History and exam

Key diagnostic factors

common

presence of risk factors

Key risk factors include young children, age >60 years, and male sex.

erythema

Indicative of a first-degree burn. [Figure caption and citation for the preceding image starts]: First-degree burnFrom Dr Sheridan's personal collection [Citation ends].com.bmj.content.model.Caption@30c1e197

dry and painful burns

Classified as first-degree burns and involve the epidermis only. [Figure caption and citation for the preceding image starts]: First-degree burnFrom Dr Sheridan's personal collection [Citation ends].com.bmj.content.model.Caption@70f586da

wet and painful burns

Classified as second-degree burns and involve the epidermis and upper dermis. [Figure caption and citation for the preceding image starts]: Second-degree burnFrom Dr Sheridan's personal collection [Citation ends].com.bmj.content.model.Caption@7e0a075b

dry and insensate burns

Classified as third-degree burns and involve the epidermis and dermis and damage to appendages. [Figure caption and citation for the preceding image starts]: Third-degree burnFrom Dr Sheridan's personal collection [Citation ends].com.bmj.content.model.Caption@6f69d890

burns affecting subcutaneous tissue, tendon, or bone

Classified as fourth-degree burns. [Figure caption and citation for the preceding image starts]: Fourth-degree burnFrom Dr Sheridan's personal collection [Citation ends].com.bmj.content.model.Caption@1cf3f3fc

cellulitis

The most common wound infection in small outpatient burns is cellulitis, usually caused by Staphylococcus aureus. This infection presents with expanding wound erythema, which, if untreated, will progress to lymphangitis and systemic toxicity.[Figure caption and citation for the preceding image starts]: CellulitisFrom Dr Sheridan's personal collection [Citation ends].com.bmj.content.model.Caption@62fd4cf3

clouded cornea

Suggests a serious burn. Any suspicion of eye injury warrants an ophthalmological consultation.

Risk factors

strong

young children

Increased risk of burning due to the lack of co-ordination, dependency, and poorly developed self-protective mechanisms.[16][17]

age >60 years

Increased risk of burning due to the lack of co-ordination, dependency, and poorly developed self-protective mechanisms.[16][17][18]

weak

female sex (thermal burns)

Worldwide, females have slightly higher rates of death from burns compared to males. WHO: fact sheet - burns Opens in new window​ This may be due to increased risks associated with cooking (open fire or other unsafe cooking environments) especially if loose clothing is worn, open flames for heating and lighting, and possibly also from self-directed or interpersonal violence. This contrasts with the usual injury pattern, where rates tend to be higher in males (e.g., due to increased risk-taking behaviours, occupational exposures), and in some countries burn rates may be higher in males for these reasons. Chemical and electrical burns are generally more common in males.[4]

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