Full Thickness Burn

GENERAL INFORMATION:

What is a full thickness burn?

• A full thickness burn is also called a third-degree burn. It is a skin injury commonly caused by exposure to a very high temperature for a long time. The skin is made up of the epidermis (outer layer), dermis (second layer), and subcutaneous (fat and muscle; third layer) tissues. Burns may be grouped based on how deep the tissue is burned. They may be grouped into superficial, partial thickness, or full thickness burns.
  
  
• A full thickness burn occurs when all layers of the skin have been burned. This may also include damage to the bones and muscles. A full thickness burn is the most serious type of burn and scars usually form. This often causes serious injuries inside the body and some of these injuries may not show on the skin.

What causes a full thickness burn? Direct exposure to heat for a long time is the most common cause of a full thickness burn. This includes contact with a flame or very hot objects, such as tar. The following may also cause full thickness burns:

• Chemicals: Harsh chemicals, such as cleaning products, car battery acid, gasoline, wet or dry cement, lime, or chlorine.
  
  
• Electricity: Electrical burn by a lightning injury, or touching faulty electrical cords, outlets, or wires.
  
  
• Scalding: Burn from steam or hot liquids, such as boiling water.

What are the signs and symptoms of a full thickness burn? A full thickness burn may be white, charred, black, brown, or leathery. This type of burn injury is often painless because the nerves are already destroyed. You may still feel pain on other burn areas that are less damaged.

How is a full thickness burn diagnosed? The diagnosis of burn injuries depends on how deep the injury is and how much of the body is burned. Knowing the amount of surface area that is burned helps caregivers decide on a treatment plan.

How is a full thickness burn treated? A full thickness burn should be treated by a caregiver. You may need one or more of the following:

• Medicines:
  
  
  • Antibiotics: Antibiotics may be given to help treat or prevent an infection caused by germs called bacteria.
    
    
  • Pain medicines: Caregivers may give you medicine to take away or decrease your pain.
    
    
  • Tetanus shot: This is medicine to keep you from getting tetanus. It is given as a shot. You should have a tetanus shot if you have not had one in the past 5 to 10 years. Your arm can get red, swollen, and sore after getting this shot.
  
  
• Surgery:
  
  
  • Debridement: This is done to clean and remove objects, dirt, or dead tissues from the burned area.
    
    
  • Escharotomy: An incision (cut) along the eschar (dead tissue or scab) is made to decrease swelling. This is usually done when the arms, legs, or chest are burned all the way around.
    
    
  • Skin grafting: A patch of skin is removed by surgery from one area of the body. The skin is transferred to the burned or wounded areas to help heal your injury. Donor skin may also be used.

What is the first-aid for a full thickness burn?

• For burns caused by heat:
  
  
  • Do not run if your clothes are burning. Running can fan the flames and they may rise to your face. Cover the flames with a blanket, jacket, or rug, and roll on to the ground.
    
    
  • Do not remove the clothing that is stuck to the burned area.
    
    
  • Flush the burn with large amounts of cool running water or apply cold moist cloths.
    
    
  • Do not use ice or ice water on the affected area. This can cause more damage to the skin.
    
    
  • Do not put butter, petroleum jelly, or other home remedies on the burned skin.
    
    
  • Use dry, clean sheets to cover the affected area.
    
    
  • Elevate or raise burned arms or legs higher than your heart when sitting or lying down.
  
  
• For burns caused by a chemical:
  
  
  • Remove clothing or jewelry on which the chemical has spilled right away.
    
    
  • Flush liquid chemicals from the skin completely with large amounts of cool running water. Avoid splashing the chemical into your eyes.
    
    
  • Brush dry chemicals off the skin if large amounts of water are not available. Small amounts of water will activate some chemicals, such as lime, and cause more damage. Be careful not to get any of the chemicals in your eyes.
    
    
  • Do not put butter, petroleum jelly, or other home remedies on skin burned by a chemical.
    
    
  • Put on a clean non-stick bandage to protect the burned area from dirt and more injury.
  
  
• For burns caused by tar:
  
  
  • Remove jewelry or tight clothing from the burned area before the skin begins to swell. Do not remove clothing if it is stuck to the burn.
    
    
  • Wash the tar and affected area with large amounts of cool running water.
    
    
  • Once the tar is cooled, remove the tar by applying antibiotics, petroleum jelly, or mayonnaise to your skin. You may also use a mixture of mineral oil and cool water.
  
  
• For an electrical burn:
  
  
  • Use an object made of wood or rubber in moving the person away from the source of electricity.
    
    
  • Cover the electrical burn with a dry, loose bandage.
    
    
  • Go to the nearest hospital. Electrical burn damage may not be obvious but it can extend deep into your tissues.

How can a full thickness burn be prevented?

• Do not leave cups, mugs, or bowls containing hot liquids at the edge of a table. Turn the pot handles away from the stove front. Children can reach up and pull them down onto themselves.
  
  
• Do not leave lit cigarettes unattended and discard them properly. Keep cigarette lighters and matches in a safe place where children cannot reach them.
  
  
• Set your water heater to low or medium.
  
  
• Use smoke detectors in the house and check them regularly to make sure they are working.

Where can I get support and more information? Having a full thickness burn may be life-changing for you and your family. Accepting that you have a burn injury may be hard. You and those close to you may feel sad, angry, depressed, or frightened. These are normal feelings. Talk to your caregivers, family, or friends about your feelings. You may also want to join a support group. This is a group of people who have burn injuries. Contact the following support groups for more information about full thickness burns:

• American Academy of Family Physicians
  PO Box 11210
  Shawnee Mission, KS 66207-1210
  Phone: 1-913-906-6000
  Web Address: http://www.aafp.org
  

• Centers for Disease Control and Prevention Mass Trauma
  1600 Clifton Rd.
  Atlanta, GA, 30333
  Web Address: www.cdc.gov/masstrauma
  

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

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