Most of the wounds we see in the Grand View Wound Care Center are chronic and non-healing. A burn is an acute wound caused by exposure to thermal extremes, electricity, caustic chemicals, or radiation.
- Thermal: Most common and results from misuse or mishandling of fire or a combustible product, like matches, kitchen accidents, or physical abuse. Exposure to extreme cold can also cause thermal burns.
- Chemical: May come from acid or alkali, usually deep burns.
- Electrical: These burns result from contact with flowing electrical current. Either low voltage around a house or high voltage at work
- Radiation: The most common radiation burn is sunburn. Other burns due to radiation exposure are the result of radiation treatment or in industries that use or process radioactive materials.
Initial Assessment:
Determining extent of injury: Burn size is expressed as a percentage of total body surface area (i.e. the rule of nines); burn depth is concerned with the extent of tissue damaged. A partial thickness burn damages the epidermis (superficial partial-thickness or first degree) and part of the dermis (deep partial-thickness or second degree); a full-thickness burn involves the epidermis, dermis and subcutaneous tissue (full-thickness or third degree). Third degree burns usually require surgical intervention for wound healing.
Factors that affect healing:
- Burn location: burns on the face, hands, feet, and genitals are most serious due to the possible loss of function
- Burn configuration: edema due to a circumferential burn can slow or stop circulation to the extremity; burns on the neck can obstruct the airway; burns to the chest can interfere with normal respiration by inhibiting expansion
- Preexisting medical conditions: note disorders that impair peripheral circulation, especially diabetes, PVD, and chronic alcohol abuse
- Other injuries sustained at the time of the burn
- Patient age: patients younger than age 4 or older than age 60 are at a higher risk for complications and experience a higher mortality rate
- Pulmonary injury: inhaling smoke or super-heated air damages lung tissue
