Types of burns and assessment of severity for appropriate treatment PTP

No matter the cause or severity of a burn wound, knowing the cause and type of burn, as well as the factors that lead to the wound, will help us understand and provide appropriate care. This helps reduce the risk of complications and leads to better recovery.
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<h2>What is a burn wound?</h2>
Burn Injury is an injury that occurs when the skin or tissue is damaged by heat, cold, electricity, chemicals, radiation, or sunlight.
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<h2>Types of burns, common causes, and mechanisms of injury</h2>
Burns can result from various causes, with the damage to the skin and tissue differing according to the type and mechanism of injury as follows:
<ul>
<li>Thermal Burn occurs from direct contact with a heat source in two forms:</li>
<li>Dry Heat usually caused by flames or sparks, where heat destroys proteins in cells causing damage to the skin cells and underlying tissue. If the heat is very high, it may damage muscles or bones deeply.</li>
<li>Moist Heat caused by hot liquids such as hot water, steam, or hot oil through immersion, flooding, pouring, or spilling. Heat from liquids often spreads in a circular pattern, causing burns that are wider and deeper, especially if the hot liquid remains on the skin for a long time.</li>
<li>Electrical Burn usually caused by electric shock or electrocution. The entry point of the electric current on the body may show small burns or marks on the skin, which may not be severely damaged, but the current starts damaging internal tissues from this point. The exit point of the current usually suffers more damage than the entry point. Due to the very high heat and rapid entry into the body, internal tissues, nerves, and blood vessels can be severely damaged.</li>
<li>Chemical Burn occurs from contact with chemicals such as acids, alkalis, or other corrosive substances that destroy tissue. Acidic chemicals cause tissue to harden, while alkaline chemicals dissolve proteins and fats in cells, potentially allowing the chemicals to penetrate deeper into the tissue.</li>
<li>Radiation Burn usually caused by high-energy radiation such as from nuclear accidents or radiation used in cancer treatment. This can directly damage the DNA of skin cells, causing inflammation and cell death, resulting in loss of normal skin function and possibly blistering, peeling, or chronic wounds.</li>
<li>Sunburn caused by exposure to ultraviolet (UV) radiation, especially UVB and UVA, which damage the DNA of outer skin cells, triggering inflammation. This results in redness, pain, heat, and possible peeling later. Generally, sunburn heals within a few days, while radiation burns may take longer to recover and can have long-term effects on tissue.</li>
</ul>
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<h2>Characteristics of burns at different levels</h2>
Burns can be classified into different levels based on the depth and severity of tissue damage, including internal organs, as follows:
<ul>
<li>First Degree Burn involves damage only to the epidermis. The skin appears red without blisters and heals on its own within 7 days without scarring.</li>
<li>Second Degree Burn is divided into two types:
<ul>
<li>Superficial with clear blisters, damaging the epidermis and part of the dermis. Heals within 2-3 weeks without scarring.</li>
<li>Deep with more extensive dermal damage, which may result in scarring after healing.</li>
</ul>
</li>
<li>Third Degree Burn destroys all layers of the skin, including fat and nerves, causing the patient to feel no pain. The skin may appear white, pale, or darkened. Treatment requires skin graft surgery.</li>
<li>Fourth Degree Burn involves damage deep into muscles, tendons, or bones. Treatment requires surgery and may involve amputation of severely damaged parts.</li>
</ul>
<h2>Differences between thermal burns and chemical burns</h2>
<table>
<tbody>
<tr>
<td>Type of Burn</td>
<td>Thermal Burn</td>
<td>Chemical Burn</td>
</tr>
<tr>
<td>Cause</td>
<td>Flames, hot water, hot liquids, sunlight</td>
<td>Hazardous chemicals such as acids or alkalis</td>
</tr>
<tr>
<td>Destruction process</td>
<td>Heat directly destroys tissue, with damage depth depending on temperature and exposure time</td>
<td>Penetrates tissue through the skin layers, rapidly and severely damaging deep tissue</td>
</tr>
<tr>
<td>Complications</td>
<td>Infection, scarring, swelling which may delay healing</td>
<td>May cause deep tissue destruction, severe scarring, and if chemicals are absorbed, internal organ damage</td>
</tr>
<tr>
<td>Initial treatment</td>
<td>Cool the burn and cover with a clean cloth</td>
<td>Rinse with clean water to dilute chemicals and immediately remove contaminated clothing</td>
</tr>
<tr>
<td>Healing time</td>
<td>Depends on the burn severity</td>
<td>May take longer due to deep tissue damage</td>
</tr>
</tbody>
</table>
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<h2>Factors affecting the severity of burns</h2>
<ul>
<li>Temperature and duration of exposure Longer exposure or higher temperature causes deeper and wider burns.</li>
<li>Heat source such as flames, hot water, electricity, chemicals, or radiation cause varying severity.</li>
<li>Location Burns on critical areas like the face, hands or wrists, feet or ankles are more severe even if the burn area is not large.</li>
<li>Body surface area affected Burns covering more than 10-20% of the body are considered severe and require close medical care.</li>
<li>Age Children and elderly have higher risk of complications due to weaker immune systems compared to young adults.</li>
<li>First aid Proper first aid reduces severity and risk of complications better.</li>
</ul>
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Additionally, the environment and circumstances causing the burn, the patient’s pre-existing health, and prompt, appropriate initial medical treatment help reduce the long-term severity of the burn.
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Burns are serious injuries. Without timely and proper care, they can cause complications that negatively affect long-term health, especially in severe burns or chemical burns. Phyathai Phaholyothin Hospital has a specialized surgical and wound care center with expert physicians, modern technology, and appropriate treatment methods for all burn stages, including rehabilitation and reducing the risk of complications, ensuring safety and restoring quality of life.
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Dr. Kamthorn Wijitkamthorn 
Surgeon, Surgical Center 
Phyathai Phaholyothin Hospital

Burn Injury is an injury caused by heat, cold, chemicals, or other factors. Learn about the types and degrees of burns, along with factors affecting the severity of the injury, for appropriate treatment and to reduce the risk of long-term complications.

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Types of Burns and Severity Assessment for Appropriate Treatment

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