Skin is made up of two layers—the thin top layer (epidermis) and a thicker bottom layer (dermis) from which nerve endings, new skin cells, hair and sweat glands begin.
A burn is an injury damaging either one or both of these skin layers and can be as a result of:
- scalds from hot liquids like oil, water, tea or coffee
- contact with hot objects
- contact with electrical currents or chemicals
- thermal contact, such as flames or flashes
- overexposure to ultraviolet light such as the sun or tanning equipment.
(Better Health Channel 2006; MDA Internet 2005; Burn Survivors Network 2007):
Symptoms and characteristics
Burn injuries are classified by the extent and depth of injury and are usually expressed using a percentage of total body surface area. A major burn for an adult is considered to be 20 per cent or greater of the body’s surface area.
There are four levels of burns to the skin:
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Superficial or first degree burns only affect the thin, top layer of the skin, causing pain, redness and swelling at the site of the burn but no blistering. Commonly caused by sunburn
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Partial thickness or second degree burns affect both the outer and underlying layer of skin, causing pain, redness, swelling and blistering at the burn site. Deemed either superficial or deep second degree burns depending on the extent
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Full thickness or third degree burns extend through and destroy both skin layers. As nerve endings have usually been destroyed in the skin layer, the site of full thickness burns is usually not painful, however burns of lesser depth surrounding this will remain painful. Skin cannot regenerate at the site of a full thickness burn, so depending on the site and extent of injury, skin graft alternatives may be required. Severe scarring can result with this level of burn and potential skin contractures may restrict movement especially if the burn site is over a joint
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Fourth degree burns involve burns which penetrate through the skin to the muscles, tendons, bones and sometimes internal organs. Surgical intervention is critical for survival at this level.
As the skin usually acts as a barrier to infection and assists with temperature regulation through circulation and sweating, burns to the skin can increase a person’s risk of infection and cause other complications. Severe burns may lead to permanent disability or death.
Workplace adjustments and solutions
As each burn is unique in location and extent, each person's circumstances within the workplace would need to be assessed. Some factors that could affect a worker returning to the workplace following a burn, particularly serious burns, include:
- burn location for example, if on the hand may have difficulty gripping daily treatment requirements
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whether pressure garments are required to be worn to assist with scar management and whether they will restrict the duties able to be completed
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if the burn occurred within the workplace—does the person require extensive support to work in the same environment or is a different environment more appropriate
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whether the person can tolerate hot or cold workplaces due to altered temperature regulation
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risk of infection if returning to work
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need to limit exposure of the burn to the sun (if working outside).
(Better Health Channel 2006; MDA Internet 2005; Burn Survivors Network 2007):
There are solutions and adjustments for the following job requirements:
References
Better Health Channel 2006, Burns, State Government of Victoria, Melbourne, viewed 23 March 2007, <http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Burns?open>.
Burn Survivors Network 2007, Psychosocial impact of a burn, Burn Survivors Network Melbourne, viewed 23 March 2007, <http://www.burnsurvivors.com.au/psychosocial-impact.html>.
Burn Survivors Network 2007, The classification of burns, Burn Survivors Network, Melbourne, viewed 23 March 2007, <http://www.burnsurvivors.com.au/classification-burn.html>.
MDA Internet 2005, Reed Group Ltd, Colorado, viewed 23 March 2007, <http://www.mdainternet.com (secure site)>.
Burn Survivors Online 1994 - 2008, Degrees of Burns, World Burn Foundation, California, viewed 17 October 2008, <http://www.burnsurvivorsonline.com/injuries/degree.asp>.