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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