Is there a 4th degree burn
Classification of the three degrees of combustion
Usually, burns (similarly also frostbite and chemical burns with acids and alkalis) are classified according to the following gradations based on their depth:
Grade I: Superficial damage with reddening and pain, there is still no blistering. The healing occurs spontaneously and without scarring.
Grade II: Redness, pain, and blistering. This group is divided into two further grades, which differ in terms of their surgical treatment necessity:
Grade II a: The wound bed under the blisters is still vital, here there is a spontaneous healing tendency, usually within two weeks. Typically, there is still a largely normal feeling of pain and touch in the burned area.
Grade II b: The wound base has died and there is no longer normal sensitivity in the affected area. At this depth, there is no spontaneous healing or scarring. The dead tissue must therefore be removed in an operation and usually replaced with a thin skin graft from another part of the body. The skin removal site heals spontaneously and without scars due to the superficial removal of the graft.
A distinction between Grade II a and Grade II b is often difficult to hit at the beginning (so-called afterburn). Therefore, the classification can change over the course of a patient's inpatient stay.
Grade III: Peeled off, dead down to the depths of the wound. Here an operation to remove the burnt layers of the skin is absolutely necessary.
In addition to the external injury, there is often an inhalation trauma, i.e. damage to the airways or the lungs from smoke or gases. Patients with such an inhalation trauma as well as severely burned patients are treated in our clinic together with colleagues from the Clinic for Operative Intensive Care Medicine and Intermediate Care in special areas of the intensive care unit.
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