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Complications of Third Degree Burns (Part I)

Third degree burns are burns that causes injury to all  layers of the skin (epidermis, dermis and subcutaneous tissue), it may also damage the muscles and bones. These burns are serious and may result in extensive scarring as well as other injuries and limitations. Third degree burns are vulnerable for  many complications, some of which are due to  the burn injury itself while others are due to the reaction of the body during treatment and healing process.

Complications may include:

Burn Infection:

The skin act as the main barrier against infection and when this is lost, the body becomes susceptible for infection by variable pathogens. Infection is one of the most common complications of burn injuries and the risk is more with third degree burns due to the depth of the burn and the wide area involved. When infection is severe, septicemia and septic shock may result due to the spread of infection to the blood stream which is a serious condition that may lead to multi-organ failure and death therefore, urgent treatment is needed.

Fluid loss and hypovolemia:

Hypovolemia is defined as a decrease in the volume of blood or fluids in the body. When the blood vessels are damaged as a result of a burn injury, their permeability to fluid increase leading to excessive fluid loss leading to a decrease in the blood volume of the patient. In addition, one of the functions of skin is to act as an insulation barrier to regulate the insensible fluid loss from the body, when this is lost in burn injury, the rate fluid loss and evaporation increases leading to hypovolemia. Hypovolemic shock and electrolyte imbalance may also happen due to excessive fluid loss, therefore fluid and electrolyte replacement are one of the main steps of burn management.

Deep vein thrombosis (DVT) and pulmonary embolism:

Patients who sustain third degree burns may need to stay bedridden for a long period of time. Lower limb muscle contraction during movement and walking act as a pump pushing the blood from the lower extremities back to the heart against gravity. Extended periods of bed rest increases the risk of developing blood clots as immobility can interfere with circulation of blood making it slower and causing the blood to collect in the veins forming blood clots. When these clots lodge in the veins of the limbs, it can cause DVT which is a serious condition that need to be treated as it may lead to pulmonary embolism and death if left untreated. It is important to start ambulating as soon as possible as the longer the patient is bedridden, the higher the risk of developing blood clots and DVT.  Using blood thinners and pneumatic compression devices (directed by the treating team) can reduce the risk of developing blood clots.

This information is not intended nor implied to be a substitute for professional medical advice; it should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. Call 911 for all medical emergencies.


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