RT Book, Section
A1 Doherty, Gerard M.
SR Print(0)
ID 58105031
T1 Burns
T2 Quick Answers Surgery
YR 2010
FD 2010
PB The McGraw-Hill Companies
PP New York, NY
SN 
LK accesssurgery.mhmedical.com/content.aspx?aid=58105031
RD 2024/04/20
AB •  Skin  is  the  largest  organ  of  the  body,  ranging  from  0.25  m2  in  infants  to  1.8  m2  in  adults•  Skin  has  2  layers:  epidermis  and  dermis-The  outermost  cells  of  the  epidermis  are  dead  cornified  cells  that  act  as  a  tough  protective  barrier-The  dermis  is  chiefly  composed  of  fibrous  connective  tissue  and  contains  the  blood  vessels  and  nerves  to  the  skin  and  epithelial  appendages  of  specialized  function-The  dermis  prevents  loss  of  body  fluids  and  loss  of  excess  body  heat•  Nerve  endings  that  mediate  pain  are  found  only  in  the  corium-Partial-thickness  injuries  may  be  extremely  painful-Full-thickness  burns  are  usually  painless•  Second-degree  (or  partial-thickness)  burns  are  deeper,  involving  all  of  the  epidermis  and  some  of  the  dermis-The  systemic  severity  and  quality  of  subsequent  healing  are  related  to  the  amount  of  undamaged  dermis•  Complications  are  rare  from  superficial  partial-thickness  burns  and  usually  heal  in  10-14  days•  Deep  partial-thickness  burns  heal  over  25-35  days  with  a  fragile  epithelial  covering  that  arises  from  residual  uninjured  epithelium  of  the  deep  dermal  sweat  glands  and  hair  follicles-Severe  hypertrophic  scarring  occurs  when  such  an  injury  heals-Evaporative  losses  remain  high-Conversion  to  full-thickness  by  bacteria  is  common•  Skin  grafting,  when  feasible,  improves  the  physiologic  quality  and  appearance  of  the  skin  cover