Burns(Thermal injury): Degree of burns

Burns are classified by two different systems: partial thickness or full thickness burns, and first, second, or third degree burns.

First-degree burns show superficial erythema with no blistering.

B. i.e. Sub epidermal

Ans is b,c,

The dermis is structurally divided into two areas: a superficial area adjacent to the epidermis, called the papillary region, and a deep thicker area known as the reticular region.

Second-degree burn affects the epidermis and the dermis, is classified as superficial (involving the epidermis and the papillary dermis) or deep (extending into the reticular dermis).

Ans is C (Hypoesthesia) 

I did not not get any material on option ‘d’. According to a Prof. in Surgery this option is true. Deep Second degree burn involves both epidermis and dermis and thus would thrombose all the vessels in the base.

Ans. is `a’ i.e., 2-3 days 

Burn wound will almost inevitably be colonised by micro oraganism within 24-48 hrs.

Ans. is ‘b’ i.e., Painful 

Ans. C i.e. Blister formation

Ans. D: Extremely painful

Depth of burn injury (deeper burns are more severe)

• Superficial burns (first-degree and superficial second-degree burns) First-degree burns
• Damage above basal layer of epidermis
• Dry, red, painful (“sunburn”)

Second-degree burns

• Damage into dermis
• Skin adnexa (hair follicles, oil glands, etc.) remain
• Heal by re-epithelialization from skin adnexa
• The deeper the second-degree burn, the slower the healing (fewer adnexa for re-epithelialization)
• Moist, red, blanching, blisters, extremely painful
• Superficial burns heal by re-epithelialization and usually do not scar if healed early.
• Deep burns (deep second-degree to fourth-degree burns) Deep second-degree burns (deep partial-thickness)
• Damage to deeper dermis
• Less moist, less blanching, less pain
• Heal by scar deposition, contraction and limited re-epithelialization

Third-degree burns (full-thickness)

• Entire thickness of skin destroyed (into fat)
• Any color (white, black, red, brown), dry, less painful (dermal plexus of nerves destroyed)
• Heal by contraction and scar deposition (no epithelium left in middle of wound)

Fourth-degree burns

• Burn into muscle, tendon, bone
• Need specialized care (grafts will not work)
• Deep burns usually need skin grafts to optimize results and lead to hypertrophic (raised) scars if not grafted

Ans. C: 3 weeks

Deep dermal burns take 3 weeks or more to heal without surgery and usually lead to hypertrophic scarring.

If the wound shows no signs of re-epithelialisation in this time, the wound requires debridement and grafting.

Ans. Second degree superficial

Ans. Third degree

Ans. d. 60°C

• When temperature of flame is 65″C or above, body is rigid with limbs flexed known as pugilistic or fencing posture due to coagulation of albumin constituents of muscles (Boxer’s posture in defense). It is seen in death due to burning, high voltage electrocution, or falling into hot liquid.”