Classification of burns depends on the depth and amount of bodily damage. Third degree burns involve all layers of the skin as well as muscles, tissue and possibly organs. Third degree burns do not cause pain to the site because nerve damage is present; however, the skin around the area may be painful, according to the Merck Manual. Chemicals, electricity, heat flames and contact with hot objects cause third degree burns. The skin may look white or leathery on the surface. Deep extensive burns may cause shock and severe infections to develop. The Merck Manual states more than 2 million Americans seek treatment for burns yearly, and up to 4,000 people die of burn-related injuries.
Immediate Care
Severe third degree burns require immediate attention. A person is often placed on oxygen therapy to avoid respiratory distress. Large amounts of intravenous fluids prevent dehydration and shock from occurring, explains the Merck Manual. The fluids also prevent further damage to the kidneys from occurring by diluting the blood. Surgical procedures include removing dead tissue from limbs or areas where circulation and breathing are impaired. Minimal pain is associated with the procedure known as escharotomy because of damaged nerves.
Wound Care
Cleaning the skin is critical to avoid infection, a common complication for severe burn patients. Wounds are cleansed throughout the day and moist sterile bandages cover the areas. Burned limbs are elevated to decrease swelling. Antibiotics are often prescribed to avoid infection. Medical staff carefully monitors wounds for signs of healing or infection. The staff commonly measures the size and depth of wounds through photography and computer imagery. Movement is limited to encourage wound healing.
Skin Graft
Skin severely burned that does not heal requires a skin graft. Most third degree burns involve skin grafting, reports the Merck Manual. Skin must be infection-free and have stable blood circulation, according to the Burn Injury Resource Center. Healthy skin is surgically removed from another area of the body, such as the thighs or buttocks, and replaces the skin on the burned area. Skin may also come from a donor, an animal or be artificially created—however, these types of skin grafts are temporary. Skin grafts aid in tissue healing and decrease fluid loss. Removal of the dead tissue is required and the area is cleaned. The new skin is surgically sewn into place. Donor, animal and artificial skins are rejected by the body within two weeks. Sterile dressings are applied to the site and antibiotics are often prescribed.
