What is the characteristic healing process of deep partial thickness dermal burns?

Deep Partial Thickness Dermal Burns Heal with Granulation Tissue and Fibrosis

Deep partial thickness dermal burns heal through a combination of granulation tissue formation and fibrosis, making option A the correct answer.

Characteristics of Different Burn Types

Deep partial thickness burns (also called deep second-degree burns) have distinct characteristics that differentiate them from other burn types:

Deep Partial Thickness Burns (Option A - Correct)

• Involve destruction of the epidermis and extend into the deeper dermis
• Heal with granulation tissue and fibrosis 1, 2
• May form hypertrophic scars during healing 1
• Often require specialized treatment to prevent scarring and contracture
• May take 2-3 weeks or longer to heal 3

Other Burn Types (Incorrect Options)

Full Thickness Burns (Option B - Incorrect)

• Full thickness burns are painless due to destruction of nerve endings
• Deep partial thickness burns remain painful to both touch AND pressure 4

Superficial Burns (Option C - Incorrect)

• Superficial burns (first-degree) have intact hair follicles
• Deep partial thickness burns involve damage to hair follicles and sweat glands

Superficial Partial Thickness Burns (Option D - Incorrect)

• Superficial partial thickness burns blanch on pressure
• Deep partial thickness burns have more compromised vasculature and may not blanch reliably

Healing Process of Deep Partial Thickness Burns

The healing of deep partial thickness burns involves:

1. Granulation tissue formation - New connective tissue forms as part of the healing process 2
2. Fibrosis - Collagen deposition leads to scar formation
3. Epithelialization - Occurs more slowly than in superficial burns
4. Risk of hypertrophic scarring - Due to the depth of injury 1

Treatment Considerations

Treatment options for deep partial thickness burns include:

• Early cooling with clean running water for 5-20 minutes 4
• Pain management with over-the-counter analgesics 4
• Specialized dressings to promote healing
• For larger or complex burns (face, hands, feet, genitalia), referral to a specialized burn center 4
• In some cases, debridement and/or grafting may be necessary 1, 5

Clinical Implications

Deep partial thickness burns require careful assessment and management:

• They may be difficult to distinguish from full thickness burns initially
• The healing process involves both epithelialization and granulation tissue formation
• Without proper treatment, they have higher risk of scarring and contracture
• Specialized dressings or treatments may improve outcomes 6, 3

Deep partial thickness burns represent a significant injury requiring proper assessment and treatment to minimize scarring and optimize functional outcomes.