Second
Degree Burns penetrate
into the dermal layer. The
epidermis is destroyed and the dermis is damaged to varying degrees
but the underlying subcutaneous issues remain undamaged.
The
dermis is a fluid rich layer beneath the epidermis. Within
the dermis lay our nerve endings, pores, hair follicles and cells
responsible for the growth and regeneration of skin. Depending on the
depth of involvement, all of these functions are at risk.
Without
the intact epidermis, the skin tissues are no longer protected from
UV light and, more importantly, bacteria. Partial and full thickness
burns are at great risk for infection, hence the use of Silver
Sulfadiazine on these deeper burns. It was used on me 30 odd year ago
and is still in use today.
Depending on the extent of
dermal damage the patient may also loose the ability to sweat and,
therefore, cool the body. This is the only lasting legacy that I have
from my burns. The left arm cannot sweat, nor can my left ribcage, both
of which are important to the body's cooling system.
It would be a bit like a car with half the radiator blocked up with
grass seeds and grasshoppers. it would run hot, as I do.
If nerve endings are destroyed the
patient
will lose feeling in the region. Hair may no longer grow within the
damaged area and if growth cells are destroyed, the skin will lose
its ability to regenerate and heal.
Patients with second degree burns are at
danger for losing some of the mobility in the body
region affected.
Partial
thickness burns may be covered by the destroyed epidermal layer or
open. If skin covers the burn it will be gray, wrinkled or blistered.
Open burns will be red or white and appear moist
Deeper partial
thickness burns
will scar, and show as a
slightly raised patch, and because the Melanin cells have been
destroyed or damaged, that area will have no pigmentation, and be very
susceptible to sunburn.