Burns

Your wound care nurse and physician will discuss your injury with you and explain the severity of your burn. The severity of your burn is listed in one of the following categories. It may be 5-7 days before the degree of your burn is determined.

Levels of severity

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Superficial
Superficial burn
Epidermal (top) layer of skin involved
Appears pink to red, is painful to touch and may swell 
Peeling will occur 2 to 3 days after injury

Superficial Partial Thickness
Partial thickness
Usually affects the top 2 layers of skin
Appears red to pale ivory and is moist
Quite painful and becomes swollen
Can take 2 to 4 weeks to heal
May require skin graft to heal

Deep Partial Thickness 
Small amount of dermis (2nd layer) remains
White or charred appearance
Less Pain
Difficult to tell from full thickness

Full Thickness and Subdermal Burns
Affects all the layers of skin
Appears white, cherry red or black, and is painless to the touch
Requires skin graft to heal

Frequently Asked Questions

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Soaking: Soak the burn in warm water 5-10 minutes before washing. Burned skin will not be able to detect the water temperature accurately, so test with an unburned body part or thermometer. The water should be comfortable to sensitive skin and not hotter than 95° F.
Washing: The burned area should be washed twice per day. Begin by washing your hands thoroughly. Wash gently but firmly with sterile gauze until all the cream and loose particles of skin have been removed. Pat dry with a clean towel.
Position: Healing skin tends to tighten. Your health care provider may recommend range of motion (ROM) exercises to help limit skin tightening. Positioning can be done in bed, while watching TV, reading, etc. Splints are sometimes prescribed.
Swelling: Your burn area may swell. Elevate the burned area when possible.
Exercise: You must use the injured area as much as possible to maintain normal muscle tone and joint motion. A physical Therapist can instruct you on exercise.
Applying medicine: If your doctor has prescribed an antimicrobial cream (example; Silvadene, Thermazene), apply each time after you wash the burn. Remove the cream from the jar with a sterile tongue blade. Use a clean blade each time you open the jar. Apply the cream over the entire burned area.
Covering the Burn: Cover the burn with a sterile gauze and wrap or tape to secure.

How can I help the healing process?

Stop smoking: Smoking decreases blood flow.
Eat right: Your body needs a good balanced diet so you have extra energy to heal.
Rest: Your body is using energy to heal itself, rest when you feel tired.
Keep your scheduled appointments.
Take your medicines as prescribed.

After the burn has healed:
Dryness: Burns often damage or destroy glands that provide oil to the skin. Healed areas may become dry and crack. To prevent dryness apply cocoa butter or water based lotion.
Sun: New skin can reburn very easily. For a minimum of one year, cover healed areas with clothes or a cap and use a good sunblock of 15 SPF or greater.
Protection: New skin is very delicate. Take special care not to bruise or bump your healing skin.
Itching: Itching is common. Scratching must be avoided. A lukewarm bath followed by lotion may help. If severe itching occurs call your doctor.

Warning Signs

If you notice any of the following changes, notify your doctor:

• Increase pain
• Rash
• Increased swelling
• Redness around the burn wound
• Pus like drainage
• Odor
• Fever (over 101° F) or skin around wound becomes hot
• Nausea and vomiting

Questions, call Rapid City Regional Hospital Wound Care Program
Wound Care Center
Regional Rehabilitation Institute
2908 Fifth Street (3rd Floor)
Rapid City, SD 57701
(605) 719-1309

Services are available Monday - Friday from 8 a.m. to 4:30 p.m.