Burns

• Classification of Burns
• When Do I Need To See Plastic Surgery For My Burn?
• Burn Care
• Burn Care Supplies
• Skin Grafts

Classifications of Burns

• Superficial (1^st degree): affects only the outermost layer of skin called the epidermis.
  • Red, pain, dry with no blisters.
  • Heals within 5-10 days without scarring.
• Partial Thickness (2^nd degree): affects the epidermis and a lower layer of the skin called the dermis.
  • Red, painful, and with blisters, may have swelling.
  • Heals within 3 weeks with minimal scarring.
• Deep Partial Thickness: affects the deeper dermis.
  • Yellow or white, dry, minimal to no pain.
  • Heals within 3-8 weeks with scarring.
  • May require a skin graft depending on how it heals.
• Full Thickness (3^rd degree): affects all layers of skin including the epidermis, dermis, and deepest layer called the subcutaneous tissue.
  • White, black, or charred appearance.
  • Destroys all layers of dermis and epidermis, therefore has decreased sensation with little to no pain. Call affect deeper structures like muscle or bone.
  • Poor healing and causes contracture. Often requires a skin graft.

When Do I Need To See Plastic Surgery For My Burn?

How do you know what classification your child’s burn falls into?

It takes about 2 weeks to know the final classification of a deeper burn. Burns take time to “settle out”. It takes about 10 to 14 days of healing to know if a burn will require a skin graft. Therefore plastic surgery will want to see the burn 10 to 14 days after the injury. This will allow time for the burn to settle out and for us to know if your child will require a skin graft.

But what if the burn is on the palm of the hand or on my child’s face?

We still need that 10 to 14 days of the bodies healing process to know the final presentation of the burn and accurately assess the need for graft. Until then, proper burn care will give your child the best chance of healing well.

Burn Care

• Remove the original bandage within 24 hours. If the bandage feel stuck to the underlying burn, try wetting it with water before removal.
• Gently wash the burn with mild soap and water. Then pat dry.
• Smear antibiotic ointment onto a Xeroform petroleum gauze and then apply it over the burn. Place a nonstick gauze pad over the Xeroform. Then wrap with dry gauze over the nonstick pad/Xeroform to keep it in place. For extremities, wrap with an ace bandage to keep the dressing from slipping off.

Burn Care Supplies

• Bacitracin (antibiotic ointment)
• Xeroform (petroleum gauze)
• Gauze pad
• Rolled gauze/Kling wrap
• Ace bandage

Skin Grafts

There are 2 types of skin grafts: Split-thickness and full-thickness. Your plastic surgery provider will decide the appropriate graft for your child.

Skin graft donor sites can vary. Common sites include upper thighs, lower abdomen, and bend of the arm. For the face, a common donor site is behind the ear.

Postop skin graft care:

For the 1^st week after a graft, leave the dressings for both the donor site and graft in place and do not remove them. If the dressings become heavily soiled or really wet, call the office.

At your one week post op visit, we will check the postop sites and ensure they are healing properly. Donor site bandaging is left in place for 2 more weeks. Graft site bandaging is re-evaluated on a week by week basis in the office.

In the 1^st stages of healing the graft site will look thick and irritated, but this will calm down and smooth over with time. The donor site will heal like any normal abrasion.

If you have any concerns for infection or graft complication, call the office: 865-824-4939