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Second-Degree Burns

Skin is divided into two basic layers – the epidermis, or top protective layer and the dermis, or bottom layer which functions to regulate temperature and carry out other important functions; the dermis can be further subdivided into the papillary layer (upper) and the reticular layer (lower).

The papillary dermis is where the small blood vessels end and it functions to provide nutrients to the epidermis, whereas the reticular layer contains many structural components. The skin varies in thickness depending on location, with the thickest skin found on the palms and soles of the feet and thinnest on the face; thus, different areas of the body will have different degrees of injury even though they were exposed to the same temperature for the same amount of time.

A second-degree burn extends from the epidermis into the dermis and is further subdivided based on the thickness of dermis involved – superficial partial thickness or deep partial thickness, as demonstrated in the pictures. With a superficial partial thickness burn, the damage extends to the papillary layer and is most often caused by hot water scalding the skin.

Other frequent causes can include contact with other hot objects and fire or small explosions that can occur during an auto accident or other major trauma. The deep partial thickness burns extend into the reticular layer of the dermis where many structural components are injured, as well as damage to hair follicles and sweat glands. They are frequently the result of direct contact with extreme temperatures such as that seen with hot liquids, steam, grease, or fire.

Symptoms and Treatment

A superficial partial thickness burn is extremely painful to the touch and the skin appears red with extensive blistering. When the skin is touched however, it will briefly lose its’ red color and turn white momentarily indicating that the blood flow to the burned skin has not been impaired. In contrast, a deep partial thickness burn will not cause any pain because the nerve endings are dead. The skin, or exposed dermis, will be white or light yellow in appearance and will not lose any color when touched signifying the loss of blood flow to the injured area.

General treatment for a burn wound includes removing the individual from the burning process (fire, steam, etc), providing oxygen (as well as placing a tube down your throat to help you breath if the face has been burned), giving copious IV fluids, relieving pain with pain medication as needed, and protecting the wound. Of these measures, the IV fluids are the most important because the skin, which normally functions to trap water in the body, has been damaged and the greater the surface area injured, the more water that will be lost.

Once the pain is adequately controlled, typically with Morphine or Fentanyl, the burn wound is cleaned with antiseptic soap and water. The blisters will be drained and the overlying skin will be removed, as well as any other dead skin. An antimicrobial cream, most often Silver Sulfadiazine (Bacitracin or Neosporin if an individual is allergic), and clean gauze dressings are usually applied to the wound 1 to 2 times each day until the burn is healed.

Prognosis

A superficial partial thickness burn will typically heal in 2 to 3 weeks with minimal scarring and full return of function. The deep partial thickness burns however can take anywhere from 3 weeks to 2 months to heal and usually have significant scarring present. The individual may not have full return of function and could require surgery to remove any dead tissue and/or do a skin graft in order to regain the maximum function possible.

Take Legal Action Today

If you or a loved one has suffered serious burn injuries in an accident caused by a negligent party, Page Law is ready to offer quality legal advocacy. Our St. Louis burn injury lawyers are dedicated to providing personal attention to every client. Call (314) 322-8515 for a free, no obligation consultation.

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