Third Degree Burn

Third Degree Burn, also called a full thickness wound, is a serious injury that affects all layers of the skin. The injury can also affect the nerves, blood vessels, and muscles under the skin.

A third-degree burn is a medical emergency.

What are the causes?

This condition may be caused by:

• Heat. A heat burn (thermal burn) can happen if your skin touches something very hot, such as a flame or hot liquid.
• Radiation. A radiation burn can be caused by sunlight, radiation used to heat food, and radiation treatment.
• Electricity. Electrical burns can be caused by frayed wires and electrical outlets.
• Corrosive (caustic) chemicals, such as bleach. A chemical burn can happen if you inhale, swallow (ingest), or touch a caustic chemical.

What are the signs or symptoms?

Symptoms of this condition include:

• Numbness in the wound.
• Only a little pain in the wound. The area around the wound may hurt more than the burned area.
• Thick, dry, or leather-like skin.
• Color changes in the skin. The skin might look white, yellow, brown, purple, or black.

If you are severely burned, you may go into shock. Symptoms of shock include:

• Dehydration. You might feel very thirsty, dizzy, or weak, or you may have trouble urinating.
• Blue color to the lips or fingernails.
• Fast breathing.
• Fainting.

How is this diagnosed?

This condition is diagnosed with an exam of the wounded area. It may take several days to determine the extent of your burn. If the wound is large, you may need to stay in the hospital so a health care team can examine the wound and watch your overall health. You may also have tests to check your heart rate, breathing, and blood pressure.

How is this treated?

Treatment for this condition focuses on:

• Replacing any lost fluids.
• Preventing infection.
• Limiting scarring.

Immediate treatment may include:

• Oxygen to help breathing.
• Giving fluids through an IV.
• Bandaging burned areas.
• Removing dead skin (debridement).
• Antibiotic medicine to fight infection.
• Pain medicine.
• A blood transfusion.
• A tetanus shot.
• Applying compression bandages (dressings).

Long-term care may include:

• Going to a burn center.
• Breathing support. This could mean getting oxygen through a mask or using a machine called a ventilator.
• Applying dressings to the wound.
• Antibiotic medicine to help prevent or treat infection.
• Surgery. This may be needed to:
  • Remove dead tissue.
  • Cover the burned area with healthy skin (skin grafts).
  • Repair damaged areas.
• Physical therapy. This helps you to return to your regular activities. It may also help to prevent or reduce scarring.

Follow these instructions at home:

Wound care

• Follow instructions from your health care provider about how to take care of the wound. Make sure you:
  • Wash your hands with soap and water before you change your dressing. If soap and water are not available, use hand sanitizer.
  • Change your dressing as told.
  • If you have a compression dressing, wear it as told.
• Apply any creams or ointments only as told by your health care provider.
• Clean your wound 2–3 times a day or as told by your health care provider. To clean your wound:
  • Wash the wound with mild soap and water.
  • Rinse the wound with water to remove all soap.
  • Pat the wound dry with a clean towel. Do not rub it.
• Check your wound every day for signs of infection. Check for:
  • More redness, swelling, or pain.
  • More fluid or blood.
  • Warmth.
  • Pus or a bad smell.
• Do not scratch or pick at the wound.
• Do not break any blisters or peel any skin.
• Avoid exposing your wound to the sun.

Medicine

• Take and apply over-the-counter and prescription medicines only as told by your health care provider.
• If you were prescribed an antibiotic medicine or ointment, use it as told by your health care provider. Do not stop using the antibiotic even if your condition improves.

Activity

• Rest as told by your health care provider.
• Do not exercise until your health care provider approves.
• Do range-of-motion movements as told by your physical therapist.

General instructions

• Raise (elevate) the injured area above the level of your heart while you are sitting or lying down.
• Drink enough fluid to keep your urine clear or pale yellow.
• Keep all follow-up visits as told by your health care provider. This is important.
• Do not take baths, swim, or use a hot tub until your health care provider approves. Ask your health care provider if you may take showers. You may only be allowed to take sponge baths.

Contact a health care provider if:

• Your symptoms do not improve with treatment.
• Your pain is not controlled with medicine.
• You have more redness, swelling, or pain around your burn.
• You have more fluid or blood coming from your wound.
• Your burn feels warm to the touch.
• You have pus or a bad smell coming from the burned area.

Get help right away if:

• You have a fever or chills.
• You develop red streaks near the burn that feel warm to the touch.
• You develop severe pain.
• You have trouble urinating.
• You are more thirsty than normal.
• You have trouble breathing or are short of breath.
• You have a rapid heart rate.
• You are confused or you lose a sense of time, place, and who you are (are disoriented).

Summary

• A third-degree burn, also called a full thickness wound, is a serious injury that affects all layers of the skin.
• This condition may be caused by heat, radiation, electricity, or corrosive (caustic) chemicals.
• Treatment for this condition focuses on replacing any lost fluids, preventing infection, and limiting scarring.
• Check your wound every day for signs of infection.
• Do not take baths, swim, or use a hot tub until your health care provider approves.