The pathology of a burn fundamentally involves protein denaturation and coagulative necrosis caused by heat.
Pathophysiology of Burn Injuries
When skin is exposed to heat from a burn injury, several pathological processes occur:
-
Protein Denaturation and Coagulative Necrosis: The intense heat denatures proteins within the skin cells. This denaturation leads to coagulative necrosis, where the tissue essentially "cooks" and dies. This is the primary and most immediate pathological change.
-
Platelet Aggregation and Vasoconstriction: Around the area of coagulated tissue, platelets aggregate. This aggregation triggers vasoconstriction, reducing blood flow to the surrounding tissues.
-
Zone of Stasis: The area surrounding the immediate burn injury is called the zone of stasis. This region is characterized by marginally perfused tissue that is at risk of further damage and potentially necrosis if blood flow isn't restored. It's hyperemic and inflamed, meaning there's increased blood flow and inflammation in this zone. The zone of stasis is critical because interventions can potentially salvage this tissue.
-
Inflammation: The zone of stasis exhibits significant inflammation, contributing to edema and further tissue compromise. Inflammatory mediators are released, contributing to both local and systemic effects.
In summary, burn pathology is characterized by heat-induced cellular damage, inflammation, and compromised blood flow, all contributing to tissue necrosis and potential systemic complications.
