What is the correct characteristic of a deep partial-thickness dermal burn, also known as a deep partial-thickness burn (SCOPB: Scar Contracture, Orthotics, Physical therapy, and Burn care)?

From the Guidelines

The correct choice regarding deep partial thickness dermal burns is D. Blanch on pressure. Deep partial thickness burns involve damage to the deeper dermis but still retain some viable dermal elements, as noted in the 2024 American Heart Association and American Red Cross guidelines for first aid 1. These burns typically blanch when pressure is applied because they maintain some blood supply to the affected area, which temporarily displaces when compressed. Unlike full thickness burns (which are painless due to destruction of nerve endings), deep partial thickness burns are painful to both light touch and pressure. They do not heal with granulation tissue and fibrosis initially - this occurs only if the burn is severe enough to progress or is not properly treated. While some hair follicles may be damaged in deep partial thickness burns, the statement that they have intact hair follicles is not universally true, as the depth of the burn can affect follicular structures. Some key characteristics of deep partial thickness burns include:

• Painful to pressure
• Blanching on pressure due to maintained blood supply
• Potential for some hair follicle damage
• Require treatment beyond first aid to prevent infection and reduce scarring, as emphasized by the 2024 guidelines 1. Blanching on pressure is the most reliable distinguishing characteristic of these burns compared to full thickness burns, which do not blanch due to coagulated blood vessels.

From the Research

Deep Partial Thickness Dermal Burn Characteristics

• Deep partial thickness dermal burns are characterized by the presence of intact hair follicles, which serve as a source for epithelialization 2
• These burns heal with the formation of granulation tissue and subsequent fibrosis, as evidenced by the treatment of hypergranulation tissue in burn wounds with topical steroid dressings 3
• The healing process of deep partial thickness dermal burns involves the migration of cells from the lateral wound edges and hair follicles, leading to the formation of granulation tissue 2

Sensation and Pressure Response

• Deep partial thickness dermal burns are typically painful to pressure, whereas full-thickness burns are usually painless due to the destruction of nerve endings 2
• The response to pressure is an important characteristic in distinguishing between different types and depths of burns

Blanching Response

• Deep partial thickness dermal burns may exhibit a blanching response to pressure, indicating the presence of intact blood vessels and a preserved microcirculation 2
• The blanching response is an important sign in assessing the depth and severity of burns

Correct Choice

• Based on the characteristics of deep partial thickness dermal burns, the correct choice is that these burns have intact hair follicles and heal with granulation tissue and fibrosis, and are painful to pressure, but may still blanch on pressure 3, 2