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Burn Is an injury produced by application of heat or chemical substances to external or internal surface of the body.

Degree of Burn

  1. Duputreyn’s classification
    1. 1st degree- epidermal burs
    2. 2nd degree- epidermal burns with blister formation.
    3. 3rd degree- burn into the true skin but not involving its complete deapth.
    4. 4th degree.- involving the complete deapth of the true skin.
    5. 5th degree- involving s/c tissue and muscles.
    6. 6th degree- bone deep.
  2. Wilson’s classification
    Epidermal : A blister is formed covered by white avascular epidermis, bordered by red hyperemic skin.
    Painful Heals without scarring.
    Dermoepidermal : whole thickness is skin is destroyed. Skin and subcutaneous tissue is affected.
    Most painful.
    Deep : Muscles and even bones are destroyed.
    Painless as even nerve endings are destroyed.
  3. Other classification’s based on depth: 
    1. Hebra’s classification
    2. Evans classification
    3. Muir and Sutherland’s classification
  4. EXTENT OF BURN: Rule of nine by wallace.
    Rule of palm in case of patchy burn (palm of an individual is 1% of his body surface area.
    1. 50% of burn prove fatal even of first degree.
    2. Neurogenic ( shock due to pain)
    3. Secondary shock due to fluid loss from burnt surface.
    4. Toxemia or sepsis
    5. Acute renal failure
    6. Suffocation
    1. Teeth become loose in their socket.
    2. Presence of soot particle in trachea, elevated CO saturation (absolute sign of AM burn ).
    3. Cyanide level is elevated.
    4. Heat haematoma: resembles
      2. Clot has honey comb appearance
      3. Light chocolate colour
      4. M/c site is Parieto-temporal region.
    5. Thermal fracture: They do not cross suture line.
    6. Pugillistic attitude / boxing / fencing or defence attitude:
      1. Coagulation of protein albumin of muscles which causes contraction and thus responsible for pugillistic attitude.
      2. It is due to heat stiffening and seen in both AM & PM burn.
      3. It is a posture of generalized flexion.
      4. Seen when the body is exposed to temp above 75o C.

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