Third-Degree Burns (Full Thickness Burns)
What is a third-degree burn?
A third-degree burn is also referred to as a full thickness burn. This type of burn destroys the outer layer of skin (epidermis) and the entire layer beneath (the dermis).
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What causes a third-degree burn?
In most cases, full thickness, third-degree burns are caused by the following:
What are the symptoms of a third-degree burn?
These are the most common symptoms of a full thickness, third-degree burn. :
Dry and leathery skin
Black, white, brown, or yellow skin
Lack of pain because nerve endings have been destroyed
Large, full thickness, third-degree burns heal slowly and poorly without medical attention. Because the epidermis and hair follicles are destroyed, new skin will not grow.
The symptoms of a third-degree burn may look like other conditions or medical problems. Third degree burns should always be evaluated immediately in the emergency department. Your child may need to be transferred to a burn center for further treatment.
Treatment for third-degree burns
Your child’s healthcare provider will figure out the best treatment based on:
How old your child is
His or her overall health and medical history
How well your child can handle specific medicines, procedures, or therapies
Your opinion or preference
Treatment for full thickness, third-degree burns will depend on the severity of the burn. Burn severity is determined by the amount of body surface area that has been affected. The burn severity will be determined by your child's doctor. Treatment for third-degree burns may include the following:
Early cleaning and debriding (removing dead skin and tissue from the burned area). This procedure can be done in a special bathtub in the hospital or as a surgical procedure.
Intravenous (IV) fluids containing electrolytes
Intravenous (IV) or oral antibiotics if your child develops an infection
Antibiotic ointments or creams
A warm, humid environment for the burn
Nutritional supplements and a high-protein diet
Skin grafting (may be needed to close the wound)
What is a skin graft?
A skin graft is a piece of the child's unburned skin which is surgically removed to cover a burned area. Skin grafts can be thin or thick. Skin grafts are done in the operating room. The burn that is covered with a skin graft is called a graft site.
What is a donor site?
The area where the piece of unburned skin was taken to be donated to a burned area is called a donor site. After a skin graft procedure, the donor sites look like a scraped or skinned knee. Your child's doctor will decide if a skin graft is needed. A skin graft is often done after removal of the dead skin and tissue.
Graft site care
A dressing is left on the graft site for 2 to 5 days before it is changed, so that the new skin will stay in place. For the first several days, graft sites need to be kept very still and protected from rubbing or pressure.
Donor site care
The donor site is covered for the first 1 to 2 weeks. The site needs to be kept covered. Donor sites usually heal in 10 to 14 days. If a dressing is applied, it usually remains on until it comes off by itself. Lotion is applied to the donor site after the dressing comes off. This skin often flakes off and looks dry.
- Duldner, John E., MD, MS
- Fetterman, Anne, RN, BSN