Burns

Burns are injuries to the skin and underlying tissues caused by heat sources (thermal burns), chemicals, electricity, or radiation. They vary in depth and area, influencing pain, healing, and the risk of complications. Depth-based classification is commonly used: first-degree burns affect only the outer skin (epidermis); second-degree burns involve part of the dermis (partial thickness) and often blister; third-degree burns destroy full thickness, potentially with insensitivity to pain in the center; sometimes fourth-degree burns extend into muscle or bone. The total body surface area (TBSA) involved helps gauge severity and the need for specialized care.

Causes include hot liquids or objects, flames, steam, contact with hot metals, caustic chemicals, electrical currents, and ionizing or other radiation. Children, older adults, and people with chronic illnesses or large burns are at higher risk of complications.

Clinical features depend on depth and TBSA. Minor burns may appear red and painful with minimal swelling. Deeper burns tend to be white or charred and progressively less painful due to nerve damage. Signs of infection or systemic impact (wide spreading redness, fever, or dehydration) require urgent evaluation.

First aid emphasizes stopping the exposure, cooling the burn with cool running water for 10-20 minutes (do not use ice), removing restrictive items, and covering with a clean, nonadherent dressing. Avoid applying butter, oils, or ointments to large burns. Seek medical care for burns larger than 3-5% TBSA in adults, burns to the face, hands, feet, genitals, or joints, deep burns, electrical or chemical burns, or signs of infection.

Medical management may include wound cleaning, dressings, analgesia, tetanus prophylaxis, infection control, and, if needed, surgical interventions such as debridement or skin grafting. Prevention focuses on safety measures, such as kitchen and appliance precautions, smoke detectors, and appropriate protective equipment.