The Ear Book by Thomas J. Balkany

Author:Thomas J. Balkany
Language: eng
Format: epub
Publisher: Johns Hopkins University Press
Published: 2017-06-03T16:00:00+00:00

Burns

Thermal injury is usually classified by the extent and degree of the burn. Superficial burns involve only the outer layer of the skin (epidermis). Partial-thickness burns extend into, but not through, the dermis (deeper layer with blood vessels and fat). Full-thickness burns extend through the full thickness of the dermis. Subdermal burns extend into the tissue below the skin including fat, muscle, tendon, cartilage, and bone.

Superficial auricular burns appear red because of blood vessel congestion. These burns are painful. Patients with partial-thickness burns usually have blisters that blanch white on direct pressure and are very painful. Deep partial-thickness burns are associated with less pain, and there may be a layer of dead tissue overlying them (eschar). Full-thickness and subdermal burns are often less painful because nerve endings have been destroyed. The wound surface eschar is of varying color, but may be gray or black and charred.

Superficial burns do not scar and may be treated with moisturizing creams. The surface of blisters caused by partial-thickness burns are often removed and antibiotic ointment applied. When not deep, these burns heal without scarring as well. Full-thickness, subdermal, and deep partial-thickness burns of the auricle heal with scarring and contracture (scar deformity) and may be complicated by infection of the cartilage. These burns should be treated with both topical (usually silver-based) and systemic antibiotics (taken orally or intravenously). Early removal of dead tissue and closure with skin grafts may be necessary. Another round of reconstruction is usually performed at approximately one year after injury.

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