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BURN MANAGEMENT

  • Overview
  • Treatment of Partial Thickness

Treatment of Partial Thickness

Burn Management
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Partial Thickness

There are several categories of partial thickness or second degree burn typically used to characterize the depth of injury which corresponds with healing time, treatment modalities and outcome. 

  • Superficial Partial Thickness
  • Mid Dermal Partial Thickness
  • Indeterminate Partial Thickness
  • Deep Dermal Partial Thickness
  • It is important to recognize that a burn injury is commonly a mixed wound depth.

Superficial Partial Thickness

Burn Management Treatment Of Partial Thickness Superficial Partial Thickness

Involves entire epidermis to basement membrane and no more than the upper third of dermis. Rapid re-epithelialization occurs in 1-2 weeks. Because of a large number of remaining epidermis cells and good blood supply there is a very small zone of injury or stasis beneath the burn eschar.

Mid-Dermal Partial Thickness

Burn Management Treatment Of Partial Thickness Mid-Dermal Partial Thickness

Destruction of the epidermis occurs to the basement membrane plus the middle third of dermis. Re-epithelization is much slower (2-4 weeks) due to fewer remaining epidermal cells and less blood. More collagen deposition will occur especially if not closed by three weeks. The depth of wound has a significant risk of conversion. The zone of stasis is much larger than in the superficial partial thickness injury because of less blood flow and more initial injury to the remaining epidermal cells.

Indeterminate Partial Thickness

Burn Management Treatment Of Partial Thickness Indeterminate Partial Thickness

Deep-Dermal Partial Thickness

Burn Management Treatment Of Partial Thickness Deep-Dermal Partial Thickness

Involves the entire epidermis and at least two thirds of the dermis leaving very little dermis and epidermal cells to regenerate. Spontaneous healing is very slow, over four weeks. Sharp debridement is needed to remove eschar. Scarring is usually severe if not skin grafted and there is a high risk of infection. Inflammation induced i.e., conversion to a full thickness burn is common. Function of a re-epithelialized deep partial thickness burn is poor due to fragility of the epidermis and the rigidity of the scar laden dermis.

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