AboutJim B Expertise I can answer a variety of questions concerning the physical care of burns and burn patients which commonly are of interest to both patients and their families. Also I may be helpful in suggesting lifestyle modifications which will help with a more complete recovery from a serious burn. I can also accept questions regarding the physical classifications of burns and the implications regarding the size, depth, and location of burns. What I cannot answer based on my own knowledge and experience I can refer to my current and former collegues in the field including the plastic and trauma surgeons and burn recovery organizations. In many of these cases I will provide a line of communication directly to a specific expert or organization. While I can describe general treatments routines with which I am experienced,I cannot answer questions dealing with specifuc diagnosis of conditions or problems. Additionally, please understand that the area of burn treatments is an experimental one in which there is constant progress and change. Each Burn Center invests a major effort in the development of new materials, treatments, medications, and techniques. In this area of constant change and growth no one can be fully aware of all treatment courses employed.
Experience I am a licensed Paramedic and have also worked as a wound technician in a large regional Burn Center in a Trauma Level 1 hospital. I have experience in the areas of burn evaluation and care, both long-term and immediate first aid. I have also worked as a volunteer couselor with post-burn patients dealing with issues ranging from life-style changes to re-entering the world as a serious burn survivor.
Education/Credentials BA Economics and Biology, AA Health Care Management, EMT-P licensed in Missouri, ABLS (Advanced Burn Life Support)qulification, ACLS-EP (Advanced Cardiac Life Support-Experienced Provider), Former National Ski Patrol Winter Emergency Care Instructor and Senior Evaluator, Emergency Medical Technician and Paramedic Instructor.
Expert: Jim B Date: 7/2/2008 Subject: Keloid scars
Question What degree (that is, how deep) does a scald or burn have to be to develop into a keloid scar? Can it be any degree?
Thank you very much! :)
Answer Hi Lolita,
Keloids form in MOST people when an area of dermis is destroyed. The dermis lies beneath the outer epidermis and above the "fatty tissue" layer and muscle/bone, etc.
The epidermis is continually in the process of being replaced by the dermis, and the dermis continually replaces itself. When the dermis is too damaged to do this the body closes the wound as best it can, often with hypertrophic tissue in which collagen fibers are randomly organized. This can produce either a flat or raised mass of tissue which lacks many of the normal functions of skin. Less flexible, lacks pores, hair follicles, but does fill the area left by the wound.
Second degree burns generally do not produce a lasting scar. They can, however leave a brownish/reddish area which in some can last over a year but eventually return to normal appearing skin as the dermis completely heals. Second degree burns can, however, develop infections or be damaged by other trauma which develop into scars due to deep damage to the dermis.
Third degree burns are burns in which the damage reaches below the dermis. Third degree burns do leave permanent scars unless there is intervention such as a skin graft from another part of the body.
