BURNS CLINICAL
A partial thickness burn involves the outer layer of the skin and
may extend into the dermis.
This wound, commonly termed a second degree burn, is
characterized by blistering of the skin and is red, moist and
painful; sensation is intact.
The clinical importance of differentiating between these depths
of injury lies on the understanding that a superficial wound
heals with minimal cosmetic or functional defect in two weeks.
The healing occurs from the peripheral migration of cells, and out pouring
of cells from sweat glands and hair follicals.
The deep partial thickness wound, although it will heal given 3
week or more and there will be a defect in function and cosmetic
defect. In these cases skin grafting will improve results.
With burn of full thickness the wounds are leathery, white or
charred dry with loss of sensation.
Because all the epidermis is destroyed, these wounds can only
heal by migration of epidermis from the margins of the wound.
During the process of healing, contraction occurs; this decreases
the area that must be epithelialized but leads to a poor cosmetic
result and the healed wound is less resistant to trauma.
If the wound is adjacent to or involves a joint, the function of
the joint will be impaired.
Large full thickness wounds should be either excised and closed
primarily or grafted with the patient's skin to prevent
deformity.
Wounds however are often of mixed depth in such cases evaluation
of discrete areas may not define the depth of the overall wound.
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