Fire-Related Injuries
About Burns
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
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