A burn injury to the skin is caused by heat, chemicals, electricity, light, radiation or friction. Most burns affect only the skin. However, severe burns damage deeper tissues such as muscle, bone, and blood vessels. Proper management of burns is very important as they are very painful and can result in disfiguring and disabling scarring. Physicians who are proficient in treatment of burn victims can help to minimize disfigurement and disability. Large severe burns can be fatal, but modern treatment modalities have significantly improved the prognosis of such burns, especially in children and young adults. In the United States alone, more than 2.5 million cases of burn cases are reported each year and approximately 4,000 of those people die from their injuries. Children are particularly at risk to these injuries as about half of burn patients are below 18. Elderly persons suffering burn injuries have greater risks for recovery as many in that age group have additional health problems that cause additional challenges in living with burn injuries.
Severe burn injuries are best treated by specialized burn centers rather than non-specialized hospitals. Burn centers specifically designed to treat burn victims and have the necessary skill and equipment to obtain optimum results for the patient. Prior to 1950, there were only a few burn injury treatment centers in the United States. There are more than 200 such burn centers actively treating burn victims in the United States today. One of the best and most well-known burn centers in the Southern California area is the Sherman Oaks Hospital Burn Center in Sherman Oaks. Berglund & Johnson has had numerous clients who have been patients at that wonderful facility.
Types of Burns
The severity of a burn injury depends on the depth of the injury and how much of the body has been burned. In many cases a person with a large burn injury will have burns of different depths. The deepest injury is usually at the center of a burned area. The severity of a burn is categorized by how hot the skin gets and the how long the tissues are exposed to the source of the burn. The location of the burn can be critical as skin thickness, water and oil content, amount of subcutaneous fat and number of blood vessels varies from one location in the body to another. The diagnosis of the type of burn injury is based on how deep the injury is.
In the past, severity of burns were classified as First, Second, Third, or Fourth Degree depending on the depth of the injury. However, in recent decades, the names given to burn injuries of various depths have change. Injury to the epidermis (top layer of skin) is now called a superficial burn (previously called a first degree burn). Injury to the dermis (second layer of skin) is now called a partial thickness or dermal injury (previously called a second degree burn). An injury extending into the subcutaneous tissue (third layer of tissue, which includes fat) is now called a full thickness injury (previously called a third degree burn). In addition, burns that damage muscles under the subcutaneous skin layer are described as full thickness burns with injury to the muscle (sometimes previously called fourth degree burns).
Superficial Burn Injuries are limited to redness involving the epidermis, such as sunburns. These burns give minimal tissue damage, but cause skin pain and swelling. Severe sun burns can cause second-degree burns.
Partial Thickness Burn Injuries cause skin-blisters and, depending on nerve involvement, can involve more or less pain than first-degree burns. These burns affect both the epidermis and the dermis and can often affect sweat glands and hair follicles.
Full Thickness Burn Injuries are the most extreme. They occur when the epidermis is fully burned through by external heat which also affects the dermis and hypodermis. Full thickness burn areas are usually numb but the surrounding partial thickness and superficially burned tissues usually cause severe pain.
How the size of a burn is determined
Physicians have developed various systems to estimate the percentage of the total body surface area (TBSA) that has been burned. One of the oldest systems in use is known as the Rule of Nines. Essentially, the Rule of Nines utilizes rough approximations that a patient’s arm comprises 9% of the body’s total skin, the head 9%, each leg 18% (two 9’s), the front of the torso 18%, the back of the torso 18%, and the neck 1%.
If partial thickness or full thickness burns comprise thirty percent, or more, of an adult total body surface area, skin grafts are usually performed in stages because the patient does not have sufficient healthy skin to graft the burned area in a single surgery.
There are more than one hundred different types of toxins in fire smoke. Inhalation injuries increase the probability of death when combined with burn injuries.
Heat Inhalation occurs when a person breathes directly from a flame/hot air source. The trachea usually shields thermal loads away from the lung, but the upper airways can be severely injured. The inhalation of steam has a greater thermal capacity than dry air which can cause secondary airway involvement to occur. The upper airway acts to cool whatever is inhaled but damage to the mucous membranes may occur when hot air enters through the nose.
Systemic Toxin prevent the intake of oxygen and can cause a person to become unconscious or disorientated in an enclosed fire. Permanent damage can occur in organs such as the brain. Carbon Monoxide poisoning can appear symptomless until the victim falls into a coma.
Smoke Inhalation is attributed to 60% to 80% of fatalities resulting from burn injury incidents. Initially, many patients appear unharmed, but can later collapse from severe internal damage.
Defective products and property that is poorly maintained are common causes of burn injuries. Automobile accidents, also, cause many severe burn injuries. Many victims spend many years rehabilitating physically and emotionally from severe burn injuries and are unable to work because of resulting disability. Costs for reconstructive surgeries and other forms of medical treatment are very expensive–many times in the millions of dollars. Berglund & Johnson is very experienced in the handling of burn injury cases and providing settlement packages that will help cope with the myriad of challenges a burn victim will face. Call Berglund & Johnson at 1-800-4-IF-HURT to discuss how we can help you receive full compensation for the injuries that you have suffered.