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types of burns

Classification of Burns

A. According to burn depth

1. First-degree burn

Damage epidermis (skin surface).

For example; sun burn (pink or reddish color on burned skin and very sensitive to touch, skin is dry without blister).


2. Second degree burn

Affect both epidermis and dermis layer causing redness, pain, swelling and blister. Affect sweat glands and hair follicles. Break open area wet looking with bright pink or cherry red colour.

3. Third degree burn

Affect epidermis, dermis, subcutaneous layer, deep scar, skin surface waxy white. Both epidermis and dermis distroy and other organ, tissues, muscles, bones may involved. No pain or feel numb due to nerve damage.

4. Fourth degree burn

Deep injury damage muscle, bone and tendon. Burn occurs with deep flame, electrical and thermal injuries, nerve ending are destroyed.


B. According to burn severity

1. Minor burn

All first degree burns/second degree burns. Involve less than 10% of body surface.


2. Moderate burn

Burn involve hands, feet, face or genitals. Second degree burns involve more than 10% of body surface area.


3. Severe burn

Burn surface involvement of 25% body surface area. All third degree burn, deep burns of haad, hands, feet, perineum, inhalation injury, chemical or high-voltage electrical burn. 

3. According to extent of body surface area injured (TBSA; total body surface area)

1. The Rule of Nine

Adult total; 100%

Head 9%; Front (4.5%) and  back (4.5%)

Chest; 18%

Back; 18%

Right arm; 9%

Left arm; 9%

Perineum; 1%

Right leg; 18%

Left leg; 18%


Child total ; 100%

Head; 18% - front 9% and back 9%

Chest; 18%

Back; 18 %

Right arm; 9%

Left arm; 9%

Perineum; 1%

Right leg; 13.5%

Left leg; 13.5%


2. Palm method

Estimation of small burns

Patient's palm including fingers is equal to 1% of their total body surface area (TBSA).


3. Jackson's burn model

1. Zone of coagulation

Nearest heat source is primary injury.

2. Zone of stasis

Inflammation occurs and vascularity impaired.

3. Zone of hyperaemia

Increase blood flow in vessel to supply tissue, intense vasodilation.


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