Burns are divided into three types, from first-degree, which is the least serious type, to third-degree, which is extremely serious. Full-thickness burns are third-degree burns. With this type of burn, all layers of the skin — epidermis and dermis — are destroyed, and the damage may even penetrate the layer of fat beneath the skin. It’s common to find all three types of burns within the same wound.
Unlike other burns, which are very painful, a full-thickness burn may not hurt when touched. This is because the nerve endings responsible for sensation are destroyed. The burned area can appear waxy and white, gray and leathery, or charred and black. Treatment for a full-thickness burn usually requires skin grafting to close the wound.
| Thickness | Degree | Depth | Characteristics |
| Superficial | First | Epidermis | Dry, redness, mild swelling, with or without blisters |
| Superficial partial | Second | Dermis: Papillary region | Moist, splotchy, swelling, blisters |
| Full thickness | Third | Hypodermis/subcutaneous tissue | Moist, white, leathery, painless |
The severity of a burn is classified by its depth and the layers of skin it affects. A burn can be superficial, partial thickness, or full thickness.
Here is an overview of each:
- Superficial. This damages only the epidermis, which is the outer layer of skin. The skin remains intact and there is no blistering.
- Partial thickness. This type causes damage to the upper layer of the dermis and may cause blistering.
- Full thickness. This type extends through every layer of the skin and may penetrate deeper to the layer of fat just below the skin.
Full-thickness burns are usually caused by contact with one of the following:
- scalding liquid
- flames
- extended contact with a hot object, such as metal
- steam
- electricity
- chemicals, such as acids
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Full-thickness burns do not heal without surgery and require long-term scar care. The treatments used depend on the extent, severity, and location of the burn. The person’s overall health and the cause of the burn will also determine the treatment.
The following are the different types of treatments used for full-thickness burns.
Tetanus prophylaxis
Tetanus prophylaxis vaccine is given to people who are taken to a hospital with burns deeper than superficial thickness. The dose depends on whether the person received their initial vaccine or booster, if that information is available.
Early cleaning and debridement
The skin is cleaned using water or a saline solution, and then dead skin, tissue, and debris is removed from the burned area.
Extra fluids
People with full-thickness burns are given extra fluids through an IV to maintain blood pressure and prevent shock.
Medication
Different types of medications are used to treat full-thickness burns. These may include:
- pain medications
- antibiotics
- anti-anxiety medications
Surgery
Full-thickness burns generally require a number of surgeries to remove burned tissue, and surgery is performed as soon as possible.
Skin grafts
Once burned skin has been removed, skin grafts are used to cover the wound. This may include a combination of natural skin grafts, artificial skin, and epidermis grown in a laboratory.
Breathing assistance
Oxygen and sometimes a tube placed down the windpipe are used to help with breathing. Burns that affect the face and neck can cause your throat to swell and interfere with breathing. People who suffer smoke inhalation may also require breathing assistance.
Feeding tube
Nourishment is an important part of healing and recovery. The body requires extra energy due to heat loss, tissue regeneration, and other effects of trauma. A feeding tube may be used if a person is unable to eat because of the extent of their injuries.
Physical and occupational therapy
Physical therapy is an important part of treatment for burns that affect joints and limbs or those that require an extended hospital stay. Physical therapy can help improve range of motion and strengthen weakened muscles. It can also help stretch the skin for easier movement. Occupational therapy is used to help you perform day-to-day activities when you leave the hospital.
Plastic surgery
Full thickness burns cause extensive, permanent scarring. Cosmetic reconstruction procedures may be used after a person has recovered from their injuries.
Counselling
Counselling may be provided to help deal with the emotional impact of the initial trauma, as well as other symptoms that are common following a traumatic experience, extensive injuries, and long recovery.
Pain management
Pain management will be provided to help deal with chronic pain from your injuries. Pain management is ongoing and may continue for weeks to years.
Treatment for full-thickness burns continues after you’ve left the hospital and gone home. Along with the treatments listed, you may also require wound care, which includes cleansing and dressing the wounds. This may be performed by a nurse in your home or in a doctor’s office. You or a family member may also be taught to clean and dress your wounds at home.
Severe burns require emergency medical assistance. Call 911 right away if you or someone else has suffered a serious burn.
A full-thickness burn is a medical emergency that requires immediate treatment. Full-thickness burns are treated in facilities with a burn unit and usually require long-term wound and scar care.