What degree of burns does a patient have with burns extending through the epidermis to the dermis?

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Burn Classification: Partial-Thickness (Second Degree)

This patient has partial-thickness (second degree) burns, as burns extending through the epidermis into the dermis define second-degree injury. The correct answer is B. Partial-thickness (second degree).

Burn Depth Classification

The classification of burn depth is based on which anatomical layers are affected:

  • First-degree (superficial) burns involve only the epidermis and present with erythema without blistering 1, 2

  • Second-degree (partial-thickness) burns extend through the epidermis and involve part of the dermis, which precisely matches this patient's presentation 1, 3, 2

  • Third-degree (full-thickness) burns extend completely through the epidermis and dermis into subcutaneous fat 2

  • Fourth-degree (complete-thickness) burns expose bone, tendons, and muscles 3

Clinical Significance for This Patient

This patient requires immediate specialist referral because the burns involve critical anatomical locations (face and bilateral hands) that carry high risk for functional impairment and require specialized care beyond first aid 4, 5, 6.

Key Management Priorities:

  • Immediate cooling with clean running water for 5-20 minutes to limit tissue damage 4, 5, 6

  • Hand burns with any partial-thickness depth mandate immediate burn specialist consultation to prevent permanent functional disability 5

  • Facial burns require specialized care regardless of total body surface area involved 6

  • Burns on these locations automatically elevate severity and require expert management even if the total body surface area is small 5

Common Pitfall to Avoid

Do not delay specialist referral based on body surface area calculations alone—the anatomical location (face and hands) makes this a severe burn requiring immediate burn center evaluation regardless of size 5, 6. Undertriage of burns involving functional areas like hands increases morbidity and mortality 5.

References

Research

Topical treatment of pediatric patients with burns: a practical guide.

American journal of clinical dermatology, 2002

Guideline

Management of Second-Degree Burns on Toes 2-4

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Guideline

Treatment for Large Hand Burns

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Guideline

Management of Second-Degree Burns

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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