The average age of burned children is 32 months. Chemical and electrical burns are less common. Thermal energy damages the skin in proportion to the intensity and duration of exposure. Viscous products produce more injury, and melted fabrics produce more damage because of skin adherence.
Thermal injury produces an area of coagulation necrosis.
This is heat injured, yet viable tissue. Histamine release following the injury leads to local edema, and other tissue active mediators lead to arteriolar vasoconstriction. Surface colonization with Gram positive cocci occurs within 24 hours, and Gram negative bacteria in 3 - 7 days. Deep tissue invasion may occur subsequently, followed by bacteremic spread. The area should be cleansed from loose debris with saline soaked gauze Surgical debridement may be necessary.