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Injuries

St. Louis Burn Injury Lawyer

Severe Burn Injury

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.

First-Degree Burns

By definition, a first-degree burn involves only the top layer of skin, the epidermis. The most common causes are too much sun exposure, exposure to hot metal or other hot object, and fire. The injury is the result of direct skin contact with high temperatures or tissue injury from the sun’s UV light radiation.

A first-degree is painful but the onset of pain is either instant, in the setting of direct skin contact, or gradual with UV light radiation. The skin will be red and may or may not have blisters form. Some individuals may also notice that the skin feels tight.

Treatment for these injuries is for symptoms only. This can include running cool water over the burned area or using cool wet cloths to cool the skin; also helpful is an over-the-counter burn ointment or other soothing agent such as aloe lotion or gel. However, even without any treatment, a first-degree burn will heal in approximately 1 week without any scarring.

Prognosis

Individuals who experience first-degree burns can recover without many complications. As the skin heals, it may feel tight for a couple days and sun/heat exposure should be limited during this time period.

Second-Degree Burns

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.

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.

Third-Degree Burns

A third-degree burn is often called a full thickness burn because it involves the entire thickness of skin, extending from the epidermis through the dermis and into the underlying layers of fat and other structural tissue. It occurs from direct contact with high temperatures commonly caused by fires, explosions, hot oil, and steam. The explosions usually involve gasoline, such as with a motor vehicle accident or lawnmower, and can be the most extensive involving greater than half of the body’s surface area.

A third-degree burn is by itself painless; however, the skin surrounding the third-degree burn will typically sustain superficial and deep partial thickness burns (also known collectively as a second-degree burn), with the superficial partial thickness burns being excruciatingly painful. Third-degree burns appear charred and white or light yellow in color with a leathery appearance.

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, and protecting the wound. With a third-degree burn, the entire layer of skin is lost and is no longer able to protect the body from bacteria or viruses, help maintain the body’s temperature, or trap water inside the body – ultimately leaving the body very vulnerable to infection, hyperthermia, or dehydration. Therefore, treatment of these individuals may also include antibiotics, keeping the room temperature as close to 98° F as possible, and even more IV fluids.

Once the pain is adequately controlled, typically with Morphine or Fentanyl, the burn wound is cleaned vigorously with antiseptic soap and water. Surgical removal of the dead and charred skin is done as soon as the individual is stable. It may take multiple surgeries to remove all of the dead skin, at which point surgery to repair the skin and do any skin grafting may finally take place. 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.

If an individual has a burn that wraps completely around an arm or leg, there is a chance that the blood flow to the distal part of the limb may be compromised, such that no pulses can be felt.

This is a serious complication that can quickly result in amputation of the limb unless the blood flow is rapidly restored. Blood flow may be restored by surgically removing the dead and damaged skin of the burn to allow the tissue to swell without being constricted. The area is covered but left open until the swelling decreases.

Prognosis

With a third-degree burn, the prognosis largely depends on the amount of surface area burned. In general, even those with 70% of their body surface area burned have a 50% chance of survival. However, these injuries do not heal on their own because all elements of the skin have been destroyed. With surgical repair and skin grafting, there is the possibility of new skin growth over time but the individual will be left with significant scarring. During the healing process, there is a high risk of infection which can quickly lead to a blood infection, or sepsis, and death if not treated quickly; thus, individuals with third-degree burns are watched closely in the hospital for long extended periods of time. Once healed, physical therapy is typically needed for a few months to regain function and strength.

Experience You Can Trust

Suffering from a burn injury is a traumatic experience. As you recover from these injuries, dealing with skin grafts and surgeries will take a toll on you emotionally, physically and financially. Our compassionate Missouri injury lawyers can help hold negligent parties responsible so that you can obtain the compensation that you deserve. For a free consultation, call (314) 322-8515 today for superior legal representation.

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