Salone News

When managing third and fourth degree burns

12 November 2021 at 18:15 | 721 views


By Dr. Nanah Sheriff Fofanah- Sesay, Special Contributor, USA

Since survivors of the Wellington Tanker explosion were mostly impacted by third and fourth degree burns, the focus of this educational narrative is limited to these types of injuries.

For identification purpose, third degree burns affect the epidermis or topmost layer of the skin, the dermis or inner layer of the skin, and the fatty tissues of the skin.

Fourth degree burns on the other hand go through both layers of the skin, underlying tissues, deeper tissues, and possibly involving the muscles and bones.

In both type of burns, the nerve endings are destroyed and as such, there is absence of feelings on the area affected.

Other impacts of these types of burns includes compartment syndrome which is described as the pressure buildup from swelling of tissues and internal bleeding. Compartment syndrome is painful and dangerous.

Other impacts resulting from these types of burns include but are not limited to organ inflammation, organ damage, shock, low body temperature, dehydration, and infection from deep wounds that may cause bacteria to enter the body.

What are the immediate and long-term treatments for these level of burns

The treatments for these level of burns occurs in stages (pre-hospital stage and during hospitalization).

In the pre-hospital or initial stage:

- Raise the injured body part above the level of the heart to facilitate circulation.

- Cover the affected area with loose bandage or clean cloth to prevent infection.

- Place a light sheet of blanket over the victim to provide warmth as reduced blood pressure often creates coldness.

- Flush area with water only if burns are caused by chemicals.


Do not apply ice, creams, ointments. Remove clothing that may be stuck to the skin, pick on the skin, or peel away any blisters.

During Hospitalization

- Cleaning and debridement or removal of dead tissues from the area.

- Pain management likely intravenously route.

- Application of antibiotic ointment to prevent infection.

- Tetanus shot if the victim had not had one in 10 years.

- Intravenous fluids to help prevent dehydration and low body temperature.

- Close monitoring of vital signs and hemodynamic status due to the high likelihood of inflammation to major organs (liver, intestines, heart, and lungs) and shock.

- The medical team are more likely able to determine the overall extent of the injury as the burn heals.

- Once a determination of the injury is established, cosmetic reconstruction such as grafting the skin that does not generate any new tissues.

- Physical and psychological therapy.

Hope these will help in shedding some light on the impact and management of victims associated with the Wellington Tanker explosion.