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                                                   Type of burn injuries

Burn injuries are inevitable and may lead to catastrophic tissue damage and disability if optimal preventive measures are not taken. Believe it or not, we are exposed to burn injuries at all times; however, most burn injuries are trivial and require no costly treatments. Healthcare providers and burn experts suggest that every individual experiences at least one moderate to significant burn injury incident in their entire lifetime regardless of the quality of preventive measures taken.

- The prevalence of burn injuries in United States is 5 – 15 cases per 1000 individuals each year (1)

- More than 100,000 burn injury victims are admitted in hospitals for the management of different types of burn injuries (1) What are some different types of burn injuries?

There are four types of burn injuries based on the severity of tissue damage (yet for practical purposes healthcare providers consider only three types of burn injuries). There are several other classification criteria (such as nature of burn injury, area of skin involved, depth of skin/ tissue involved etc.)

Before understanding the pathophysiology of burn injuries, it is imperative to discuss the structure of skin and underlying tissues. There are three layers of the skin and each layer has its own function (which is why every injury has different manifestations and complications). Most importantly, based on several factors (such as vulnerability of tissue, vascular supply, involvement of vital organs etc.) the burn injury classification may appear a little confusing. For example a mild to moderate burn injury involving genitals or visual apparatus is usually classified as severe burn injury.

Types of burn injuries based on tissue depth:

A brief overview of burn injury classification based on the depth of skin/ tissue affected is discussed as under: - First-degree burn: First-degree burns involve only the top layer of skin (also referred to as epidermis). This layer is made up of squamous epithelial cells that have a remarkable tendency to regenerate and heal. Other notable structures include skin appendages (hair, nail, sweat glands etc.) First degree burns are usually mild and characterized by minimal pain, redness or burning sensation. Most first degree burn injuries can heal within a week without scarring or permanent disability and do not need extensive medical attention.

- Second-degree burn: when the source of heat is intense and penetrating (such as flames, corrosives, chemicals) the burn injury can involve the second layer of skin, also referred to as dermis. The dermis has connective tissues and sensory nerves that increases the sensation of pain and discomfort. Due to involvement of deeper layers of skin and destruction of protein components, the risk of blister formation is fairly high. Mild scaring may occur but in most cases, the second degree burn usually heals within a month, provided proper medical attention is given.

- Third-degree burn: a serious burn injury that can damage all three layers of the skin is usually referred to as third-degree burns. These burns are severe in nature and can result in extreme pain, scarring, discoloration of skin or even charring away of skin pieces. Such injuries expose the interior part of the skin that increases the risk of infections over time and also leads to cosmetic disfigurement. Cosmetic and reconstruction surgeries are often needed and long term medical attention is mandatory to minimize the risk of complications.

- Fourth-degree burn: this is the most severe variety of burn injuries in which not only all three layers of skin but also to the muscles and bone structures beneath the connective tissue are damaged or destroyed. Intense pain is a hallmark of this injury; yet it also depends on the components involved; for example, in certain burn injuries, the nerve component is completely destroyed and no pain is felt. However, in almost all cases extensive cosmetic reconstruction is needed. Life-long scarring and physical deformity are some of the after

effects of these burns. In extreme cases amputations can also take place.



2. Sahin, I., Ozturk, S., Alhan, D., Açikel, C., & Isik, S. (2011). Cost analysis of acute burn patients treated in a burn centre: the Gulhane experience. Annals of burns and fire disasters, 24(1), 9-13.

3. Alnababtah, K. M., Davies, P., Jackson, C. A., Ashford, R. L., & Filby, M. (2011). Burn injuries among children from a region-wide paediatric burns unit. British Journal of Nursing, 20(3), 156.

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