The Skin and Burns

The skin is a waterproof cover designed to protect the body’s cells from damage, drying out, infection and temperature changes.

The Epidermis Layer

• This is the outermost layer of the skin and is especially thick on the palms of the hands and the soles of the feet
• There are no blood vessels in the epidermis but its deepest layer is supplied with lymph fluid

Dermis or Corium Layer

The dermis is a tough, elastic layer containing white fibrous tissue interlaced with yellow elastic fibres

Many structures are embedded in the dermis including:

• Blood vessels
• Lymphatic capillaries and vessels
• Sensory nerve endings
• Sweat glands and their ducts
• Sebaceous glands
• Hair follicles, hair bulbs and hair roots

Hypodermis or Subcutaneous Skin Layer

• This is the deepest skin layer. It connects or binds the dermis above it to the underlying organs
• This layer is mainly composed of loose fibrous connective tissue and fat (adipose) cells interlaced with blood vessels
• Females have a hypodermis that is generally about 8% thicker than males
• The functions of the hypodermis include storing lipids, insulation, cushioning the body and temperature regulation

Burns

Burns is body tissue injuries caused by contact with dry and/or wet heat. When a burn occurs, the heat destroys the epidermis (top layer of skin). If the burn progresses, the dermis (second layer) is injured or destroyed. Burns breaks the skin and can cause infection, fluid loss and loss of temperature control. Deep burns can damage muscle, tissue and bone.

Burns are classified by the source, such as heat, cold, chemical, electricity, or radiation. They are also classified by depth. Due to the increased risk of infection with burns, you should attempt not to touch it with your hands or apply lotions or creams.

The three classifications of superficial burns, partial thickness burns and full thickness burns will help you determine emergency care.

Superficial Burn

• The least serious burns are those in which only the outer layer of skin (epidermis) is burned. The skin is usually red, with swelling and pain sometimes present
• The inner layer of skin hasn’t been affected
• Treat a superficial burn as a minor burn unless it involves substantial portions of the hands, feet, face, groin, buttocks, or a major joint

Partial Thickness Burn

• When the first layer of skin has been burned through and the second layer of skin (dermis) is also affected, the injury is termed a partial thickness burn
• Blisters develop and the skin takes on an intensely reddened, splotchy appearance
• Partial thickness burns produce severe pain and swellingIf the partial thickness burn is no larger than 2 to 3 inches in diameter, treat it as a minor burn

Full Thickness Burns

• The most serious burns are painless and involve all layers of the skin
• Fat, muscle and even bone may be affected
• Areas may be charred black or appear dry and white
• Difficulty inhaling and exhaling, carbon monoxide poisoning or other toxic effects may occur if smoke inhalation accompanies the burn

Treatment for a Burn (Heat, Thermal or Contact):

• Always monitor a burn victim for signs and symptoms of shock, seek emergency assistance
• Immediately cool burns with cool running water for 20 minutes
• If possible, without causing further tissue damage, remove all rings, watches, jewellery or other constricting items from the affected area
• Remove wet, clothing soaked with hot liquids if non-adherent
• Cover the burnt area with a sterile, non-stick dressing
• Prevent the casualty from the risk of hypothermia by covering unburnt areas

Note:

The objective of first aid treatment of burns should be to stop the burning process, cool the burn and cover the burn. This will provide pain relief and minimize tissue loss.

• Do not use ice or iced water to cool burns – these may cause further injury
• Do not break blisters
• Do not apply ointments, creams or powders other than hydrogel
• Do not peel off clothing or burning materials that is stuck to the casualty
• Where possible elevate burnt limbs to minimise swelling

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