By Dr. David Edward Marcinko MBA
Graphic video image warning!
Back in the day, when I was a surgical resident and fellow, I treated my fair share of electrical, thermal and chemical burn injuries. Some were life, eyeball and limb threatening; but fortunately most were not! Treatment was with local wound care, followed by full, split thickness or postage stamp skin grafts, flaps, or various plastic surgery techniques, etc.
And, many were accidental of course, but a few were simply ill-conceived ideas from dumb or inebriated patients seen through the emergency room of the old Emory University – Northlake Regional Medical Center, in Tucker, GA.
So, for you medical types, here is a recap on the way we doctors classify burns, as referenced in several of my surgical textbooks and related medical publications.
Classification of Burn Depths
A. Superficial burn injury
1st degree burn
- Limited to the epidermis
- Presents with erythema and minimal swelling
- Mild discomfort
- Commonly treated on outpatient basis
B. Superficial partial-thickness burns
Second Degree Burn
- Superficial 2nd degree burns
- Involves the epidermis and superficial portion of the dermis
- Often seen with scalding injuries
- Presents with blister formation and typically blanches with pressure
- Sensitive to light touch or pinprick
- Commonly treated on outpatient basis; heal in 1-3 wks.
C. Deep partial-thickness burns
Deep 2nd degree burns
- Involves the epidermis and most of the dermis
- Patients often require excision of the wound and skin grafting
- Appears white or poorly vascularized; may not blister
- Less sensitivity to light touch and pinprick than superficial form
- Extensive time to heal (3-4 wks)
D. Full-thickness burns
Third Degree Burn
- Involves epidermis, and all layers of dermis, extending down to subcutaneous tissue
- Appears dry, leathery, and insensate, often without blisters
- Can be difficult to differentiate from deep partial-thickness burns
- Commonly seen when patient’s clothes caught on fire/skin directly exposed to flame
- Usually require referral to burn surgeon; need skin grafting to heal.
E. Fourth degree burns
Fourth Degree Burn
- Full-thickness burn extending to muscle or bone
- Common result of high-voltage electric injury or severe thermal burns
- Requires hospital admission
Assessment
So, why do we review this clinical material on Independence Day? It is to remind our readers not to drink and shoot fireworks today; or to stop and re-think before proceeding with same. Don’t be like the fool in this YouTube video. I don’t want to see you in any ER; any where today! GOMER.
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Conclusion
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Filed under: LifeStyle, Risk Management, Touring with Marcinko, Videos | Tagged: burn wounds, burns, Classification of Burn Depths, classification of burns, Don’t be a Fireworks Jack Ass, Dr. David Marcinko, fireworks | 2 Comments »