Superficial partial-thickness burn
Depth of injury · Epidermis + papillary dermis Heals under 3 weeks No graft
Destroys the epidermis and papillary dermis but leaves the deeper dermis and the whole adnexal reservoir intact, so the surface is resurfaced from surviving follicular, sebaceous and sweat gland epithelium as well as from the wound margin.
Traced from the start
Detail
- Depth destroyed
- Epidermis and papillary dermis; the reticular dermis and all appendages survive
- Clinical signs
- Blisters, brisk capillary refill and severe pain, because the dermal nerve endings are intact
- Healing
- Re-epithelialises in about 7-14 days from adnexal epithelium and wound edges, with no scarring and at most pigment change
- Epidermal (superficial) burn
- A sunburn-type injury involving epidermis only: painful, no blister, heals in 3-7 days, and is excluded from the percentage total body surface area used for fluid calculation
- Fluids
- Partial and full-thickness burns above 20% TBSA in an adult (10% in a child) need formal resuscitation: 3-4 mL/kg per %TBSA of Hartmann's over 24 hours from the time of the burn, half in the first 8 hours, titrated to a urine output of 0.5-1 mL/kg/h
When it goes wrong
Scald or brief flash burn reaching the papillary dermis
Cool with running water for 20 minutes (effective up to 3 hours after injury), avoid ice, cover with cling film; the wound heals without grafting
Wound infection or hypoperfusion in the first 48 hours
The zone of stasis converts, and a superficial partial-thickness burn deepens to a deep dermal burn that will now scar
Practise this structure
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