Posted: September 17th, 2023

Classification and management approaches to burn wounds

Classification and management approaches to burn wounds
Burn wounds can be classified in a variety of ways to help determine the appropriate treatment approach. One common classification system categorizes burns based on depth and severity (Sood, 2019).
Superficial burns, also known as first-degree burns, involve only the epidermis or outer layer of skin. These burns cause pain, redness and swelling but do not blister. As they only impact the top layer of skin, superficial burns usually heal within a week with simple wound care and no scarring (American Burn Association, 2022).
Partial-thickness or second-degree burns extend deeper into either the epidermis and dermis or just the dermis. These burns result in pain, blistering, redness and swelling. They take longer to heal, usually 2-4 weeks, and may result in some scarring. Partial-thickness burns are further divided into superficial and deep partial-thickness categories (Sood, 2019).
Full-thickness or third-degree burns extend through the entire dermis and potentially into underlying tissues such as muscle, tendon or bone. They destroy both the epidermis and dermis and result in a leathery or waxy appearance with little or no pain sensation due to destruction of nerve endings. These severe burns require skin grafting and have long healing times, often months, with extensive scarring (American Burn Association, 2022).
Burns can also be classified based on the total body surface area (TBSA) involved. Minor burns involve less than 10% TBSA, moderate burns 10-20% TBSA, and major or extensive burns over 20% TBSA (Sood, 2019). TBSA calculations help guide fluid resuscitation needs and determine whether hospitalization is required.
In terms of management approaches, superficial burns are usually treated with simple wound care including cleaning with mild soap and water, applying antibiotic ointment and dressing, and allowing the wound to heal on its own (American Burn Association, 2022). Partial-thickness burns may require additional wound care such as silver sulfadiazine cream application and dressing changes, along with pain management. Full-thickness burns necessitate prompt evaluation by a burn specialist and likely surgical debridement, skin grafting and other reconstructive procedures (Sood, 2019). Major burns also warrant intensive fluid resuscitation, nutritional support, infection monitoring and potential intensive care.
Sood, A. (2019). Burn wound classification and management. Indian Journal of Plastic Surgery, 52(2), 264–267. https://doi.org/10.4103/ijps.IJPS_504_18
American Burn Association. (2022, February 8). Burn First Aid. American Burn Association. https://www.ameriburn.org/resources/burn-first-aid/
Sood, A. (2019). Burn wound classification and management. Indian Journal of Plastic Surgery, 52(2), 264–267. https://doi.org/10.4103/ijps.IJPS_504_18
Sood, A. (2019). Burn wound classification and management. Indian Journal of Plastic Surgery, 52(2), 264–267. https://doi.org/10.4103/ijps.IJPS_504_18
American Burn Association. (2022, February 8). Burn First Aid. American Burn Association. https://www.ameriburn.org/resources/burn-first-aid/