Superficial (1st degree) |
Epidermis |
Dry, red; blanches; painful |
Healing time 3–6 days, no scarring |
Superficial partial thickness (Superficial 2nd degree) |
Papillary dermis |
Blisters; moist, red, weeping; blanches; severe pain to touch |
Cleaning; topical agent; sterile dressing; healing time 7–21 days; hypertrophic scar rare; return of full function |
Deep partial thickness (Deep 2nd degree) |
Reticular dermis Most skin appendages destroyed |
Blisters; wet or waxy dry; reduced blanching: decreased pain sensation to touch, pain present to deep pressure |
Cleaning; topical agent; sterile dressing; possible surgical excision and grafting; scarring common if not surgically excised and grafted; earlier return of function with surgery |
Full thickness (3rd degree) |
Epidermis and dermis; all skin appendages destroyed |
Waxy white to leathery dry and inelastic; does not blanch; absent pain sensation; pain present to deep pressure: pain present in surrounding areas of second degree burn |
Treatment as for deep partial- thickness burns plus surgical excision and grafting at earliest possible time; scarring and functional limitation more common if not grafted |
Fourth degree |
Involves fascia and muscle and/or bone |
Pain to deep pressure, in the area of burn; Increased pain in surrounding areas of second degree burn |
Healing requires surgical intervention |