Treatment of 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.
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.
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.
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.