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  • Burn wounds can be categorized into superficial, partial-thickness, and full-thickness injuries to skin, depending on depth of injury to the epidermis and dermis.
  • The severity of a burn is determined largely by the depth of injury and the extent or percentage of total body surface area involved.
  • Areas such as the face, hands, feet, and perineum have special considerations in terms of functional and cosmetic outcomes.
  • When assessing a large burn, a primary survey starting with airway, breathing, and circulation (ABC) must be done as in any trauma patient, with each problem encountered treated adequately.
  • Early and adequate fluid resuscitation is vital and improves outcome in large burns.
  • Burn patients may have sustained other injuries during their thermal injury. Do not forget to fully assess the patient.
  • In circumferential, full thickness burns of the thorax and extremities, escharotomies may be necessary to allow adequate ventilation and circulation.
  • In children and the elderly or incapacitated, consider non-accidental injury for suspicious injuries.
  • Superficial and partial-thickness wounds may be treated with topical ointments and dressings.
  • Deep dermal and full-thickness burns need surgical debridement and skin grafting. The wound may be covered temporarily with allo- or xenograft.



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