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Third-Degree Burns (Full Thickness Burns)

What is a third-degree burn?

A third-degree burn is also referred to as a full thickness burn. This type of burn destroys the outer layer of skin (epidermis) and the entire layer beneath (the dermis).

Anatomy of the skin
Click Image to Enlarge

What causes a third-degree burn?

In most cases, full thickness, third-degree burns are caused by the following:

  • A scalding liquid

  • Skin that comes in contact with a hot object for an extended period of time

  • Flames from a fire

  • An electrical source

  • A chemical source

What are the symptoms of a third-degree burn?

These are the most common symptoms of a full thickness, third-degree burn. :

  • Dry and leathery skin

  • Black, white, brown, or yellow skin

  • Swelling

  • Lack of pain because nerve endings have been destroyed

Large, full thickness, third-degree burns heal slowly and poorly without medical attention. Because the epidermis and hair follicles are destroyed, new skin will not grow.

The symptoms of a third-degree burn may look like other conditions or medical problems. Third degree burns should always be evaluated immediately in the emergency department. Your child may need to be transferred to a burn center for further treatment.

Treatment for third-degree burns

Your child’s healthcare provider will figure out the best treatment based on:

  • How old your child is

  • His or her overall health and medical history

  • How well your child can handle specific medicines, procedures, or therapies

  • Your opinion or preference

Treatment for full thickness, third-degree burns will depend on the severity of the burn. Burn severity is determined by the amount of body surface area that has been affected. The burn severity will be determined by your child's doctor. Treatment for third-degree burns may include the following:

  • Early cleaning and debriding (removing dead skin and tissue from the burned area). This procedure can be done in a special bathtub in the hospital or as a surgical procedure.

  • Intravenous (IV) fluids containing electrolytes

  • Intravenous (IV) or oral antibiotics if your child develops an infection

  • Antibiotic ointments or creams

  • A warm, humid environment for the burn

  • Nutritional supplements and a high-protein diet

  • Pain medicine

  • Skin grafting (may be needed to close the wound)

  • Reconstructive surgery

  • Tetanus shot

What is a skin graft?

A skin graft is a piece of the child's unburned skin which is surgically removed to cover a burned area. Skin grafts can be thin or thick. Skin grafts are done in the operating room. The burn that is covered with a skin graft is called a graft site.

What is a donor site?

The area where the piece of unburned skin was taken to be donated to a burned area is called a donor site. After a skin graft procedure, the donor sites look like a scraped or skinned knee. Your child's doctor will decide if a skin graft is needed. A skin graft is often done after removal of the dead skin and tissue.

Graft site care

A dressing is left on the graft site for 2 to 5 days before it is changed, so that the new skin will stay in place. For the first several days, graft sites need to be kept very still and protected from rubbing or pressure.

Donor site care

The donor site is covered for the first 1 to 2 weeks. The site needs to be kept covered. Donor sites usually heal in 10 to 14 days. If a dressing is applied, it usually remains on until it comes off by itself. Lotion is applied to the donor site after the dressing comes off. This skin often flakes off and looks dry.

Online Medical Reviewer: Duldner, John E., MD, MS
Online Medical Reviewer: Fetterman, Anne, RN, BSN
Date Last Reviewed: 8/16/2015
© 2000-2015 The StayWell Company, LLC. 780 Township Line Road, Yardley, PA 19067. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.
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