Etiology
Etiology is very important when we talk about burn injuries.
Contact
With a contact burn injury, which is touching a hot object, right away you are going to possibly see blisters and within 24 hours, you are going to know what that burn will be; whether it will be a full thickness, superficial, etc. Sometimes the burn hides underneath the blister, which is why sometimes they remove blisters. However, we know what those contact injuries are going to be within the first 24 hours.
Scald
With a scald injury, it is a little bit trickier. We do not know how deep these wounds are going to be until after 72 hours. Those wounds can look very different from the first time you see them until about 3 days later, which is why it is very important to have a follow-up within that first week.
Electrical
Electrical injuries are almost always going to be very deep. We are talking about a three-degree burn, where you will have eschar.
Chemical
A chemical burn is along the same lines as electrical and is going to be very deep most likely and have eschar.
Friction
A friction burn, which can happen from a treadmill injury, a fall onto pavement, or a hand possibly getting stuck in some type of machinery, tends to be a full thickness burn as well.
Burn Location
Burn location is the second thing that we want to look at and think about when we are talking about hand burns. Is it on the palm, dorsum of the hand, digits, tips of the fingers or crossing any of the joints on the hand? It is best to try to observe that wound during the dressing change. The best knowledge of a burn is to be able to see it. You want to be able to visualize the burn to help you know the progression of the burn, the location, and to see if all of the structures are intact.
