1) Burns are injuries caused by heat or chemicals and can be classified based on depth and surface area affected. 2) First degree burns involve only the epidermis, second degree extend deeper to the dermis, and third degree destroy the entire skin. 3) Complications can include shock, infection, organ failure and death in severe cases. 4) Treatment depends on severity but generally involves cooling the burn, pain relief, wound care, fluid resuscitation and antibiotics to prevent infection.

1. BURNS
By
HimaSri Reddy

2. INTRODUCTION:-
• Heat is form of energy which when transferred to body produces
thermal injury in the form scalds &burns.
• Scalds :-
produced due to application of moist heat to body. The Boiling
liquids that can scald include water ,milk, oil etc.
• Burns:- produced due to application of dry heat.
min. temp for producing burn is 440 c for exposure of about 5 to
6 hours while 65 0 c for 2 seconds is sufficient to cause burns.

3. DEFINITION:-
•A burn is an injury which is
caused by application of heat /
chemical substance to external
or internal surface of body

4. VARIOUS TYPES OF BURNS:-

5. Burns due to X-rays
Electrical burns

6. CLASSIFICATION:-
Based on depth
Based on surface area
Based on depth –
1)Hebra’s classification
2)Wilson’s classification
3)Dupuytren’s classification

7. DUPUYTREN’S CLASSIFICATION
• Classified depending on severity of burns.
• First degree- erythema then desquamation of superficial layer of
epidermis.
• Second degree- blister formation
• Third degree- destruction of epidermis
• Fourth degree- destruction of whole thickness of skin
• Fifth degree- destruction of muscles
• Sixth degree- destruction of bone,nerve trunks etc.

8. In practical situations Dupuytren’s
classification is limited to three degrees.
First degree : Epidermal burns
In this the lesion is
confined to the epidermis. There may be
Blistering without lose of epidermis . If the
blister bursts reddened base is seen.

9. • Second degree : Dermoepidermal burns
• There is a destruction of full thickness of the
skin.
• The epidermis is coagulated or charred.
• There is a central zone of necrotic tissue
surrounded by first degree
• Scarring is in evitable & is due to formation
contractures, there is disfiguration.

10. Third degree burns : Deep burns
• There is a destruction of deeper tissues
below the skin surface.
• The skin is totally destroyed, though in
some deep burns, islands of intact
dermis may be found.
• Damage to subcutaneous fat & loss of
muscle, bone etc., is seen.

11. CLASSIFICATION BASED ON
SURFACE AREA:-
• The rule of nines
• Body part effected % of burns
• Head & neck 9
• Rt upper limb 9
• Lt upper limb 9
• Rt lower limb 18
• Lt lower limb 18
• Front of trunk 18
• Back of trunk 18
• Genitals 1

12. • Burn injury is more severe if heat applied is of great intensity
& exposure to heat is for long time.
• It also depends on area involved. Burns to face, genital,
lower part of abdomen is more dangerous.
• Infants & elderly people are more susceptible to
complications of burns.

13. COMPLICATIONS OF BURNS:-
Heat haematoma:-
Haematoma may form in extra dural
space between skull & dura mater when
cranium is exposed to severe heat.
Heat rupture:-
Heated skin contracts & splits .It is usually
seen on elbows, knees & head

14. Heat rigor:-
It is observed mainly in muscles. There is
generalized flexion of trunk , arms &legs
.upper limbs held out with fingers curled
inwards assembling attitude of boxer
{pugilist} .This is refers as pugilistic attitude.
Heat fracture:-
Due to intense heat bones get fractured
especially cranial vaults & limb bones.

15. MANAGEMENT OF BURNS
• Mild or moderately severe-
First aid-
• Cool area with running water for 20 min.
• For chemical and eye burns, irrigate with copious volumes of water.
Pain relief-
• Paracetamol,codeine,morphine
• Airway and breathing should be ensured
• Circulation- signs for circulatory obstruction should be checked.

16. • Severe
 Airway and breathing-
• In case of airway burn and lung injury,arrange intubation before
airway swelling occurs.
Circulation-
• If > 10% body surface involved,commence fluid resuscitation.
• If > 10% deep partial thickness or full thickness burns,start feeding
within 6-18 hrs.
• Analgesia should be adequate.
• Closed dressing recommended for partial thickness burns.

17. CAUSES OF DEATH IN BURNS
• Primary shock or neurogenic shock
• Secondary shock due to fluid loss
• Smoke inhalation
• Toxaemia
• Septicaemia
• biochemical disturbances
• Acute renal failure
• oedema of glottis & pulmonary oedema
• Malignant transformation of burns scar {marjolin’s ulcer} after years
of recovery

19. AUTOPSY FINDINGS:-
External :-
 The body may demonstrate the
attitude.
 Antemortem burns appear reddened &
blistered. Hair is signed or burnt.
 Blisters may be seen , but they also in
postmortem burns, even in a
body.

21. • Often there may be Signs of gross
infection of burns on a dead body with
discoloration & pus formation.
• Burning of clothes, singeing of hair,
charring of the body etc., are also seen ,
which are not seen in scalds.
• Heat ruptures may be evident , which
must not be confused with the
antemortem incised wounds.

22. Internal :-
• Blood may be cherry red in colour, due to the presence of
carboxyhaemoglobin.
• Extra dural heat haematoma may be seen
• Soot particles or carbonaceous material may be seen in the
respiratory passages due to smoke inhalation.
• Curling’s ulcers may be seen on stomach are duodenum.
• Serous pleural are common. Lungs are congested & appear
“cooked”
• Spleen & adrenal gland may be enlarged, congested & softened.

23. REFERENCES:-
• V.v.pillay
Text book of Forensic science & Toxicology.
• Dr. Ks. Narayan Reddy
The synopsis of Forensic Science & Toxicology.

24. THANK
YOU….