Feature of 3deg burn:
Correct Answer: Whole dermis destroyed
Description: Ans: C (Whole...) FULL-THICKNESS BURNS(3rd BURN) L & B 25th/381The whole of the dermis is destroyed in these burns.Clinically, they have a hard, leathery feel. The appearance can vary from that similar to the patient's normal skin to charred black, depending upon the intensity of the heat.There is no capillary' return. Often, thrombosed vessels can be seen under the skin.These burns are completely anaesthetised: a needle can be stuck deep into the dermis without any pain or bleeding.BURN CSDT 11th/267-72# Traditionally, burns have been classified as first-, second-, and third-degree, but the current emphasis on burn healing has led to classification as partial-thickness burns, which can heal spontaneously, and fall-thickness burns, which require skin grafting, although deep partial-thickness burns are usually excised and grafted as well.A first-degree burn involves only the epidermis and is characterized by e rythem a a nd m inor mi crosco pi c changes; tissue damage is minimal, protective functions of the skin are intact, skin edema is minimal, and systemic effects are rare. Pain, the chief symptom, usually resolves in 48-72 hours, and healing takes place uneventfully.Second-degree or partial-thick ness burns are deeper, involving all of the epidermis and some of the corium or dermis. The systemic severity of the burn and the quality of subsequent healing are directly related to the amount of undamaged dermis. Superficial burns are often characterized by blister formation, while deeper partial- thickness burns have a reddish appearance or a layer of whitish nonviable dermis firmly adherent to the remaining viable tissue. Blisters, when present, continue to increase in s ize in the postburn period as the osmoticaliy active particles in the blister fluid attract water.Deep dermal burns heal over a period of 25-35 days with a fragile epithelial covering that arises from the residual uninjured epithelium of the deep dermal swreat glands and hair follicles. Severe hypertrophic scarring occurs when such an injury heals; the resulting epithelial covering is prone to blistering and breakdown, evaporative losses after healing remain high compared with losses in normal skin.full thickness (third degree] burns have a characteristic white, waxy appearance and may appear to the untrained eye as unburned skin. Bums caused by prolonged exposure, whth involvement of fat and underlying tissue, may be browm, dark red, or black. The diagnostic findings of fullthickness burns are lack of sensation in the burned skin, lack of capillary refill, and a leathery texture that is unlike normal skin. All epithelial elements are destroyed, leaving no potential for reepithelialization.Fig: Layers of the skin showing depth of first-degree, second-degree, and third-degree burns.
Category:
Surgery
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