Abramson Smith Waldsmith, LLP has extensive experience handling cases involving burn injuries, fires and explosions. Thermal burn injuries can be catastrophic and devastating. Burns can permanently alter the body by destroying tissue. Burns are traditionally classified by their depth in degrees:
First-degree burns are somewhat superficial, involving only the top most layer of skin, the epidermis. While painful and red, the long-term effects of first-degree burns are limited. Usually, such burns leave no scars.
Second-degree burns are deeper than the top layer of skin, (i.,e., the epidermis), entering the second layer of skin, the dermis. They often are referred to as partial thickness burns. These burns manifest as erythema (i.e., redness) with some blistering. Second-degree burns are very painful because the nerve endings are located in the dermis. Although second-degree burns can heal within two to three weeks without scarring, this is not always the case.
Third-degree burns occur when the epidermis and dermis are exceptionally compromised or completely destroyed. These are often referred to as full thickness burns. Third-degree burns require skin grafting surgery, wherein skin is transplanted from one part of the body and takes root and grows in the injured area. The harvested skin that grows in the burn wound is not always optimal and sensation may be compromised. Further, the skin grafting procedure often leaves scars in both the area of the burn and the harvest area. Scar revision surgery is usually required.
Fourth-degree burns (not a technical term) describe the most severe and deepest burns, wherein the epidermis, dermis, and subcutaneous fat are completely destroyed and the muscle and bone are affected. Fourth-degree burns require skin grafting, which can be challenging due to the level of destroyed skin.
Fires and explosions can cause all or a mixture of the four degrees of thermal burns. The intense heat generated from an explosion or gas fire can cause nearly instantaneous burns of all degrees. Recovery from serious burns can take weeks to months, as dead tissue has to be painfully removed (rubbed away with a brush) or removed surgically, a process known as debridement. Debridement can be painful and prolonged over many months in some cases. The resulting scar tissue is dramatically different than normal, healthy skin in its elasticity, sensation and appearance. During the healing process, infection is a significant potential complication that can dramatically affect the outcome, and overall health.
Beyond the physical pain of burns is the cosmetic impact. The most common burn locations are in areas of exposed skin, i.e., the face and hands. Unfortunately, these areas cannot easily be hidden and remain visible as a permanent reminder of the incident that caused the burn.
Other causes of burns include hot liquids (scalding water), chemicals, radiation, high-voltage electricity and friction.
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