Burns and scalds

Burns are thermal injuries in which a portion of the body surface is exposed to dry heat of sufficiently high temperature to cause local and systemic reactions. Scalds occur with wet heat. Burns may also be caused by medical and chemical substances, mechanical friction, electricity and ionizing radiations.

The severity of a cutaneous burn wound depends not only upon the depth of the burn but also upon the extent of the body surface area affected, which determines the loss of fluids and heat and therefore the impact on the major physiological systems of the body.

Burns which only injure the epidermis, such as mild sunburn, are known as first degree burns. They result in temporary erythema (redness), due to dilation of the capillaries, and oedema (swelling). Burns which extend into the living layer of the skin, the dermis, are much more serious. It is common to distinguish between second degree, or partial thickness, burns, and third degree, or full thickness, burns. Second degree burns are those in which necrosis extends into the dermis, but with the survival of a sufficient foundation of such skin appendages as sweat glands and hair follicles to ensure that the skin regenerates without having to heal from the edges of the wounds. Third degree, or full thickness, burns are those in which all the dermis is destroyed. In addition there may be destruction of the underlying fat, muscle, bone and other tissues. The terms fourth and fifth degree burns are sometimes used to describe such injuries.

Every month hundreds of persons in the world die from burns and thousands are crippled and disfigured. The cost of care for burn patients is very high. As an indication, the market for bite and burn remedies in the UK in 1986 was £2 million.