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How Serious is a Fourth-Degree Burn?

According to medical classifications, fourth-degree burns are the most threatening and severe of all burns. The skin is destroyed, most likely leaving the muscles, vessels, and bones exposed. Many victims do not survive a burn incident like this. In the event of survival, victims of fourth-degree burns often experience extended hospital stays, extensive reconstruction, and possible amputation.

Structure

To better understand fourth-degree burns, it is best to begin with an overview of the skin. As the largest organ of the human body, the skin covers a total area of approximately 20 square feet. Under normal circumstances, our skin protects us from outside elements, toxins, and trauma. It’s also full of nerve sensors that let us feel pressure, touch, and temperature. The skin’s important duties are divided up among its three layers—all of which are effectively destroyed by fourth-degree burns.

  1. Epidermis – the outermost layer of skin
  2. Dermis – the middle layer of skin
  3. Hypodermis – the fat, vessels, and connective tissue that lies underneath the skin
Significance

The damage caused by fourth-degree burns reaches past the epidermis and dermis, usually extending deep into the hypodermis. Because of this, they are termed “full-thickness burns”. Fourth-degree burns always require medical treatment because they injure many important elements of the human body.

  • Muscle
  • Ligaments
  • Tendons
  • Nerves
  • Blood vessels
  • Bones
Causes

The cause of a fourth-degree burn is typically prolonged exposure to any of the following.

  • Flames
  • High-voltage electricity
  • Any hot object or source of thermal heat
Outlook

The medical prognosis of a victim of fourth-degree burns is usually very grim. These types of burns cause irreparable damage to the skin and underlying tissues. Since the nerve endings are damaged, the victim has no sensation at the burn site. Often times, this leads to amputation or a very serious impairment. However, in some cases of fourth-degree burns, patients can recover with the help of extensive medical interventions like debridement, skin grafts, and reconstruction.

Treatment Options

For survivors of fourth-degree burns, there are a wide variety of treatments and procedures that may be helpful during the healing process. All of these interventions seek to return the skin to its normal protective state with full functionality.

  • Debridement: The unhealthy and dead tissue surrounding a burn wound can slow healing. Medical professionals may suggest removing this tissue by a variety of means. It can be done surgically, other mechanical means, medication, or special bandages to stimulate healing on your own.
  • Skin Grafting: Serious burns will not regrow skin on their own, so burn specialists will use skin from another part of the body to cover the wound. The “new” skin attaches to the burned skin, but scaring is still noticeable.
  • Escharotomy: The skin surrounding such a serious burn as a fourth-degree burn can become tough and non-elastic. This leaves no room for the surrounding tissue to receive circulation or expand. This type of proceduremakes incisions in the fourth-degree burns to expose the fatty tissue below and allow adequate blood flow.


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