The anatomy of the skin, depth of burns and Jackson burn wound model JAHD Presentation Perry Crofts

The skin The largest organ in the body Consists of the epidermis and dermis Epidermis is the outer layer of stratified squamous epithelium. It is avascular and varies in thickness The dermis is a dense bed of vascular connective tissue Functions as a physical barrier and a sensory and thermoregulatory organ

The skin

Superficial erythema Only the epidermis involved Red Painful Technically not a burn Not included in total body surface area calculations No complications

Deep & superficial partial thickness Red with clear blisters Deep partial thickness Red and white with bloody blisters Complications can include infections, scarring and contractions

Full thickness and Fourth degree burns Full thickness burns Extend through entire dermis (full thickness) Stiff, white and brown Painless Fourth Degree burns Extends through entire skin and into underlying tissue Black and charred Painless Scarring, contractures and in the worst case scenario amputation particularly with fourth degree burns

Jackson burn wound model Considers the effect of secondary injury on burns Zone of coagulation is central, this tissue is most severely damaged and lost Outside is the zone of stasis which can potentially recover Most periphery is the zone of hyperaemia The borders of the zones are not static and can be affected by factors such as hypovolaemia, hypotension and infection. The zone of coagulation can be extended by excessive oedema therefore increasing the area of necrosis