Friday, January 25, 2013

Burn Injuries

One thing that has changed recently is how medical professionals talk about burns or burn terminology.

Burns used to be classified as follows:

  • First Degree: Skin is pink, but no fluid-filled blisters.
  • Second Degree: Skin had fluid-filled blisters of varying sizes.
  • Third Degree: Multiple layers of the skin are involved. There may be charring of the wound. The picture would denote, at the very least, a third degree burn.
  • Fourth Degree: Charring and burning that involves muscle and bone.

Now, we refer to burns as partial thickness or full thickness. Partial thickness would include first and second degree burns. Full thickness would be considered third and fourth degree burns.

Here is a good resource that discusses the difference. 

Treatment of burns depends on location, size and depth. 

Very simply, localized burns are usually treated by cleaning, leaving blisters intact, slathering them with triple antibiotic ointment and then dressing them.

Not all burns need to be followed up by a specialist at a burn clinic but burns that involve the hands or feet (because of functionality), the face (for cosmetic reasons or if they could hinder the senses), or genitalia (including nipples) are usually referred for further care.

Also, burn injuries need to be estimated on what percentage of the skin is involved. Based on the percentage-- a patient can be referred for follow-up or flat out admitted if the burn injury is severe. You may have heard this referenced to as the "Rule of Nines". Pediatric patients have different ratios so keep that in mind.

Here are a few links that help estimate burn percentage based on skin area:

Most patients with significant burn injuries have significant pain. We do tend to give something that has a narcotic to help their pain. Also, based on the percentage of burned skin, some patients will also need fluid resuscitation, ICU admission, intubation--- etc, to manage the injury.

So, if you're writing about burns and your POV character is a medical professional, keep these things in mind so your character can be treated the right way with the medical professional using the right language. 



  1. The another term that doctor use to define burn terminology is what percent of body get affected from burn in all the for degrees of the burn i.e different percent is fixed for each degree.
    Burn Injuries

  2. How would they treat burns in children? Then I imagine as they grow the burn would shrink right? My heroin received a burn as a child and I write it like she still has this big burn that apart of her life, is that still possible? Maybe I'm over thinking it. I'm just now taking her burn serious. 😏 So I have all of these what if questions.

    1. Hi Latedra!

      Thanks for leaving a question. It depends on what kind of burn you're talking about. Burns that need a higher level of care would be those that would inhibit function. We get concerned about burns that cover a large portion of the feet, hands, face or genitalia (including breasts). The larger the burn area or the deeper the burn-- the more it may require skin grafting to heal.

      Let's take a simple burn. Red with some blisters but covers maybe a palm size of the thigh. We would wash it with mild soap and water. Apply a copious layer of Neosporin. And put something over top that won't stick to it-- we use a Vaseline impregnated gauze called Adaptic-- then it won't stick as the dressing comes off. More extensive burns would be referred to a burn center.

      Scars generally stay the same size. They don't grow as the child grows so it may appear that they are shrinking because the child is bigger but really they are the same size.

      Hope this helps!