injuries and poisoning
Burns
Classification of Burns
Doctors classify burns according to strict, widely accepted definitions. The definitions classify the burn’s depth and the extent of tissue damage. The depth of injury from a burn is described as superficial, partial thickness, or full thickness: Superficialburns are the most shallow (also called first-degree burns). They affect only the top layer of skin (epidermis). Partial-thicknessburns (also called second-degree burns) extend into the middle layer of skin (dermis). Partial-thickness burns are sometimes further described as superficial (involving the more superficial part of the dermis) or deep (involving both the superficial and the deep parts of the dermis). Full-thicknessburns (also called third-degree burns) involve all three layers of skin (epidermis, dermis, and fat layer). Usually, the sweat glands, hair follicles, and nerve endings are destroyed as well. To determine the severity of a burn, doctors estimate what percentage of the body’s surface has partial-thickness or full-thickness burns. For adults, doctors use the rule of nines. This method divides almost all of the body into sections of 9% or of 2 times 9% (18%). For children, doctors use charts that adjust these percentages according to the child’s age (Lund-Browder charts). Adjustment is needed because different areas of the body grow at different rates. Burns are classified as minor, moderate, or severe. These classifications may not correspond to a person’s understanding of those terms. For example, doctors may classify a burn as minor even though it can cause the person significant pain and interfere with normal activities. The severity determines how they are predicted to heal and whether complications are likely. Doctors determine the severity of the burn by its depth and by the percentage of the body surface that has partial-thickness or full-thickness burns. Special charts are used to show what percentage of the body surface various body parts comprise. For example, in an adult, the arm constitutes about 9% of the body. Separate charts are used for children because their body proportions are different. Minor burns: All superficial burns as well as partial-thickness burns that involve less than 10% of the body surface usually are classified as minor. Moderate and severe burns: Burns involving the hands, feet, face, or genitals, partial-thickness burns involving more than 10% of the body surface area, and all full-thickness burns involving more than 1% of the body are classified as moderate or, more often, as severe. 