CHAPTER 10 Integumentary System^401
Just the Facts
Burns
WHAT WENT WRONG?
Burns are damage to the skin and body tissues caused by flames, heat, cold, fric-
tion, radiation (sunburn), chemicals, or electricity. Burns are generally divided into
three categories, depending on the damage. First-degree burns are those with
injury to the outer layer of skin called the epidermis. They will be red, and painful,
with some swelling. A second-degree burn is when the epidermis is burned, as well
as the next layer, the dermis. Severe pain, white and reddened areas, swelling, blis-
ters, and perhaps drainage will be seen. A third-degree burn goes through all the
layers of the skin and could involve underlying tissues. It is often painless due to
destruction of the nerves in the area. The area will look black (termed eschar)
and/or reddened. Many drugs may make the skin more sensitive to the sun, pro-
ducing the effect of a sunburn with little exposure. Common medications with this
effect include: amiodorone, carbamazepine, furosemide, naproxen, oral contra-
ceptives, piroxicam, quinidine, quinolones, sulfonamides, sulfonulureas, tetracy-
clines, and thiazides, among others.
PROGNOSIS
Prognosis depends on the severity of the burn plus the amount of surface area
involved. When large portions of the face, chest, hands, feet, genitalia, or joints
have sustained a large second- or third-degree burn, prompt medical attention is
necessary. Serious burns can lead to death. If smoke inhalation has occurred, or if
the nasal hairs are singed, or if quantities of soot are present around the face, assess
for adequacy of breathing and damage to the respiratory tract. CPR may need to be
started. Infants and elderly patients with burns require prompt medical attention.
HALLMARK SIGNS AND SYMPTOMS
- Redness, no break in skin—indicates a first-degree burn from damage to the
epidermis - Deeper red, with clear fluid blisters—indicates a second-degree burn as the
epidermis and dermis are burned
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