Types of Burns

Burns are classified by degree:

• First degree--Involving only the epithelium (top layer of skin).
• Second degree--Involving the epithelium and some of the dermal layer, a second degree burn is deeper than the first. A deep second degree burn extends through the dermis and affects some of the soft tissues below the skin.
• Third degree--Extending through the skin and nerves and including vascular tissue.
• Fourth degree--Generally including bones. With a burn of this degree there is a poor prognosis for the body part involved.

Fourth degree burns that include a section of a limb can lead to a life-threatening condition, called compartment syndrome, that threatens the viability of the limb. In this case, surgeons may have to perform a fasciotomy or an escharotomy (eschar is another name for dead tissue) to relieve the pressure in the wound area. Untreated, this could lead to amputation or gas gangrene and death. An immunological and inflammatory response called the complement cascade is triggered. The cascade also causes increased fibrinolysis (tissue damage) and blood clots can form. A person at this stage may be very prone to develop deep vein thromboses and pulmonary emboli.

How burns affect the body

_{Information courtesy of Ann Burkhardt, OTR/L,
a fellow of the American Occupational Therapy Association}