![]() ![]() ![]() Burn injuries are more likely to occur in children and older people. Pruritus, hypertrophic scarring, and permanent hyperpigmentation are long-term complications of partial-thickness burns. People with diabetes mellitus are at increased risk of complications and infection, and early referral to a burn center should be considered. Prophylactic antibiotics are not indicated for outpatient management and may increase bacterial resistance. Full-thickness (third-degree) burns involve the entire dermal layer, and patients with these burns should automatically be referred to a burn center. Deep partial-thickness burns require immediate referral to a burn surgeon for possible early tangential excision. Superficial partial-thickness burns extend into the dermis, may take up to three weeks to heal, and require advanced dressings to protect the wound and promote a moist environment. Partial-thickness (second-degree) burns are subdivided into two categories: superficial and deep. Superficial (first-degree) burns involve only the epidermal layer and require simple first-aid techniques with over-the-counter pain relievers. Initial treatment is directed at stopping the burn process. All burn injuries are considered trauma, prompting immediate evaluation for concomitant injuries. Two key determinants of the need for referral to a burn center are burn depth and percentage of total body surface area involved. Most patients with burn injuries are treated as outpatients.
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