Burns, whether they're the result of too much sun exposure or contact with a hot object, can result in major tissue damage and can be intensely painful. Some burns are safe to treat at home, while others require medical intervention. A third-degree burn is the most serious type of burn, and you shouldn't try to treat it at home. Instead, because even small areas of third-degree burn can be very serious -- even life-threatening -- you shouldn't try to get someone with a third-degree burn to a doctor on your own; call 911, and wait for medical personnel to arrive.
Third-Degree Burns
Burns fall into different categories depending upon their severity, where less severe -- first-degree -- burns involve only the outermost layers of skin, and third-degree burns involve all layers of tissue. Because third-degree burns result from damage that extends far below the bottom layer of the skin, they may not be as painful as second-degree burns. However, almost all third-degree burns have areas of less severe, second-degree damage around the edges, which is intensely painful. If skin looks red and blistered, it has sustained a second-degree burn. Third degree burns look charred or white, due to the deep tissue damage.
First Aid
If you or someone you know has a third-degree burn, seek medical help immediately. You should not try to remove burned clothing that remains stuck to a burned area, as this can cause the skin to peel off and inflict more damage. Wrap the burned area, including the blistered area, loosely in with a cool, moist, clean -- ideally sterile -- bandage, but don't submerge the burn in cold water. While cold water and ice help to relieve the pain of a minor burn, they're not appropriate to severe burns and can cause more damage, or worse, cause the burn victim to lose body heat and go into shock. Leave blisters alone; do not try to pop them, as this can further damage tissue. If it's possible to elevate the burned area, do so. You can also gently separate burned fingers or toes, using a clean cloth.
At the Hospital
One of the major problems associated with hospital treatment of third-degree burns is that the damage to skin is so complete, it's impossible for the burned area to recover on its own. Skin grafts are one option for treating burned skin, but these can prove problematic for large burned areas: It's difficult to donate enough of your own skin to cover an extensive burn, and skin from a donor poses the risk of rejection. A 2003 article published in the "Journal of Burn Care and Rehabilitation" by Dr. David Heimbach and colleagues discusses the use of a dermal regeneration template, which is a combination of silicon and fibrous material. It acts as an artificial skin, helping to maintain moisture and offer some temperature control, while simultaneously providing a scaffold for growth of new skin cells.
Therapies
An additional difficulty associated with hospital care of third-degree burns is pain management. Researchers are examining new ways to improve quality of life and reduce pain without having to resort to long-term, high-level drug therapy in burn patients. For instance, a 2001 article by Maria Hernandez-Reif and colleagues in the journal "Burn Care and Research" reports that massage helps reduce the perceived pain of child burn victims. Even once a burn has healed and pain is no longer an issue, there's the matter of the appearance of the healed tissue. Extensive scarring can be psychologically troubling to burn victims. In a 2009 study reported in the "Journal of Drugs in Dermatology," Dr. J. Waibel and colleagues report using a laser to ablate tissue, meaning that the laser destroys cells in scarred areas. The skin then slowly resurfaces, which results in a greatly improved appearance.
References
- "Journal of Burn Care and Rehabilitation"; Multicenter Postapproval Clinical Trial of Integra(R) Dermal Regeneration Template for Burn Treatment; D. Heimbach et al; 2003
- "Burn Care and Research"; Childrens' Distress During Burn Treatment Is Reduced by Massage Therapy; M. Hernandez-Reif et al; 2001
- "Journal of Drugs in Dermatology"; Ablative Fractional Laser Resurfacing for the Treatment of a Third-Degree Burn; J. Waibel et al; 2009
