Show Summary Details
Page of

Pathophysiology and assessment of burns 

Pathophysiology and assessment of burns
Pathophysiology and assessment of burns

John A. M. Paro

and Geoffrey C. Gurtner

Page of

PRINTED FROM OXFORD MEDICINE ONLINE ( © Oxford University Press, 2022. All Rights Reserved. Under the terms of the licence agreement, an individual user may print out a PDF of a single chapter of a title in Oxford Medicine Online for personal use (for details see Privacy Policy and Legal Notice).

date: 16 May 2022

Burn injury represents a complex clinical entity with significant associated morbidity and remains the second leading cause of trauma-related death. An understanding of the local and systemic pathophysiology of burns has led to significant improvements in mortality. Thermal insult results in coagulative necrosis of the skin and the depth or degree of injury is classified according to the skin layers involved. First-degree burns involve only epidermis and heal quickly with no scar. Second-degree burns are further classified into superficial partial thickness or deep partial thickness depending on the level of dermal involvement. Damage in a third-degree burn extends to subcutaneous fat. There is a substantial hypermetabolic response to severe burn, resulting in significant catabolism and untoward effects on the immune, gastrointestinal, and renal systems. Accurate assessment of the extent of burn injury is critical for prognosis and initiation of resuscitation. Burn size, measured in total body surface area, can be quickly estimated using the rule of nines or palmar method. A more detailed sizing system is recommended once the patient has been triaged. Appropriate diagnosis of burn depth will be important for later management. First-degree burns are erythematous and painful, like a sunburn; third-degree burns are leathery and insensate. Differentiating between second-degree burn types remains difficult. There are a number of formalized criteria during assessment that should prompt transfer to a burn centre.

Access to the complete content on Oxford Medicine Online requires a subscription or purchase. Public users are able to search the site and view the abstracts for each book and chapter without a subscription.

Please subscribe or login to access full text content.

If you have purchased a print title that contains an access token, please see the token for information about how to register your code.

For questions on access or troubleshooting, please check our FAQs, and if you can't find the answer there, please contact us.