Burn Injuries and Cosmetic Disfigurement

When a person suffers a serious traumatic burn injury, the victim will often suffer long-term health effects that must be managed clinically in order to optimize their quality of life, often for the remainder of his or her life. Serious burn injuries often result in very serious and chronic physiological problems that will require a prolonged healing process.

In addition, while burn scarring and disfigurement may be surgically restored to some extent, a person’s psychological suffering often cannot. Burn victims often face a plethora of challenges through life – often leaving long-term psychological effects, such as depression, anxiety, suicidal ideation and post-traumatic stress disorder. In most cases, the psychiatric outcomes of a traumatic burn injury are brutally debilitating, distressful and life-altering.

Understanding the Skin and its Relation to Burn Wound Healing

What is the function of the skin?

The skin is the largest organ in the body and is responsible for many functions, such as keeping nutrients in the body, being a physical barrier, controlling infection, providing sensation, water and electrolyte balance, and temperature regulation. The skin also provides a protective barrier against the harmful effects of UV radiation.

The surface layer of the skin is called the epidermis, and the deeper layers are called the dermis. You can see the basic anatomy of the skin below :

The epidermis is capable of complete regeneration. When burns are confined solely to the epidermis, or outer layer of the skin, the burn will heal with no or very minimal scarring. The dermis, or underlayer, has no regeneration property. When burns involve both the epidermis and dermis, vital functions of the skin can be lost.

Degree of Burns

What are the 4 degrees of burns?

Burns are a three-dimensional injury. The severity of burns depends on the severity of the burn and how deep the damage has penetrated beneath the surface of the skin.

First-degree burns (superficial burns): A first-degree burn is the least severe type of burn. It typically does not penetrate the surface of the skin (epidermis), leaving the area of injury red or painful without any blisters or long-term damage. A typical first-degree burn is a sunburn. First-degree burns normally have no blister formation and will normally get better in 3 to 5 days.

Second-degree burns: A second-degree burn is when the epidermal integrity has been damaged. Second-degree burns are typically divided into superficial second-degree burns and deep (or deep partial) second-degree burns. If the injury is limited to the upper layer of the dermis, it will be classified as a superficial second-degree burn. However involvement of the deeper layers leads to deep or “deep partial” second-degree burns. Burn penetrates the surface of the skin (epidermis) and the middle layer (dermis) underneath. Usually, a second-degree burn will result in blisters, redness, swelling, and pain.

Third-degree burns: These are also known as “full thickness burns,” which involve the full thickness of skin – meaning the whole epidermis and dermis. Third-degree burns can be life-threatening. In most cases, third-degree burns can go through the dermis and epidermis and cause damage to bone, muscles, and tendons. Third-degree burns often don’t heal by themselves, so surgery and skin grafting are often necessary.

Fourth-Degree Burns: Fourth-degree burns are when all layers of the skin, subcutaneous fat tissue, and deeper tissue are involved, and there is a “carbonized” type of appearance.

What are the Main Causes of Burns?

The main causes of serious burns are thermal burns, flames, scalds, and chemical and electrical burns.

Flame burns – These are mostly caused and accidental situations, such as in house fires, explosions, or flaming vehicles in car accidents, motorcycle accidents or trucking accidents.  Flame burns often have a high morbidity rate. Victims who suffer flame-burning injuries often have to endure pain for years after the burn-off injury wounds have closed. In addition to dealing with ongoing pain, numerous medical journals tell us that flame burn victims often show very poor lifelong adjustment. Many times, chronic pain that a person suffers will no doubt be a predictor of PTSD. A burn victim who suffers PTSD is often brought back to their hospital environment and the pain and agony that they suffered at the time of the accident.

Scald burns – These are the most common types of burns in kids. Scalds are often caused by spilled hot liquid., which can cause first, second or third-degree burns. A common type of scald injury is when a child pulls the handle of a hot pan or pot off of the stove, causing the liquid to fall forward and burn their skin. Scalds burns are the leading cause of burn injuries, particularly to young kids and senior adults.

Thermal Burns – These are caused by heat and are the most common type of burn as they can vary in degree, severity, and cause. When the skin is exposed to a heat source, the temperature of the skin begins to rise, and tissue cells may begin to either die or become charred. A heat source may include fire or flames, steam, hot metal, boiling water, or contact with hot objects. There are many ways an individual may sustain a severe thermal burn injury after an accident. For example, after a car accident, the wreckage may expose victims to hot metal or even burning equipment. Construction and industrial accidents, house fires or arson cases, and open steam vents on public property could also contribute to thermal burn injuries.

Thermal burns sustained by fire can lead to death or serious injury: according to Statistics Canada, between 2010 and 2014, 110 Canadians suffered fatal burns from fires, and approximately 1,100 people were hospitalized from fire-related burns. Children are also at a higher risk for severe, permanent consequences from thermal burns because a child’s skin is still developing and can burn up to four times more quickly and deeply than adult skin (according to Parachute).

Chemical Burns – A chemical burn is one of the more severe types of burns a victim may experience, as chemicals typically cause more damage to deeper layers of the skin tissue. This type of burn occurs when chemicals such as acids, detergents, solvents, or alkalies come into contact with the skin or the eyes. These chemicals can include carbon monoxide, ammonia, strong cleaners, chlorine, or sulfuric acid. Any time a chemical makes contact with the skin, the acids in the chemicals can cause cell deterioration and penetrate into any layer, which could leave serious disfigurement, scarring, and permanent nerve damage.

Chemical burns comprise approximately 2.1% to 6.5% of all burn center admissions in the United States and occur more commonly in workplace accidents such as industrial accidents or construction accidents.

Electrical Burns – These occur when the skin comes into contact with an electrical current. This often occurs alongside electrocution and is typically more likely to occur from a construction or workplace accident or a car accident that caused mechanical or equipment malfunction. 

Electrical burns can cause deep organ issues because electricity can travel quickly through the body when contact is made. A victim may go into cardiac arrest, suffer severe nerve damage, or experience kidney failure if the electrical burn is severe. Additionally, an electrical burn can lead to death if not treated immediately. Even if the victim does not experience any internal pain, medical attention should always follow an electrical burn.

Radiation Burns – These are typically a non-traumatic burn caused by prolonged exposure to ultraviolet rays, such as from the sun, or from a source that utilizes radiation energy, such as an X-ray or chemotherapy. They are typically localized to the area of contact and often look similar to thermal burns.

The most common type of radiation burn is a first-degree sunburn, which is usually treated topically with ointments or hydration therapy. This type of burn being caused by an accident is less common but could occur in premises liability cases. 

Road Rash – These are friction burns that occur when the skin comes into contact with a hard object, usually at a high impact. These types of burns often result in skin being rubbed off and the body generating heat, which is why they are typically a combination of a thermal burn and an abrasion. 

Road rash is a common type of friction burn that occurs in motorcycle accidents, but it could also be the result of a pedestrian accident, bicycle accident, or car accident. This is because road rash is often caused by an individual being struck with a high-velocity force and being thrown across the road or sidewalk. For example, in a motorcycle or bicycle accident, the rider may be thrown from the handlebars across the road. In a forceful impact accident, the victim’s contact with the road can be severe enough to penetrate through deep layers of skin and require skin grafting to repair the damage.

Another form of friction burn injury may include carpet burn or rope burn. A carpet burn is usually not too severe but could occur from a slip and fall accident or a children’s accident at school or daycare.

Complications From Serious Burn Injuries

The most common complication of a serious burn, by far, is infection. Infection can cause the burn to deepen, which can, in rare circumstances, cause sepsis. Serious burn injuries can also cause immune response, inflammatory response, as well as metabolic changes or overall body shock, which can be very hard to manage and lead to internal organ failure. Hormonal disruption is often disabling, as is overall muscle dysregulation.

Serious burn injuries can be overwhelming. Again, victims who suffer serious burn injuries are never really considered healed. Most serious burn injury wounds require lifelong medical management in order for the victim to optimize his or her quality of life.

Burn injury victims are often left with prolonged pain, which can be chronic and lifelong. Chronic burn pain can be a very onerous burden not only during the time of acute medical recuperation following the accident or injury but also for the rest of a person’s life. It can interfere with a person’s sleep, ability to work and overall quality of life. Chronic burn pain also often requires a multidisciplinary approach, including medication and non-medication treatments, including anti-inflammatory drugs for long-term pain relief, opiates, anticonvulsant medications, sleep medications, antidepressants and medication for burn-related topical care.

Many, if not most, burn injury victims who suffer serious burn injuries and cosmetic disfigurement are left to deal with alterations in their body appearance, which is an issue that is often never overcome.

With some types of injuries, such as orthopedic injuries, wounds heal, albeit with chronic pain. The traumatic nature of burn injuries is different. Not only are victims dealing with chronic pain, but they are also dealing with repeated reminders every time they look at themselves and their appearance, reminders that take them back to their burn injury accident every single day. Post-traumatic stress disorder is highly prevalent with burn injury victims, as is depression, anxiety, neuropsychological problems, social problems, sex life problems and social interaction problems. In short, burn trauma and related cosmetic disfigurement go beyond physical pain but, in most cases, evolve into a serious problem that has significant psychiatric influence over a victim’s life.

If You or Your Loved one has Suffered a Serious Burn Injury, Our Hamilton Burn Injury Lawyers Can Help

Our Hamilton burn injury lawyers understand that for a burn injury victim, rehabilitation starts from the day of injury and will likely remain throughout the rest of that person’s entire life. If you have suffered a serious burn injury, you will no doubt require a comprehensive rehabilitation program that is essential to decrease the negative effects associated with your mental health and post-traumatic stress disorder and improve your functional independence and overall long-term quality of life.

Our Hamilton burn injury lawyers have seen burn victims who have had to endure numerous surgeries, hospitalization, extremity amputation and burn trauma victims who have gone on to suffer serious psychiatric symptoms and post-traumatic stress disorders. We have seen the quality of life of a burn victim plagued with persistent problems in relation to scarring, weakness, itching, chronic pain, chronic medical care, body image and contracture of muscles, tendons and skin.

Our Hamilton burn injury lawyers understand victims who have suffered serious burn injuries experience limitations related to pain, discomfort, daily activities, self-care, physical functioning, etc. and, more importantly, experience extremely serious psychiatric issues as a result of their cosmetic disfigurement and body image.

For burn victims and their families, it is important that you retain a personal injury lawyer who has experience with traumatic burn injuries and the

If you or a loved one has suffered a severe burn injury due to someone else’s negligence, please contact our Hamilton burn injury lawyers nationwide at 1-844-LALANDE or local in the Mississauga to Kitchener to Niagara area at 905-333-8888.  You can also contact us online through our website, confidentially, by clicking here. Our Hamilton burn injury lawyers would be happy to advise you of your legal rights and what insurance compensation you might be entitled to. Remember, talking to our law firm is always free, and we never ask clients for money upfront.

---

CONTACT US LALANDE PERSONAL INJURY LAWYERS  – HAMILTON OFFICE
1 King Street East, Suite 1705
Hamilton, On L8P 1A4
905-333-8888
1-844-LALANDE

Important References

Burn Care And Treatment A Practical Guide (Hb 2013) By Jeschke M G
Mental disorders after burn injury: a prospective study – 2011 Jun;37(4):601-9. doi: 10.1016/j.burns.2010.06.007. Epub 2010 Nov 14.