Burn injuries are painful and traumatic, especially when hospitalization and surgery are required. We understand that patients can become overwhelmed during the healing process and concerned with the changes in appearance of the burn injury and donor site.
Below, we have provided answers to some of the most common questions regarding burn treatment and recovery.
Admission
24 Hours Later
Burns can change in appearance in the first 48 hours. They may “convert” from a 2nd degree burn to a 3rd degree burn.
FIRST DEGREE BURN
• Involves only epidermis • Skin is red (like a sunburn) • Painful
SECOND DEGREE BURN
• Involves epidermis and part of the dermis • Skin is red, blistered, swollen • The most painful type of burn
THIRD DEGREE BURN (FULL THICKNESS INJURY)
• Involves all of epidermis and dermis • Whitish or charred appearance, can be tough and leathery • Sensation is diminished
Once the severity of the burn is determined, the burn specialist will recommend a treatment plan that will require outpatient visits or hospitalization.
Outpatient
Inpatient
If your doctor has decided you need to stay in the hospital to receive care for your burns, here are some reasons for this:
1. Burns can change in appearance in the first 48 hours. They may “convert” from a 2nd degree burn to a 3rd degree burn. Your burn can be monitored for this by staff experienced in burn care.
2. Your bandages may be too complex to be changed at home or in our outpatient clinic.
3. The part of your body that is affected needs to be cared for in the hospital.
4. You may need IV fluids or medications that cannot be given at home.
5. Many 2nd and most 3rd degree burns need surgery.
The surgery involves going to the operating room to have the dead skin removed by a burn surgeon. This is called debridement or surgical excision. You will have a general anesthetic for this. After the dead skin is removed, a temporary covering of cadaver skin (homograft) or a type of synthetic skin will be put on top of the burn. Occasionally this is all that is needed but many times this is done to promote some healing and to prepare your burns for the next stage.
A homograft is cadaver skin obtained from an organ donor. It is placed on the burns in the operating room after the dead skin has been removed. You are under general anesthesia when this is done. Homograft is a temporary measure to promote healing so the burn will be ready to “accept” your own skin permanently. It will also help in reducing the pain and risk of infection.
After each surgery the bandages will be bulkier than usual, this will help keep the skin grafts in place and absorb drainage.
The next surgery happens a few days later. The temporary skin covering is removed and the burn is cleaned again and this time, if the burn is more severe, the surgeon will do a skin graft, also known as an autograft.
An autograft is a very thin layer of your own skin taken from another part of your body that is not burned. It is placed on your burn after the homograft has been removed in the second surgery. This is a permanent graft. The area where your own healthy skin is removed is called the donor site.
The same autograft 6 months later
The donor site is the place where the skin is taken from. It is taken from an unburned area on your body and placed on the area that was burned. The most common areas for the donor are the thighs or the scalp although other areas can be used. Your doctor will decide which area is the best to use.
Donor site immediately after surgery
Donor site 4 days after surgery
Donor site 7 days after surgery
Donor site 2 weeks after surgery
Donor site 1 year after surgery
Your skin will look different than before you were burned. The appearance will go through many changes before the final outcome. No two persons are the same and different skin types heal differently.
Your doctor will decide if you need to wear special garments to minimize scarring. You must protect your skin from the sun as the areas burned will burn in the sun more easily than the rest of your skin, sun lotion with a high SPF # and clothing such as a hat with brim (for facial burns) or long sleeve cotton shirts may be needed.
If you or someone you care about is injured by a burn, the skilled and highly trained medical staff of the world-renowned Grossman Burn Centers are available to provide the very best care possible.
Grossman Burn Center at West Hills Hospital and Medical Center 7300 Medical Center Drive, West Hills, CA 91307 818-676-4177 24-Hour InPatient 888-676-2876 OutPatient Clinic
Grossman Burn Center at Memorial Hospital 420 34th Street Bakersfield, CA 93301 661-323-BURN (2876) 24-Hour InPatient 661-633-BURN (2876) OutPatient Clinic
Grossman Burn Center at Research Medical Center 2316 E. Meyer Blvd, Kansas City, MO 64132 816-276-4325 24-Hour InPatient 816-276-3518 OutPatient Clinic