Burn

Burn
Hand2ndburn.jpg
Second-degree burn of the hand
SpecialtyCritical care medicine
SymptomsSuperficial: Red without blisters[1]
Partial-thickness: Blisters and pain[1]
Full-thickness: Area stiff and not painful[1]
ComplicationsInfection[2]
DurationDays to weeks[1]
TypesSuperficial, partial-thickness, full-thickness[1]
CausesHeat, cold, electricity, chemicals, friction, radiation[3]
Risk factorsOpen cooking fires, unsafe cook stoves, smoking, alcoholism, dangerous work environment[4]
TreatmentDepends on the severity[1]
MedicationPain medication, intravenous fluids, tetanus toxoid[1]
Frequency67 million (2015)[5]
Deaths176,000 (2015)[6]

A burn is a type of injury to skin, or other tissues, caused by heat, cold, electricity, chemicals, friction, or radiation.[3] Most burns are due to heat from hot liquids, solids, or fire.[7] While rates are similar for males and females the underlying causes often differ.[4] Among women in some areas, risk is related to use of open cooking fires or unsafe cook stoves.[4] Among men, risk is related to the work environments.[4] Alcoholism and smoking are other risk factors.[4] Burns can also occur as a result of self-harm or violence between people.[4]

Burns that affect only the superficial skin layers are known as superficial or first-degree burns.[1][8] They appear red without blisters and pain typically lasts around three days.[1][8] When the injury extends into some of the underlying skin layer, it is a partial-thickness or second-degree burn.[1] Blisters are frequently present and they are often very painful.[1] Healing can require up to eight weeks and scarring may occur.[1] In a full-thickness or third-degree burn, the injury extends to all layers of the skin.[1] Often there is no pain and the burnt area is stiff.[1] Healing typically does not occur on its own.[1] A fourth-degree burn additionally involves injury to deeper tissues, such as muscle, tendons, or bone.[1] The burn is often black and frequently leads to loss of the burned part.[1][9]

Burns are generally preventable.[4] Treatment depends on the severity of the burn.[1] Superficial burns may be managed with little more than simple pain medication, while major burns may require prolonged treatment in specialized burn centers.[1] Cooling with tap water may help pain and decrease damage; however, prolonged cooling may result in low body temperature.[1][8] Partial-thickness burns may require cleaning with soap and water, followed by dressings.[1] It is not clear how to manage blisters, but it is probably reasonable to leave them intact if small and drain them if large.[1] Full-thickness burns usually require surgical treatments, such as skin grafting.[1] Extensive burns often require large amounts of intravenous fluid, due to capillary fluid leakage and tissue swelling.[8] The most common complications of burns involve infection.[2] Tetanus toxoid should be given if not up to date.[1]

In 2015, fire and heat resulted in 67 million injuries.[5] This resulted in about 2.9 million hospitalizations and 176,000 deaths.[6][10] Most deaths due to burns occur in the developing world, particularly in Southeast Asia.[4] While large burns can be fatal, treatments developed since 1960 have improved outcomes, especially in children and young adults.[11] In the United States, approximately 96% of those admitted to a burn center survive their injuries.[12] The long-term outcome is related to the size of burn and the age of the person affected.[1]

Signs and symptoms

The characteristics of a burn depend upon its depth. Superficial burns cause pain lasting two or three days, followed by peeling of the skin over the next few days.[8][13] Individuals suffering from more severe burns may indicate discomfort or complain of feeling pressure rather than pain. Full-thickness burns may be entirely insensitive to light touch or puncture.[13] While superficial burns are typically red in color, severe burns may be pink, white or black.[13] Burns around the mouth or singed hair inside the nose may indicate that burns to the airways have occurred, but these findings are not definitive.[14] More worrisome signs include: shortness of breath, hoarseness, and stridor or wheezing.[14] Itchiness is common during the healing process, occurring in up to 90% of adults and nearly all children.[15] Numbness or tingling may persist for a prolonged period of time after an electrical injury.[16] Burns may also produce emotional and psychological distress.[17]

Type[1] Layers involved Appearance Texture Sensation Healing Time Prognosis Example
Superficial (first-degree) Epidermis[8] Red without blisters[1] Dry Painful[1] 5–10 days[1][18] Heals well.[1] Repeated sunburns increase the risk of skin cancer later in life.[19] A sunburn is a typical first-degree burn.
Superficial partial thickness (second-degree) Extends into superficial (papillary) dermis[1] Redness with clear blister.[1] Blanches with pressure.[1] Moist[1] Very painful[1] 2–3 weeks[1][13] Local infection (cellulitis) but no scarring typically[13]

Second-degree burn of the thumb

Deep partial thickness (second-degree) Extends into deep (reticular) dermis[1] Yellow or white. Less blanching. May be blistering.[1] Fairly dry[13] Pressure and discomfort[13] 3–8 weeks[1] Scarring, contractures (may require excision and skin grafting)[13] Second-degree burn caused by contact with boiling water
Full thickness (third-degree) Extends through entire dermis[1] Stiff and white/brown.[1] No blanching.[13] Leathery[1] Painless[1] Prolonged (months) and incomplete[1] Scarring, contractures, amputation (early excision recommended)[13] Eight day old third-degree burn caused by motorcycle muffler.
Fourth-degree Extends through entire skin, and into underlying fat, muscle and bone[1] Black; charred with eschar Dry Painless Requires excision[1] Amputation, significant functional impairment and in some cases, death.[1] 4th-degree burn
Other Languages
العربية: حرق (إصابة)
asturianu: Quemadura
Avañe'ẽ: Kái
বাংলা: পোড়া
беларуская: Апёк
беларуская (тарашкевіца)‎: Апёк
български: Изгаряне
čeština: Popálenina
dansk: Brandsår
ދިވެހިބަސް: ފިހުން
Ελληνικά: Έγκαυμα
español: Quemadura
euskara: Erredura
فارسی: سوختگی
français: Brûlure
galego: Queimadura
ગુજરાતી: દાહ
한국어: 화상
հայերեն: Այրվածքներ
hrvatski: Opeklina
Bahasa Indonesia: Luka bakar
italiano: Ustione
עברית: כווייה
ქართული: დამწვრობა
қазақша: Күйік
Kiswahili: Jeraha la moto
Кыргызча: Күйүк
latviešu: Apdegums
lietuvių: Nudegimas
മലയാളം: പൊള്ളൽ
Bahasa Melayu: Lecur
Nederlands: Brandwond
नेपाली: पोलेको घाउ
日本語: 熱傷
occitan: Cremadura
ଓଡ଼ିଆ: ଦଗ୍ଧ
oʻzbekcha/ўзбекча: Kuyish
ਪੰਜਾਬੀ: ਸਾੜ-ਸੋਜ਼
Patois: Bon (injri)
polski: Oparzenie
português: Queimadura
română: Arsură
русский: Ожог
саха тыла: Уокка сиэтии
Simple English: Burn (injury)
slovenčina: Popálenina
slovenščina: Opeklina
српски / srpski: Opekotina
srpskohrvatski / српскохрватски: Opekotina
suomi: Palovamma
svenska: Brännskada
தமிழ்: எரிகாயம்
Türkçe: Yanık
українська: Опік
Tiếng Việt: Bỏng
粵語: 辣親
中文: 灼傷