third degree/ full thickness

[Phosphate]

I understand why an area that has had a third degree burn is numb, the loss of nerve endings.

However, if the third degree burn is say 5in x 5in, will the pateint still be in pain? And is this becuase the rim of the burn is not usually burnt as much?

Thanks

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[GSresident]

That is a good question. I think you are on the right track. I think there may be partially burned tissue around the edges of a burn (can I use the word penumbra even though its not the brain?) that may still be sensate and causing pain.

 

[Roux-en-Y]

I understand why an area that has had a third degree burn is numb, the loss of nerve endings.

However, if the third degree burn is say 5in x 5in, will the pateint still be in pain? And is this becuase the rim of the burn is not usually burnt as much?

Thanks

There are 3 zones surrounding a 3rd degree burn focus, kind of like a 3-D bullseye: a central zone of necrosis/coagulation, zone of stasis and zone of hyperemia (from inside to outside). central zone is dead, will have to be excised; o/w will become infection source. Zone of stasis may or may not heal without intervention (which I liken to superficial versus deep 2nd degree). All of Zone of hyperemia will heal unaided (which I liken to 1st degree. We (burn unit at my institution) usually wait several days to allow the eschar to demarcate itself before tangential excision and subsequently split thickness skin graft...But I digress....

To answer your question, you do not feel pain @ the eschar,3rd degree site but do in the surrounding zones, feeling less pain as you spread outward radially.

Hope this helps.

Roux