Burns and scalds (2024)

About burns

Burns can be caused by flames, ultraviolet (UV) radiation, hot liquids, electricity, lightning and certain chemicals.

All burns require immediate first aid treatment.

Partial and full thickness burns require urgent medical attention. Full thickness burns often require skin graft surgery.

Types of burns

There are 3 levels of burns:

• Superficial – these burns cause damage to the first or top layer of skin only. The burn site will be red and painful.
• Partial thickness – these burns cause damage to the first and second skin layers. The burn site will be red, peeling, blistered and swelling with clear or yellow-coloured fluid leaking from the skin. The burn site is very painful.
• Full thickness – involves damage to both the first and second skin layers, plus the underlying tissue. The burn site generally appears black or charred with white exposed fatty tissue. Very deep burns may damage the underlying muscle or bone. The nerve endings are generally destroyed and so there is little or no pain at the site of the full-thickness burn. However, surrounding partial thickness burns will be very painful.

It can be difficult to tell the difference between partial and full-thickness burns. The depth of a burn is not critical in the initial treatment of burns. An assessment of the extent of the burn is more important initially.

First aid for burns

Complications of major burns

Some of the potential complications of major burns include:

• injury to lungs from smoke inhalation
• hypovolaemia – loss of fluid from burnt skin. This may lead to shock
• heat loss (hypothermia) – since burnt skin is unable to properly regulate body temperature
• infection.

Treatment for burns

The medical treatment you will receive on admission to the hospital emergency department could include:

• pain relief - morphine may be required
• a cool shower
• intravenous fluids through a drip
• intensive medical monitoring
• wound dressing
• topical antiseptics.

Admission to a burns unit

• for adults – partial or full thickness burns over 10% of the body surface
• for children – partial or full thickness burns over 5% of the body surface
• respiratory burns – lungs or other parts of the breathing system affected
• circumferential burns – burns that go right around the body
• burns to hands, feet, face, perineum and joints
• electrical burns
• chemical burns.

Skin graft surgery

If the body is not able to heal the injury by itself, skin grafts will be needed. The specifics of skin graft surgery depend on the location and severity of your burns. Skin grafts are usually performed under anaesthetic in an operating theatre.

Self-care for burns

Be guided by your doctor, but general suggestions include:

• Rest as much as you can.
• Follow all self-care instructions from your doctor.
• Try to avoid moving or stretching the area, as you may injure your skin graft.
• Silver impregnated wound dressings protect against infection. Medi-honey also has antiseptic properties.
• Foam dressings absorb moisture and protect the wound.
• Non-adhesive dressings are preferred.
• If antibiotics have been prescribed to reduce the risk of infection, then make sure you take the full course.
• A change in the colour of the wound, discharge from the wound, or a foul or sickly sweet odour may indicate infection. See your doctor in this case.
• Avoid getting your dressings wet.
• See your doctor immediately if you experience any unusual symptoms.

Where to get help

• Your GP (doctor)
• Dermatologist

Need treatment today?

Need treatment today, but it’s not life-threatening and you can’t get a GP appointment, there are services available:

• Priority Primary Care Centres – provide care for conditions that require treatment today but not an emergency response (extended hours)
• Victorian Supercare Pharmacies – offer healthcare advice and support (after-hours, 7 days)
• NURSE-ON-CALL Tel. 1300 60 60 24 – for expert health information and advice (24 hours, 7 days)

Emergency care

• In an emergency, always call triple zero (000) – for a major burn or where breathing has been affected
• Emergency department of your nearest hospital

More information

• Victorian Adult Burns Service at The Alfred Hospital