Cutaneous burns

Cutaneous burns can usually be managed in an outpatient setting. Early management affects long-term outcome.

Severity is assessed by burn size (% total body surface area) and depth (first to fourth degree).

Initial treatment of minor burns consists of wound cooling, cleaning, and dressing. Pain management and tetanus prophylaxis are important.

Serious burns are most effectively managed in regional burn centres.

Prognosis varies from excellent to poor depending on the severity of the burn. Associated injuries (such as inhalation injury or trauma) adversely affect the prognosis.

The majority of patients will have satisfying outcomes.

Burns are very common injuries, predominantly to the skin and superficial tissues, caused by heat from hot liquids, flame, or contact with heated objects, electrical current, or chemicals. Burn injuries can result in local and systemic responses. The local response involves the coagulation of injured tissue, and to some degree incites progressive microvascular reactions in the surrounding dermis. As burns become larger than about 20% of the total body surface area, a systemic response ensues, driving fluid loss and release of vasoactive mediators from the injured tissue. Clinically this results in early capillary leak, interstitial oedema, and organ dysfunction.