What is a Burn?
Burns are an injury to any layer of the skin and are caused by extreme heat or cold, contact with electricity, chemicals, friction or radiation.
Thermal (heat) burns are the most common cause of injury and occur when some or all of the cells in the skin or other tissues are destroyed by
- flames (flame burn) – 40%*
- hot liquids (scalds) – 22%*
- hot solids (contact burns) 15%*
*Primary burn agent Royal Perth Inpatient Admissions 2013
Why is the skin so important?
Our skin is the body’s largest organ and is critical to survival. It has many functions including
- moderating temperature
- retaining and maintaining fluid levels in our body
- protecting us from bacteria and infection
- gathering sensory information
The skin consists of two distinct layers each with their own function
- waterproof layer (from keratinocytes); contains pigment producing cells (melanocytes); protects the nerve endings
- scaffold of the skin, mainly collagen; contains capillaries, hair follicles, nerve fibres cells and sweat glands
Underneath the dermis lies the padding layer of subcutaneous tissue which separates the skin from deeper muscular and bony structures. These layers provide important cushioning from trauma.
What happens following a burn?
The picture on the right best illustrates what happens to the skin following a burn.
Burns are classified depending on the amount of damage done to the different layers of skin and to the structures within these layers.
- Superficial thickness burns affect the outer layer or epidermis. Common symptoms include localised redness and pain.
- Partial thickness burns affect the second layer of skin or the dermis. Symptoms include blisters, clear fluid emitting from the site and localised pain or with a whitish appearance for a deeper burn and deeper damage. This burn may have limited associated pain due to damage to the blood vessels and nerve endings.
- Full thickness burns often leave a hard leather-like eschar (dead tissue), purple fluid and no or little pain due to the depth of damage. Skin may appear whitish or black depending on the type of burn.
The severity of the burn determines the patient journey and road to recovery.