Proper Medical Treatment of Burns Critical To Positive Outcomes

Health Minute     Fall 2017

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A critical countdown begins the minute a person sustains a burn to their skin because the next 72 hours will ultimately decide its outcome.

Travis Perry, MD, with Comprehensive Burn and Wound Specialists, said people often underestimate a burn’s ability to harm the body because they think that what they see at the moment is what they’ll get in the long-term. Science proves opposite: A burn can actually morph and deepen up to 72 hours after the initial incident.

“Individuals need to understand that immediate medical evaluation of a burn is critical because once a patient sustains a burn injury we are on a timeline,” Dr. Perry said. “How soon the burn process is stopped and how quickly a person gets specialized medical care determines the physiological, functional and cosmetic outcomes of the injury.”

Degree of Burns

The degree of a burn is diagnosed through the clinical exam done by a specialist, and is often determined by the level of skin that is involved. First degree burns are superficial burns that only involve the top layer of skin. Second degree burns involve the dermis – the thick layer of living tissue below the epidermis that forms the true skin, which involves blood capillaries, nerve endings, sweat glands and other structures.

Third degree burns involve the fatty tissue underneath the epidermis, and fourth degree burns involve the deeper structures including tendons, muscle and bone. Diagnosis of a burn is a process that involves observation up to 72 hours after the incident has occurred.

“Patients may come in with what appears to be a superficial, second degree burn, but because of the natural progression of a burn injury, microscopically it could end up being a third degree burn with a 72-hour time-frame,” said Dr. Perry, who practices with Premier Physician Network.

Flame burns and scald burns are the two most commonly seen. Flame burns are common in young adults, especially young males who tend to be engaged in risky activity. Scald burns are common among the young children and older adults. Children’s burns are caused by immature judgement while older adults may experience burns from accidents as a result of other medical issues such as a cardiac event, Dr. Perry said.

Dr. Perry said knowledge is critical when it comes to properly treating a burn:

  • Know the look – There are specific characteristics of burns that should always be evaluated by a specialist. Any burn that is larger than a quarter, forms blisters, is dry or tender to the touch, is firm or is surrounded by a large ring of redness needs medical attention. Such characteristics signal the burn is equal to a second-degree burn.
  • Seek advice when in doubt – Those who think they are in the clear because their burn has not penetrated the first layer of skin shouldn’t be so quick to relax. It is possible for some first-degree burns – such as a bad sunburn – to convert to second degree burns. 
  • It’s a race against time – Seeking medical attention for burns as fast as possible is extremely important. Burns that convert to the second-degree stage or beyond are more susceptible to infection. A person has 72 hours in which to seek medical attention for a burn in order to obtain the best outcomes of care.
  • Wives’ tales are harmful – There are misconceptions about how to treat burns that can actually do significant harm. Applying grease and butter to a burn, for instance, can expose the skin to bacteria and infection. And the idea that placing the burn in cold or freezing water will stop the pain and progress actually do the exact opposite.

“Submerging a burn into ice water actually causes the burn to go much deeper into the skin while causing the small blood vessels that supply that skin to clot off,” Dr. Perry said. “The skin no longer receives the nutrients, oxygen and blood supply that is needs and ultimately dies off. I can still remember when I was a kid one of the beliefs was that it was good to let a burn ‘air out.’ However, a burn needs the right amount of moisture and humidification to heal. Drying it out impedes the healing process.”

For more information on burns or to find a Premier Physician Network physician near you, visit

It's easy to get the care you need.

See a Premier Physician Network provider near you.