From the Research
Coagulation is a stage of third degree burn. Third degree burns, also known as full-thickness burns, involve damage to all layers of the skin and sometimes underlying tissues. During the coagulation stage, proteins in the affected tissues denature and coagulate due to the extreme heat, causing cell death throughout all skin layers. This results in a characteristic leathery, dry appearance of the burned area, which may appear white, brown, or black. Unlike first or second degree burns, third degree burns destroy nerve endings, so they may actually be less painful despite being more severe. The coagulation process in these burns leads to irreversible tissue damage, making skin grafting necessary for healing since the skin cannot regenerate on its own due to destruction of the regenerative elements in the dermis. Some key points to consider when evaluating third degree burns include:
- The zone of coagulation is definitely lost and the pathophysiological changes in the zone of hyperaemia are spontaneously reversible 1
- The zone of stasis although not immediately destroyed converts to necrosis during the first week after injury owing to a fatal combination of several factors 1
- Early operative intervention and wound closure, metabolic interventions, early enteral nutrition, and intensive glucose control have led to continued improvements in outcome 2
- The thermal injury produced by the first, second and third degree burn is defined by the zones of coagulation, stasis and hyperaemia 1
- Tissue injury in response to excessive heat results in a clinical burn, with denaturation of macromolecular structures, leakage of cell membranes, activation of cytokines, and cessation of blood flow, all leading to tissue death 3
- A burn injury can be stratified into three main zones, coagulation, stasis and edema, which correlate with the extent of heat exposure and thermal properties of the tissue 4