Management of Third-Degree Burns

Third-degree burns are a type of full-thickness burn that damages both the epidermis and dermis. They can occur due to direct skin exposure to heat, steam, radiation, or caustic chemicals for an extended period. The treatment depends on the patient's symptoms, age, and general health, and may involve wound debridement, breathing and blood circulation support, administration of electrolytes and antibiotics, and tetanus vaccine. Prevention is key, as third-degree burns can be prevented by taking safety precautions in risky environments, such as installing smoke alarms and practicing fire escape routes.

Running head: THIRD DEGREE BURN 1
THIRD DEGREE BURN
Name
Institution

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Table of Contents
Abstract......................................................................................................................................3
Third Degree Burn.....................................................................................................................4
Background................................................................................................................................4
Cause..........................................................................................................................................4
Symptoms...................................................................................................................................5
Method of diagnosis...................................................................................................................5
Effects........................................................................................................................................5
Treatment...................................................................................................................................6
Prevention..................................................................................................................................7
Recommendations......................................................................................................................8
Conclusion..................................................................................................................................8
References..................................................................................................................................9

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Abstract
Third degree burns are considered as one of the extreme levels of burns. The definition of
‘third degree burns’ often varies, with one group claiming the involvement of the epidermis
and dermis only whereas another faction claims of the inclusion of both the dermis,
hyperdermis and the hypodermis. However, the explanation that’s commonly accepted is the
one on the inclusion of the first two skin layers. This basically forms the background into the
topic. The symptoms and effects of third degree burns are well-explained and so is the
treatment procedure which is extensive.

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Third Degree Burn
Background
A burn is a damage to body tissues which results from contact with elements such as
heat, chemical or radiation. Third-degree burns are a type of burn damage that affects both
the epidermis and the dermis i.e. both the outer and inner layer respectively. Third-degree
burns are also referred to as full thickness burns. The classification of burns can be traced
back to the 18th century by two German surgeons. The description of third degree burns at
that time was a burn damage to both the skin and the underlying flesh, with a formation of a
crust (Lee, Joory, & Moiemen, 2014). Later in the 19th century, burns were classified into six
degrees with the third-degree burns classified as burns resulting in the destruction of both the
“papillary layer and the subpapillary network of the corium”. This classification done by
Dupuytren is the one that’s still in use up to date (Mieny & Mennen, 2003). however, most of
the literature works prefer a simpler classification which classifies burns into three degrees.
This classification can be attributed to the works of a French surgeon by the name Boyer in
the 18th century. According to Boyer, a third-degree burn is a burn that leads to “tissue
disorganisation leading to a dry yellow crust” (Lee, Joory, & Moiemen, 2014). Regardless,
the most acceptable description being the type of burns that destroys both the epidermis and
dermis.
Cause
Third-degree burns in most cases result from direct skin exposure to heat for an extended
period of time. This includes contact with hot objects such as iron or a skillet. Additionally,
exposure to flames from a fire for a long time can also cause full-thickness burns. A third-

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degree burn may also be caused by hot water or steam, caustic chemicals (such as acids),
radiation exposure, friction and exposure to an electrical source (Borke, 2016).
Symptoms
An area of the skin that has suffered a third-degree burn, the skin generally appears either
black, white, charred, brown or leathery in appearance. The wound is often surrounded by
dry, black necrotic tissue. Owing to the fact that most nerve endings in the dermis are
destroyed alongside it, full-thickness burns are typically painless (Singer, Taira, & Lee,
2014). Regardless, since these wounds are surrounded by wounds of different thicknesses, the
areas surrounding these wounds are often painful.
Method of diagnosis
A third-degree burn can be diagnosed depending on the patient’ symptoms and general health
history. Through a physical exam, a patient can be diagnosed based on the signs and
symptoms, and recent exposure to anything that can cause burns (i.e. anything hot, or a
chemical, or any of the above-mentioned agents.
Effects
Third-degree burns are often difficult to treat and also runs the risk of disability upon
recovery. The following are the most prevalent effects of full-thickness burns:
Infections: Third degree burns interfere with the integrity of the skin hence hampering its
capacity to perform the full function of serving as a barrier against external infections. Third-
degree burn sites create hard avascular eschar forms that provide an environment that’s

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attractive to microbial growth. In addition, antibodies and antibiotics cannot pass past the
thick eschar
Hypovolemia and hypothermic shock – With third-degree burns, the capacity of the skin to
perform the functions of regulation of fluid loss and the regulation of body heat. When third-
degree burns occur over a large area, there is the risk of hypovolemia, alongside hypothermia
which significantly increases the mortality rates in persons with severe trauma.
Tetanus: There is an elevated risk for tetanus for burn sites. Patients suffering from third-
degree burns and who haven’t been immunised in the past five years, are often at increased
risk of developing tetanus, hence requiring a booster shot.
Treatment
Treatment depends on the patient's symptoms, age, and general health. It also depends on the
severity of the condition. typically, treatment is done in a hospital unit specialised in burns.
The three primary goals in the treatment of any burns are prevention of shock, relieve pain
and discomfort, and the reduction of risk of infection (Kestrel Health Information, 2017).
Treatment for full-thickness burns depends on the severity of the burn. The severity of a burn
is determined by three major factors: the location of the burn, the amount of body surface
affected and the depth of the burn (Adler & Brown, 2017).
The treatment may include immediate care in the emergency department, precisely the
hospital burn unit. The care provided may include wound debridement to remove the dead
tissue and foreign materials, breathing and blood circulation support, intravenous
administration of electrolytes and antibiotics (can also be administered orally), administration
of antibacterial cream, bandaging, administration of nutritional supplements and a diet rich in

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protein, administration of anti-itch and pain medications, and the tetanus vaccine (Cecil,
Goldman, & Schafer, 2012)
Such wounds heal slowly. Often after it heals, surgery may be needed in order to facilitate
movement of the limb and also to remove and repair the tissue that was scarred. Often, skin
grafting may be required to cover or close the burnt area. Skin grafting involves removal of
an unburnt healthy skin from another part of the body to cover the affected part. When an
individual covers third-degree burns over a large percentage of the body, there are options of
either using cadaver skin or using healthy skin as a skin graft (Lozano, 2017).
Prevention
Third-degree burns can be prevented by undertaking the appropriate precautions. Full-
thickness burns often results from accidents. Therefore, it is necessary to take safety
precautions whenever working in risky environments. This may include performing jobs in
environments with electricity, and inflammable substances. These environments are
precursors for accidents that may cause third-degree burns.
To minimise the general risk of burns, individuals should take precautions such as installing
smoke alarms in homes and at workplaces, learning about fire safety and emergency first aid,
making the home environment risky free especially for children, installation of fire-fighting
equipment at homes and workplaces, and knowing about and practicing fire escape routes at
homes, schools and workplaces.

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Recommendations
For the prevention of burns, it is recommended to work in risky-free environments at all
times. Always minimise the risk of exposure and take precautionary measures.
Conclusion
Third-degree burns are a type of burns which damage both the epidermis and the dermis.
They are also referred to as full thickness burns. Third-degree burns in most cases result from
direct skin exposure to heat, steam, radiations, or caustic chemical for an extended period of
time. Their diagnosis depends on the degree of damage and the general health of the patient.
Without proper management, there is an overall risk of disability, hypovolaemia,
hypothermia, tetanus and infections of the wounds.

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References
Adler, L., & Brown, K. (2017). Third-Degree Burn in Children. Retrieved from University of
Rochester Medical Center:
https://www.urmc.rochester.edu/encyclopedia/content.aspx?
ContentTypeID=90&ContentID=P01760
Borke, J. (2016, May 5). Burns. Retrieved from MedlinePlus:
https://medlineplus.gov/ency/article/000030.htm
Cecil, R. L., Goldman, L., & Schafer, A. I. (2012). Goldman's Cecil Medicine. Philadelphia:
Elsevier Health Sciences.
Kestrel Health Information. (2017). BUrns, Full-Thickness (Third- and Fourth -Degree).
Retrieved from Wound Source: http://www.woundsource.com/patientcondition/burns-
full-thickness-third-and-fourth-degree
Lee, K. C., Joory, K., & Moiemen, N. S. (2014). History of burns: The past, present and the
future. Burns & Trauma, 169-180.
Lozano, D. (2017). Third-Degree Burn: Treatment. Retrieved from Lehigh Valley Network:
https://www.lvhn.org/conditions_treatments/burn/third_degree_burn/
learn_about_third_degree_burn/treatment
Mieny, C., & Mennen, U. (2003). Principles of Surgical Patient Care. Pretoria: New Africa
Books (Pty) Ltd.

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Singer, A., Taira, B., & Lee, C. (2014). Thermal burns. In J. Marx, R. Hockberger, & R.
Walls, Rosen's Emergency Medicine: Concepts and Clinical Practic (p. Chapter 63).
Elsevier Saunders: Philadelphia, PA.