When most people think of burns, they think of hot stoves, blazing fires, or boiling water - things which cause damage through heat. While heat burns are indeed very common. Burns are classified by the depth of tissue affected. The depth of dermis lost is due to the degree of temperature of the burn and duration of exposure to the offending source. These burns are classified as:

1. First-degree burns: are limited to the epidermal skin layer. These burns are erythematous, blanch with light pressure, and are often minimally to quite painful. Vesicles/blisters do not develop. Tissue damage and edema are minimal and most of the skin’s function is still intact. Given enough time, most heal spontaneously. Systemic effects from this type of burn are rare. Scarring is rare, but they do often peel.

2. Second-degree burns: also known as partial thickness, which involve part of the dermis and are characterized as superficial partial-thickness burn and deep partial-thickness burns.

• Superficial partial-thickness burn: injuries involve the first half of the dermis. These burns usually heal in 2 to 3 weeks and rarely scar unless infection sets in. Healing for these burns occurs from the epidermal cells which line sweat gland ducts and hair. They grow to the surface and migrate across (divide) until they “meet” cells from neighboring sites. These burns blanch with pressure and are also painful. Vesicles/blisters develop within 24 hours. The vesicle bases are pink and develop a fibrinous exudates.
• Deep partial-thickness burns: involve the second or lower half of the dermis. These burns take greater than 3 weeks to heal. Healing of these burns occurs from the hair follicles and scarring is common. These burns may be white, red, or mottled red/white. These burns do not blanch and are less painful than the more superficial burns due to extensive nerve damage. Localization of a pinprick is more difficult after this injury. Blisters may develop, but these burns are often dry (as destruction of the sweat glands occurs). Skin grafting may be necessary. Careful dressing and avoiding infection help prevent progression to a full-thickness. These burns are often ambiguous and will either spontaneously heal or evolve into a full-thickness burn.

3. Third-degree burns: also called Full-thickness burns extend through the entire dermis and project into the underlying fat (subcutaneous) layer. Healing occurs only from the peripheral layers and these burn injuries require skin grafting unless the area of burn is relatively small. These burns may be white and pliable, black and charred, brown and leathery, or bright red due to fixed hemoglobin in the sub dermal region. Full-thickness burns that are white in color may resemble skin, but will not blanch when pressure is administered. These burns are usually not or are minimally painful. Blisters do not often develop. It may take days to be able to determine the differences between full thickness and deep partial-thickness burns (Merck, 2005). Hair follicles and sweat glands may be lost if the dermis is completely destroyed.

4. Fourth-degree burns: may also be classified as full-thickness burn if they involve destruction of the entire dermis and involves the deep tissues and bone. The skin is tough and leathery and sometimes has charring. They can be white, brown, or black in appearance. These burns are painless and heal with heavy scarring and granulation. Skin grafting is mandatory. One potential complication of this type of injury is compartment syndrome due to excessive

Other types of burn injury exist which are equally harmful but require different methods of treatment. Other types of burn injury is the chemical burn, fertilizer Burns.

• Chemical Burns: Like heat burns, chemical burns can occur in a variety of ways, and not just in an industrial setting with volatile chemicals bubbling in vats. Many household goods contain chemicals which are useful when handled correctly, but can cause serious damage when accidents happen. The majority of chemical burns are caused either by strong acids or strong bases. While these dangerous chemicals are more often found in factories and manufacturing plant, some examples can also be found around the house. Toilet bowl cleaners bleach, and drain cleaners are all products used around the house which, because they contain strong chemical components, can be dangerous if used incorrectly.

Treatment of Burns

1. Third-degree burn Treatment: are the most serious of burns. They affect the epidermis, dermis, and hypodermis and result in charring of the skin or in the skin becoming a translucent white color. In addition, coagulated blood vessels are frequently visible just below the skin surface it is important to know what to do. First Aid is frequently the most important part of how an individual will recover from a burn. (Call 911) for help.

• Do Not: remove burned clothing unless it comes off easily. Do make sure that the victim is free of burning or smoldering materials as these will only make the burns worse.
• Do Not: under any circumstance, apply any sort of ointment, butter, ice, medication, fluffy cotton dressing, adhesive bandages, cream, oil spray, or any household burn remedy to the burn site. All of these interfere with the proper healing process.
• Do Not: under any circumstance, apply any sort of ointment, butter, ice, medication, fluffy cotton dressing, adhesive bandages, cream, oil spray, or any household burn remedy to the burn site. All of these interfere with the proper healing process.
• Do Not: allow the burn to become contaminated. If it is possible, do not bread or cough on the burn site. This increases the chance of infection.
• Do Not: rupture or disturb any blisters.
• Do not: apply a cold compress or immerse the burn in cold water. These two actions can cause the burn victim to go into shock which is equally unhealthy.
• Make sure the person is breathing. If the burned victim is not breathing, check to make sure the airway is open and begins artificial respiration if necessary. If the victim does not have a pulse, start CPR.
• If the victim is breathing, cover the burn with a cool, moist sterile bandage or clean cloth. If the burned area is large, a sheet is frequently the best option.
• A victim’s fingers and toes should be separated with dry, sterile, non-adhesive bandages if they have been burned. This prevents the hands from fusing.
• If possible, elevate the burned area and protect it from pressure or friction.

2. Minor Burns Treatment: Immediately after receiving a minor burn, apply cold water (not ice water) for several minutes. After the burn has been cooled by water for several minutes, apply one of the following: aloe vera, baking soda & egg white, banana, birch, blueberry, burdock, calendula, carrots, chamomile, chickweed, comfrey, echinacea, elderberry, flaxseed, ginger, honey, lavender, milk, mullein, okra, onion, potato, radish, raspberry, sage, shavegrass, slippery elm, sunflower, tea tree, or thyme. After treatment with one of the aforementioned, apply vitamin E and cover with a sterile bandage. It may also be helpful to take herbal and oatmeal baths, to aid in healing. Never break blisters.