temperature
regulation.
The amount of damage that a burn can cause depends upon its location, its
depth, and how much body surface area that it involves.
How are burns classified?
Burns are classified based upon their depth.
A first degree burn is superficial and causes
local inflammation of the skin. Sunburns often are categorized as first degree
burns. The inflammation is characterized by pain, redness, and a mild amount of swelling. The skin may be
very tender to touch.
Second degree burns are deeper and in addition to the pain, redness and
inflammation, there is also blistering of the skin.
Third degree burns are deeper still, involving all layers of the skin, in
effect killing that area of skin. Because the nerves and blood vessels are
damaged, third degree burns appear white and leathery and tend to be relatively
painless.
Burns are not static and may mature. Over a few hours a first degree burn may
involve deeper structures and become second degree. Think of a sunburn that
blisters the next day. Similarly, second degree burns may evolve into third
degree burns.
Regardless of the type of burn, inflammation and fluid
accumulation in and around the wound occur. Moreover, it should be noted that
the skin is the body's first defense against infection by microorganisms. A burn
is also a break in the skin, and the risk of infection exists both at the site
of the injury and
potentially throughout the body.
Only the epidermis has the ability to regenerate itself. Burns that extend
deeper may cause permanent injury and
scarring and not allow the skin in that
area to return to normal function.
Next: What is the significance of the amount of body area burned? »
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