MEDICAL ANIMATION TRANSCRIPT: The skin contains three main layers: the epidermis, dermis, and hypodermis, or subcutaneous. Burns are tissue injuries caused by heat, chemicals, electricity, radiation, extreme cold, or friction that disrupt the skin's framework and function. Superficial burns affect the epidermis only, causing erythema, or redness, and pain. Partial thickness burns are either superficial or deep. Superficial partial-thickness burns involve the epidermis and the upper, or papillary, dermis, causing immediate blistering and intense pain and sensitivity. Deep partial-thickness burns destroy the papillary dermis, epidermis, and most of the lower, or reticular, dermis, sparing some cutaneous nerve endings, capillaries, and dermal appendages. Full-thickness burns destroy the entire epidermis, dermis, and portions of the hypodermis. The burned area is white, brown, dry, and charred, has no sensation, and cannot heal without surgical intervention. Burns can also be evaluated by determining the percentage of body surface area they cover. This percentage can be estimated quickly using the rule of nines, a formula in which each body part is assigned a value of 9% or a multiple of nine. Severe burns involving a large surface area increase capillary permeability and lead to two stages of shock. In hypovolemic shock, water, electrolytes, and plasma proteins leak from the bloodstream into interstitial spaces creating widespread edema. In burn shock, the lowered intravascular volume increases blood viscosity and vascular resistance. To compensate, the heart rate speeds up. As a result, organs and tissues do not receive adequate blood supply, resulting in tissue and organ death from a lack of oxygen. Burn treatment aims to restore fluid balance through administration of intravenous fluids, electrolytes, and proteins, which increases intravascular volume. Wound care reduces complications by preventing infection and promoting healing of damaged tissues. Analgesics control the pain and inflammation of superficial burns. Superficial partial-thickness burns are cleansed, covered with a sterile dressing, and monitored regularly for infection. In deep partial-thickness burns, dead skin, or eschar is routinely detached or debrided to a healthy level. The wound bed is kept clean and moist to allow epithelial regeneration and to accept transplanted tissue called a skin graft. Full-thickness burns are excised and regularly debrided to prevent ischemia and infection, and to create a viable base for grafting. ♪ [music] ♪

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