Full Thickness Burn

What is a full thickness burn?

A full thickness burn is also called a third-degree burn. Your skin contains 3 layers. A full thickness burn occurs when all 3 layers have been burned. This may also include damage to the bones and muscles. A full thickness burn is the most serious type of burn.

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 hot objects or flames such as an iron, a skillet, tar, cigarettes, or fireworks. The following may also cause a full thickness burn:

  • Harsh chemicals, such as cleaning products, car battery acid, gasoline, wet or dry cement, lime, or chlorine

  • Lightning injury or damaged electrical cords or electrical outlets

  • Hot water or steam

What are the signs and symptoms of a full thickness burn?

Your skin may be white, black, brown, or leathery. This type of burn injury is often painless because the nerves have been damaged.

How is a full thickness burn diagnosed?

Your caregiver will ask about your symptoms and ask how you were burned. He will examine your body to see how much was burned. Laser scanners may be used to check the blood flow in your skin.

How is a full thickness burn treated?

  • Medicines:

    • Ointments: These medicines prevent infection and help your burn heal. The ointment may be placed on your skin or may be part of your bandage.

    • Acetaminophen: This medicine decreases pain and lowers a fever. It is available without a doctor's order. Ask how much to take and how often to take it. Follow directions. Acetaminophen can cause liver damage. Do not drink alcohol if you take acetaminophen.

    • Pain medicine: You may be given a prescription medicine to decrease severe pain. Take the medicine as directed. Do not wait until the pain is severe before you take your medicine.

    • Td vaccine: This vaccine is a booster shot used to help prevent diphtheria and tetanus. The Td booster may be given to adolescents and adults every 10 years or for certain wounds and injuries.

  • Surgery:

    • Debridement: Caregivers remove damaged tissue from your body to prevent infection, decrease inflammation, and improve healing.

    • Skin grafts and flaps: Caregivers cover or replace lost skin with healthy skin to help close your wounds, prevent infection, and decrease scarring. Skin flap surgery is done to fix large wounds that cannot be covered by skin grafting. A skin flap is skin and tissue near the wound that is used to cover the wound area. Skin flaps may improve the appearance of your skin.

    • Escharotomy: Caregivers make an incision through the dead tissue into the fat layer below. This surgery helps relieve pressure caused by swelling and improves blood flow.

How do I care for my full thickness burn?

  • Wash your hands with soap and water. Remove old bandages and place them in a small plastic bag. You may need to soak the bandage in water before you remove it so it will not stick to your wound.

  • Gently clean the burned area daily with mild soap and water, and pat dry. Look for any swelling or redness around the burn. Do not break closed blisters, because this increases the risk of infection.

  • Apply cream or ointment to the burn with a cotton swab. Place a nonstick bandage over your burn.

  • Wrap a layer of gauze around the bandage to hold it in place. The wrap should be snug but not tight. It is too tight if you feel tingling or lose feeling in that area.

  • Apply gentle pressure for a few minutes if bleeding occurs.

  • Prop your burned arm or leg on pillows to raise the area above your heart as often as you can. This will help decrease swelling.

Why may I need physical therapy?

Your muscles and joints may not work well after a full thickness burn. You may need to see a physical therapist to teach you exercises that will improve movement and decrease pain. Physical therapy can also help improve strength and decrease your risk for loss of function.

What are the risks of a full thickness burn?

You may become dehydrated. You may have serious internal injuries, such as organ damage. You have a higher risk of infection. Full thickness burns are so deep that they usually cause scarring. Scarring in some places, such as over joints, can cause loss of motion. Without treatment, your burn may become infected, and you may have increased pain. If the burn becomes infected, the burn will take longer to heal.

How can I prevent a full thickness burn?

  • Do not leave cups, mugs, or bowls that contain hot liquids at the edge of a table. Keep pot handles turned away from the stove front.

  • Do not leave a lit cigarette. Discard it properly. Keep cigarette lighters and matches in a safe place where children cannot reach them.

  • Keep your water heater setting to low or medium.

When should I contact my caregiver?

Contact your caregiver if:

  • You feel weak and have pale, clammy skin.

  • You have questions or concerns about your condition or care.

When should I seek immediate care?

Seek care immediately or call 911 if:

  • You have a fever.

  • You have increased redness, numbness, or swelling in the burned area.

  • Your pain is not relieved or is getting worse even after you take pain medicine.

  • Your wound or bandage is leaking pus and has a bad smell.

  • You have sudden shortness of breath.

  • You have a fast heartbeat and chest pain.

  • You feel so dizzy that you have trouble standing up.

  • Your lips or fingernails turn blue.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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