burn

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An injury to tissues caused by heat, chemicals, electricity, or irradiation effects.

The commonest type of burn is that due to thermal injury, in which some portion of the body surface is exposed to either moist or dry heat of sufficient temperature to cause local and systemic reactions. Clinically, the extent of such a burn is often expressed as first degree, second degree, and so forth. Different systems of classification exist.

First-degree burns result in some redness and swelling of the injured part, without necrosis of any tissue or the formation of blisters. Healing is completed in a few days without scarring.

Second-degree burns show a variable destruction of parts of the epidermis so that blistering occurs. Healing by regeneration in such superficial burns does not necessitate skin grafting, unless secondary infections ensue; no scarring results.

Third-degree burns are marked by complete destruction of the epidermis of a region, including the necrosis of accessory skin structures like hair and sweat glands. A brownish-black eschar marks the destroyed tissue. This is sloughed off and that defect becomes filled with granulation tissue that later consolidates and changes to form a dense, thick scar. Complications may occur without adequate care, and grafting is not unusual, sometimes being required because of contracture of the scar tissue.

In fourth-degree burns, tissue is destroyed to the level of or below the deep fascia lying beneath the subcutaneous fat and connective tissue of the body. Muscle, bone, deeper nerves, and even organs may be injured or destroyed by this severe degree of burn. Healing is usually a slow, involved process, requiring much reparative and reconstructive work by surgical specialists.

Electrical burns result from the amount of heat incident to the flow of a certain amount of electricity through the resistance offered by tissues. From a practical standpoint, most of the resistance offered to the passage of an electric current is that of the skin and the interface between the skin and the external conductor. Therefore, most electrothermal injuries are limited to the skin and immediately subjacent tissues, although deep penetration may follow large voltages.

Most chemical burns result from the action of corrosive agents which destroy tissues at the point of contact. Exposure of the skin, eyes, and gastrointestinal tract are commonest.

To write a write-once optical medium such as a CD-R, DVD-R or BD-R disc. Such a disc is considered "burned," because once recorded, it cannot be erased and rewritten. The term is also erroneously used for rewritable disks, such as CD-RWs and DVD-RWs, but rewritable media are not "burned;" they are "written." Burn means "once and done." See CD-R, DVD-R and DVD+R. See also burn in.

A Burned Disc

Download Computer Desktop Encyclopedia to your PC, iPhone or Android.

Film production: in filming, image that remains after the camera has focused on a shining object and then withdrawn. The picture tends to retain an after-ghost of the original image, which actually burns into the camera's picture tube.

Printing: term used for the part of the printing process when the image is imprinted on the plate (plate exposure).

Trade name for an energy drink.

1. Thermal damage to the skin or other tissues as a result of excessive heat. During the performance of vigorous physical activities, heat is generated by friction and the skin can be burned wherever it rubs against another surface. When a burn has occurred, you should avoid activities that risk further friction.

2. A form of weight training designed to increase the size of muscle. The exerciser makes rapid half contractions which produce a burning sensation in the muscle. This is believed to be due to the pumping of blood into muscle. See also pumping-up.

verb

1. To undergo combustion: blaze, combust, flame, flare. See hot/cold/lukewarm.
2. To undergo or cause to undergo damage by or as if by fire: char, scorch, sear, singe. See hot/cold/lukewarm.
3. To emit a bright light: beam, blaze, gleam, glow, incandesce, radiate, shine. See light/darkness.
4. To feel or look hot: bake, broil, roast, swelter. See hot/cold/lukewarm.
5. To feel or cause to feel a sensation of heat or discomfort: bite, smart, sting. See pain/pleasure.
6. To cause to become sore or inflamed: inflame, irritate, sting. See help/harm/harmless.
7. To cause to feel or show anger. anger, enrage, incense, infuriate, madden, provoke. Idioms: make one hot under the collar, make one's blood boil, put one's back up. See feelings.
8. To be or become angry: anger, blow up, boil over, bristle, explode, flare up, foam, fume, rage, seethe. Informal steam. Idioms: blow a fuse, blow a gasket, blow one'sstacktop, breathe fire, fly off the handle, get hot under the collar, hit theceilingroof, lose one's temper, see red. See feelings.
9. To be in a state of emotional or mental turmoil: boil, bubble, churn, ferment, seethe, simmer, smolder. See calm/agitation.

phrasal verb - burn out

To lose so much strength and power as to become ineffective or motionless: give out, run down. Slang poop out. See tired/fresh.

noun

Damage or a damaged substance that results from burning: char, scorch, sear, singe. See hot/cold/lukewarm.

Idioms beginning with burn:
burning question
burn into
burn one's bridges
burn one's fingers
burn oneself out
burn rubber
burn someone up

See also crash and burn; ears are burning; fiddle while Rome burns; (burn) in effigy; money burns a hole in one's pocket; money to burn; slow burn.

Definition: be excited about; yearn for
Antonyms: stifle, subdue

v

Definition: be on fire; set on fire
Antonyms: cool, extinguish, put out, quench, smother, wet

v

Definition: cheat
Antonyms: aid, help

Definition

Burns are injuries to tissues that are caused by heat, friction, electricity, radiation, or chemicals.

Description

Burns are characterized by degree, based on the severity of the tissue damage. A first-degree burn causes redness and swelling in the outermost layers of skin (epidermis). A second-degree burn involves redness, swelling and blistering, and the damage may extend beneath the epidermis to deeper layers of skin (dermis). A third-degree burn, also called a full-thickness burn, destroys the entire depth of skin, causing significant scarring. Damage also may extend to the underlying fat, muscle, or bone.

Demographics

The severity of the burn is also judged by the amount of body surface area (BSA) involved. Healthcare workers use the "rule of nines" to determine the percentage of BSA affected in people more than 9 years of age: each arm with its hand is 9 percent of BSA; each leg with its foot is 18 percent; the front of the torso is 18 percent; the back of the torso, including the buttocks, is 18 percent; the head and neck are 9 percent; and the genital area (perineum) is 1 percent. This rule cannot be applied to a young child's body proportions, so BSA is estimated using the palm of a person's hand as a measure of 1 percent area.

The severity of the burn determines the type of treatment and also where the burned person should receive treatment. Minor burns may be treated at home or in a doctor's office. These are defined as first- or second-degree burns covering less than 15 percent of an adult's body or less than 10 percent of a child's body, or a third-degree burn on less than 2 percent BSA. Moderate burns should be treated at a hospital. These are defined as first- or second-degree burns covering 15 percent to 25 percent of an adult's body or 10 percent to 20 percent of a child's body, or a third-degree burn on 2 percent to 10 percent BSA. Critical, or major, burns are the most serious and should be treated in a specialized burn unit of a hospital. These are defined as first- or second-degree burns covering more than 25 percent of an adult's body or more than 20 percent of a child's body, or a third-degree burn on more than 10 percent BSA. In addition, burns involving the hands, feet, face, eyes, ears, or genitals are considered critical. Other factors influence the level of treatment needed, including associated injuries such as bone fractures and smoke inhalation, presence of a chronic disease, or a history of abuse. Also, children and the elderly are more vulnerable to complications from burn injuries and require more intensive care.

Causes and Symptoms

Burns may be caused by even a brief encounter with heat greater than 120°F (49°C). The source of this heat may be the sun (causing a sunburn), hot liquids, steam, fire, electricity, friction (causing rug burns and rope burns), and chemicals (causing caustic burn upon contact).

Signs of a burn are localized redness, swelling, and pain. A severe burn will also blister. The skin may also peel, appear white or charred, and feel numb. A burn may trigger a headache and fever. Extensive burns may induce shock, the symptoms of which are faintness, weakness, rapid pulse and breathing, pale and clammy skin, and bluish lips and fingernails.

When to Call the Doctor

A physician or healthcare professional should be consulted whenever first or second degree burns cover more than 15 percent of a person's body surface area (BSA) or third degree burns involve more than 2 percent of a victim's BSA.

Diagnosis

A physician will diagnose a burn based on visual examination and will also ask the burned person or family members questions to determine the best treatment. He or she may also check for smoke inhalation, carbon monoxide poisoning, cyanide poisoning, other event-related trauma, or, if suspected, evidence of child abuse.

Treatment

Burn treatment consists of relieving pain, preventing infection, and maintaining body fluids, electrolytes, and calorie intake while the body heals. Treatment of chemical or electrical burns is slightly different from the treatment of thermal burns but the objectives are the same.

Thermal Burn Treatment

The first act of thermal burn treatment is to stop the burning process. This may be accomplished by letting cool water run over the burned area or by soaking it in cool (not cold) water. Ice should never be applied to a burn. Cool (not cold) wet compresses may provide some pain relief when applied to small areas of first- and second-degree burns. Butter, shortening, or similar salve should never be applied to the burn because these prevent heat from escaping and drive the burning process deeper into the skin.

If the burn is minor, it may be cleaned gently with soap and water. Blisters should not be broken. If the skin of the burned area is unbroken and it is not likely to be further irritated by pressure or friction, the burn should be left exposed to the air to promote healing. If the skin is broken or apt to be disturbed, the burned area should be coated lightly with an antibacterial ointment and covered with a sterile bandage. Aspirin, acetaminophen, or ibuprofen may be taken to ease pain and relieve inflammation. A doctor should be consulted if these signs of infection appear: increased warmth, redness, pain, or swelling; pus or similar drainage from the wound; swollen lymph nodes; or red streaks spreading away from the burn.

In situations in which a person has received moderate or critical burns, lifesaving measures take precedence over burn treatment, and emergency medical assistance must be called. A person with serious burns may stop breathing, and artificial respiration (also called mouth-to-mouth resuscitation or rescue breathing) should be administered immediately. Also, a person with burns covering more than 12 percent BSA is likely to go into shock; this condition may be prevented by laying the person flat and elevating the feet about 12 inches (30 cm). Burned arms and hands should also be raised higher than the person's heart.

In rescues, a blanket may be used to smother any flames as the person is removed from danger. The person whose clothing is on fire should "stop, drop, and roll" or be assisted in lying flat on the ground and rolling to put out the fire. Afterwards, only burned clothing that comes off easily should be removed; any clothing embedded in the burn should not be disturbed. Removing any smoldering apparel and covering the person with a light, cool, wet cloth, such as a sheet but not a blanket or towel, will stop the burning process.

At the hospital, the staff provide further medical treatment. A tube to aid breathing may be inserted if the person's airways or lungs have been damaged, as can happen during an explosion or a fire in an enclosed space. Also, because burns dramatically deplete the body of fluids, replacement fluids are administered intravenously. The person is also given antibiotics intravenously to prevent infection, and he or she may also receive a tetanus shot, depending on his or her immunization history. Once the burned area is cleaned and treated with antibiotic cream or ointment, it is covered in sterile bandages, which are changed two to three times a day. Surgical removal of dead tissue (debridement) also takes place. As the burns heal, thick, taut scabs (eschar) form, which the doctor may have to cut to improve blood flow to the more elastic healthy tissue beneath. The person will also undergo physical and occupational therapy to keep the burned areas from becoming inflexible and to minimize scarring.

In cases where the skin has been so damaged that it cannot properly heal, a skin graft is usually performed. A skin graft involves taking a piece of skin from an unburned portion of the person's body (autograft) and transplanting it to the burned area. When doctors cannot immediately use the individual's own skin, a temporary graft is performed using the skin of a human donor (allograft), either alive or dead, or the skin of an animal (xenograft), usually that of a pig.

The burn victim also may be placed in a hyperbaric chamber, if one is available. In a hyperbaric chamber (which can be a specialized room or enclosed space), the person is exposed to pure oxygen under high pressure, which can aid in healing. However, for this therapy to be effective, the burned individual must be placed in a chamber within 24 hours of being burned.

Chemical Burn Treatment

Burns from liquid chemicals must be rinsed with cool water for at least 15 minutes to stop the burning process. Any burn to the eye must be similarly flushed with water. In cases of burns from dry chemicals such as lime, the powder should be completely brushed away before the area is washed. Any clothing which may have absorbed the chemical should be removed. The burn should then be loosely covered with a sterile gauze pad and the person taken to the hospital for further treatment. A physician may be able to neutralize the offending chemical with another before treating the burn like a thermal burn of similar severity.

Electrical Burn Treatment

Before electrical burns are treated at the site of the accident, the power source must be disconnected if possible and the victim moved away from it to keep the person giving aid from being electrocuted. Lifesaving measures again take priority over burn treatment, so breathing must be checked and assisted if necessary. Electrical burns should be loosely covered with sterile gauze pads and the person taken to the hospital for further treatment.

Alternative Treatment

In addition to the excellent treatment of burns provided by traditional medicine, some alternative approaches may be helpful as well. (Major burns should always be treated by a medical practitioner.) The homeopathic remedies Cantharis and Causticum can assist in burn healing. A number of botanical remedies, applied topically, can also help burns heal. These include aloe (Aloe barbadensis), oil of St. John's wort (Hypericum perforatum), calendula (Calendula officinalis), comfrey (Symphytum officinale), and tea tree oil (Melaleuca spp.). Supplementing the diet with vitamin C, vitamin E, and zinc also is beneficial for wound healing.

Prognosis

The prognosis is dependent upon the degree of the burn, the amount of body surface covered, whether critical body parts were affected, any additional injuries or complications like infection, and the promptness of medical treatment. Minor burns may heal in five to ten days with no scarring. Moderate burns may heal in ten to 14 days and may leave scarring. Critical or major burns take more than 14 days to heal and leave significant scarring. Scar tissue may limit mobility and functionality, but physical therapy may overcome these limitations. In some cases, additional surgery may be advisable to remove scar tissue and restore appearance.

Prevention

Burns are commonly received in residential fires. Properly placed and working smoke detectors in combination with rapid evacuation plans minimize a person's exposure to smoke and flames in the event of a fire. Children must be taught never to play with matches, lighters, fireworks, gasoline, and cleaning fluids.

Burns by scalding with hot water or other liquids may be prevented by setting the water heater thermostat no higher than 120°F (49°C), checking the temperature of bath water before getting into the tub, and turning pot handles on the stove out of the reach of children. Care should be used when removing covers from pans of steaming foods and when uncovering or opening foods heated in a microwave oven.

Thermal burns are often received from electrical appliances. Care should be exercised around stoves, space heaters, irons, and curling irons.

Sunburns may be avoided by the liberal use of a sunscreen containing either an opaque active ingredient such as zinc oxide or titanium dioxide or a nonopaque active ingredient such as PABA (para-aminobenzoic acid) or benzophenone. Hats, loose clothing, and umbrellas also provide protection, especially between 10 a.m. and 3 p.m. when the most damaging ultraviolet rays are present in direct sunlight.

Electrical burns may be prevented by covering unused electrical outlets with safety plugs and keeping electrical cords away from infants and toddlers who might chew on them. Persons should also seek shelter indoors during a thunderstorm to avoid being struck by lightning.

Chemical burns may be prevented by wearing protective clothing, including gloves and eyeshields. Chemical agents should always be used according to the manufacturer's instructions and properly stored when not in use.

Nutritional Concerns

Adequate nutrition, including liquids and electrolytes, is essential when recovering from burns.

Parental Concerns

Parents should fire-proof their homes to protect small children. They should teach fire safety to their children from a very young age. Smoke detectors should be installed and tested at least twice each year. Parents are advised to discuss fire and escape routes (including alternates) from their home with their children. Holding a fire drill at night may be momentarily unpopular but may save lives and prevent serious injuries. Proper childproofing tools can prevent young children from being burned in the kitchen and bathroom.

Resources

Books

Antoon, Alia Y., and Mary K. Donovan. "Burn Injuries." In Nelson Textbook of Pediatrics, 17th ed. Edited by Richard E. Behrman, et al. Philadelphia: Saunders, 2003, pp. 330–7.

Bosworth, Chrissie. Burns Trauma: Management and Nursing Care, 2nd ed. London: Whurr Publishers, 2002.

Demling, Robert H., and Jonathon D. Gates. "Medical Aspects of Trauma and Burn Care." In Cecil Textbook of Medicine, 22nd ed. Edited by Lee Goldman, et al. Philadelphia: Saunders, 2003, pp. 642–8.

Hall, Jesse B., and Gregory Schmidt. Principles of Critical Care, 3rd ed. New York: McGraw-Hill, 2004.

Periodicals

Collier, M. L., et al. "Home treadmill friction injuries: a five-year review." Journal of Burn Care Rehabilitation 25, no. 5 (2004): 441–4.

Patterson, D. R., et al. "Optimizing control of pain from severe burns: a literature review." American Journal of Clinical Hypnosis 47, no. 1 (2004): 43–54.

Rabbitts, A., et al. "Car radiator burns: a prevention issue." Journal of Burn Care Rehabilitation 25, no. 5 (2004): 452–5.

Stokes, D. J., et al. "The effect of burn injury on adolescents' autobiographical memory." Behavior Research and Therapy 42, no. 11 (2004): 1357–65.

Organizations

American Academy of Dermatology. 930 N. Meacham Road, PO Box 4014, Schaumburg, IL 60168–4014. Web site: www.aad.org/.

American Academy of Emergency Medicine. 611 East Wells Street, Milwaukee, WI 53202. Web site: www.aaem.org/.

American Academy of Family Physicians. 11400 Tomahawk Creek Parkway, Leawood, KS 66211–2672. Web site: www.aafp.org/.

American Academy of Pediatrics. 141 Northwest Point Boulevard, Elk Grove Village, IL 60007–1098. Web site: www.aap.org/default.htm.

American College of Emergency Physicians. PO Box 619911, Dallas, TX 75261–9911. Web site: www.acep.org/.

American College of Surgeons. 633 North St. Clair Street, Chicago, IL 60611–32311. Web site: www.facs.org/.

International Shrine Headquarters. 2900 Rocky Point Dr., Tampa, FL 33607–1460. Web site: www.shrinershq.org/index.html.

Web Sites

"Burns." KidsHealth. Available online at (accessed December 7, 2004).

"Burns." MedlinePlus. Available online at www.nlm.nih.gov/medlineplus/burns.html (accessed December 7, 2004).

"Burns." Merck Manual. Available online at www.merck.com/mmhe/sec24/ch289/ch289a.html (accessed December 7, 2004).

"Burns: Taking Care of Burns." American College of Family Physicians, September 2002. Available online at (accessed December 7, 2004).

"Chemical Burns to the Skin." University of Iowa Health Care. Available online at www.uihealthcare.com/topics/prepareemergencies/prep4904.html (accessed December 7, 2004).

[Article by: L. Fleming Fallon, Jr., MD, DrPH]

v. to deliberately expose the true status of a person under cover.

the legitimate destruction and burning of classified material, usually accomplished by the custodian of the material, as prescribed in regulations.

See the Introduction, Abbreviations and Pronunciation for further details.

A spoken charm for curing burns and scalds has been recorded from various parts of England. The Shropshire version ran:

There was three angels came from the west,
The one brought fire and the other brought frost,
The other brought the book of Jesus Christ.
In the name of Father, Son and Holy Ghost, Amen.
(Burne, 1883: 183-4)

There came two Angels from the north,
One was fire and one was Frost.
Out, Fire; in Frost.
In the name of Father, Son, and Holy Ghost.
(Latham, 1878: 35-6)

Damage to the skin or other tissue as a result of excessive heat. In sport, burns are seldom caused by direct heat (except sunburn). They are usually caused by friction when the skin rubs against another surface. A burn should be cooled immediately with tap water or an ice pack. The pain of a minor burn may be relieved with an analgesic. Extensive burns require hospitalization. The ability of a burns sufferer to participate in sport is determined largely by the extent and location of the burns. Even with minor burns, activities that involve the risk of friction against the affected areas should be avoided. In the case of more severe burns, activities that could lead to infection should be avoided. See also blister, mat burn.

LearnThatWord.com is a free vocabulary and spelling program where you only pay for results!

Injury to tissues caused by contact with dry heat (fire), moist heat (steam or liquid), chemicals, electricity, lightning or radiation. The damage done by a burn includes shock due to the tissue damage, severe dehydration due to the loss of the protective effect of the skin, infection of the burn site, damage to lungs and eyes by exposure to high temperatures and smoke and debris, damage to external somatic addenda including vulva, teats, prepuce, scrotum. The critical decision in a burn case is whether to allow the animal a faint chance of recovery and therefore to continue with treatment. See also bushfire injury.

• friction b. — the skin is damaged by the heat created by friction as by a rope burn, or when a dog is dragged by its lead behind a car.
• full thickness b. — involves all of the epidermis and the dermis and may include underlying structures, as well. In alternative classification, it is equivalent to third- and fourth-degree burns.
• partial thickness b. — involves part or all of the epidermis. Generally, equivalent to first- and second-degree burns.
• solar b. — sunburn is noticeable mainly in white pigs, white cats and in dogs with little or no pigmentation on the nose (areas not protected by haircoat) or following close clipping. Of little importance in pigs, other than esthetic importance, but in dogs and cats causes actinic dermatitis, which occasionally precedes the development of squamous cell carcinoma. See also solar dermatitis, photosensitive dermatitis.
• sole b. — damage caused to the sensitive laminae of the feet by the prolonged application of an overheated horseshoe during a shoeing session. The horse is very lame and part of the hoof may subsequently slough.

A lesion caused by contact of heat, radiation, friction, or chemicals with tissue. Thermal burns are classified as follows: first degree, manifested by erythema; second degree, manifested by formation of vesicles; third degree, manifested by necrosis of the mucosa or dermis; and fourth degree, manifested by charring into the submucous or subcutaneous layers of the body.

• Injuries and Accidents - burn: first, second, or third degree injury and damage to skin and subcutaneous tissue caused by heat, fire, wind, radiation, or caustic substance
• Space Exploration and Rocketry - burn: firing of rocket engine
• Fabrication and Manufacturing Processes - burn: (vb) transform with fire or intense heat
• General Technology - burn: act of leaving new computer system turned on for several days or more to test for failure of electronic components
• General Sports Terminology
• Fraud, Treachery, and Deception - burn: (vb) Slang. deceive or cheat in transaction, esp. by overpricing or failing to deliver goods
• Paraphernalia and Behavior - burn: (vb) Slang. cheat someone on drug deal; (n) drug swindle
• Violent Actions - burn: set fire to; incinerate
• Unnatural Deaths - burn: (vb) Slang. die in the electric chair

This article is about the injury. For other uses, see Burn (disambiguation).

Burn
Classification and external resources
Second-degree burn of the hand
ICD-10	T20-T31
ICD-9	940-949
MeSH	D002056

A burn is a type of injury to flesh caused by heat, electricity, chemicals, light, radiation or friction.^[1][2][3] Most burns affect only the skin (epidermal tissue and dermis). Rarely, deeper tissues, such as muscle, bone, and blood vessels can also be injured. Burns may be treated with first aid, in an out-of-hospital setting, or may require more specialized treatment such as those available at specialized burn centers.

Managing burn injuries properly is important because they are common, painful and can result in disfiguring and disabling scarring, amputation of affected parts or death in severe cases. Complications such as shock, infection, multiple organ dysfunction syndrome, electrolyte imbalance and respiratory distress may occur. The treatment of burns may include the removal of dead tissue (debridement), applying dressings to the wound, fluid resuscitation, administering antibiotics, and skin grafting.

While large burns can be fatal, modern treatments developed in the last 60 years have significantly improved the prognosis of such burns, especially in children and young adults.^[4][5] In the United States, approximately 4 out of every 100 people to suffer burns will die from their injuries. The majority of these fatalities occur either at the scene or on the way to hospital.^[6]

Contents 1 Sign and symptoms 1.1 By depth 2 Cause 2.1 Chemical 2.2 Electrical 2.3 Radiation 2.4 Scalding 3 Pathophysiology 4 Diagnosis 4.1 By severity 4.1.1 Major 4.1.2 Moderate 4.1.3 Minor 4.2 By surface area 5 Management 5.1 Intravenous fluids 5.2 Wound care 5.3 Antibiotics 5.4 Analgesics 5.5 Surgery 5.6 Alternative treatments 6 Complications 7 Prognosis 8 Epidemiology 8.1 United States 8.2 Other 9 References 10 Further reading 11 External links

Sign and symptoms

Burns can be classified by mechanism of injury, depth, extent and associated injuries and comorbidities.

By depth

Currently, burns are described according to the depth of injury to the dermis and are loosely classified into first, second, third, and fourth degrees. This system was devised by the French barber-surgeon Ambroise Pare and remains in use today.^[7]

It is often difficult to accurately determine the depth of a burn. This is especially so in the case of second degree burns, which can continue to evolve over time. As such, a second-degree partial-thickness burn can progress to a third-degree burn over time even after initial treatment. Distinguishing between the superficial-thickness burn and the partial-thickness burn is important, as the former may heal spontaneously, whereas the latter often requires surgical excision and skin grafting.

The following tables describe degrees of burn injury under this system as well as provide pictorial examples.

Names	Layers involved	Appearance	Texture	Sensation	Time to healing	Complications	Example
First degree	Epidermis	Redness (erythema)	Dry	Painful	1wk or less	None
Second degree (superficial partial thickness)	Extends into superficial (papillary) dermis	Red with clear blister. Blanches with pressure	Moist	Painful	2-3wks	Local infection/cellulitis
Second degree (deep partial thickness)	Extends into deep (reticular) dermis	Red-and-white with bloody blisters. Less blanching.	Moist	Painful	Weeks - may progress to third degree	Scarring, contractures (may require excision and skin grafting)
Third degree (full thickness)	Extends through entire dermis	Stiff and white/brown	Dry, leathery	Painless	Requires excision	Scarring, contractures, amputation
Fourth degree	Extends through skin, subcutaneous tissue and into underlying muscle and bone	Black; charred with eschar	Dry	Painless	Requires excision	Amputation, significant functional impairment, possible gangrene, and in some cases death.

Cause

Burns are caused by a wide variety of substances and external sources such as exposure to chemicals, friction, electricity, radiation, and heat.

Chemical

Main article: Chemical burn

Most chemicals that cause chemical burns are strong acids or bases.^[8] Chemical burns can be caused by caustic chemical compounds such as sodium hydroxide or silver nitrate, and acids such as sulfuric acid.^[9] Hydrofluoric acid can cause damage down to the bone and its burns are sometimes not immediately evident.^[10] Chemical burns can be either first, second, or third degree burns, depending on duration of contact, strength of the substance, and other factors.

Electrical

Main article: Electrical burn

Electrical burns are caused by either an electric shock or an uncontrolled short circuit (a burn from a hot, electrified heating element is not considered an electrical burn). Common occurrences of electrical burns include workplace injuries, taser wounds, or being defibrillated or cardioverted without a conductive gel. Lightning is also a rare cause of electrical burns.

Since normal physiology involves a vast number of applications of electrical forces, ranging from neuromuscular signaling to coordination of wound healing, biological systems are very vulnerable to application of supraphysiologic electric fields. Some electrocutions produce no external burns at all, as very little current is required to cause fibrillation of the heart muscle. Therefore, even when the injury does not involve any visible tissue damage, electrical shock survivors may experience significant internal injury.^[11] The internal injuries sustained may be disproportionate to the size of the burns seen (if any), and the extent of the damage is not always obvious. Such injuries may lead to cardiac arrhythmias, cardiac arrest, and unexpected falls with resultant fractures or dislocations.^[12]

The true incidence of electrical burn injury is unknown. In one study of 220 deaths due to electrical injury, 40% of those associated with low-voltage (<500 AC volts) injury demonstrated no skin burns or marks whatsoever. This is sufficient to cause cardiac arrest and ventricular fibrillation but generates relatively low heat energy deposit into skin, thus producing few or no burn marks at all.^[13] High voltage electricity, on the other hand, is a common cause of third and fourth degree burns due to the extreme heat yielded by high temperature arcs and flashover associated with voltages over 1000v.

Radiation

Main article: Radiation burn

Radiation burns are caused by protracted exposure to UV light (as from the sun), tanning booths, radiation therapy (in people undergoing cancer therapy), sunlamps, radioactive fallout, and X-rays. By far the most common burn associated with radiation is sun exposure, specifically two wavelengths of light UVA, and UVB, the latter being more dangerous. Tanning booths also emit these wavelengths and may cause similar damage to the skin such as irritation, redness, swelling, and inflammation. More severe cases of sun burn result in what is known as sun poisoning or "heatstroke". Microwave burns are caused by the thermal effects of microwave radiation.

Scalding

Scalding (from the Latin word calidus, meaning hot^[14]) is caused by hot liquids (water or oil) or gases (steam), most commonly occurring from exposure to high temperature tap water in baths or showers or spilled hot drinks.^[15] A so called immersion scald is created when an extremity is held under the surface of hot water, and is a common form of burn seen in child abuse.^[16] A blister is a "bubble" in the skin filled with serous fluid as part of the body's reaction to the heat and the subsequent inflammatory reaction. The blister "roof" is dead and the blister fluid contains toxic inflammatory mediators. Scald burns are more common in children, especially "spill scalds" from hot drinks and bath water scalds.

Generally scald burns are first or second degree burns, but third degree burns can result, especially with prolonged contact.

Pathophysiology

Burn injury results in a local inflamatory response. In larger burns there is a systemic inflamatory response. The lungs may be doubly compromised by smoke inhalation and the venous affluent returning from circulation through the burned skin. Following a major burn injury, heart rate and peripheral vascular resistance increase. This is due to the release of catecholamines from injured tissues, and the relative hypovolemia that occurs from fluid volume shifts. Initially cardiac output decreases. At approximately 24 hours after burn injuries, cardiac output returns to normal if adequate fluid resuscitation has been given. Following this, cardiac output increases to meet the hypermetabolic needs of the body.

The effects of high temperature on tissue include speeding chemical reactions and unfolding (denaturing) proteins. ^[17]

Diagnosis

Three degrees of burns

By severity

In order to determine the need for referral to a specialised burn unit, the American Burn Association devised a classification system to aid in the decision-making process. Under this system, burns can be classified as major, moderate and minor. This is assessed based on a number of factors, including total body surface area (TBSA) burnt, the involvement of specific anatomical zones, age of the person and associated injuries.^[6]

Major

Major burns are defined as:

• Age 10-50yrs: partial thickness burns >25% of total body surface area
• Age <10 or >50: partial thickness burns >20% of total body surface area
• Full thickness burns >10%
• Burns involving the hands, face, feet or perineum^[18]
• Burns that cross major joints
• Circumferential burns to any extremity
• Any burn associated with inhalational injury
• Electrical burns
• Burns associated with fractures or other trauma
• Burns in infants and the elderly
• Burns in persons at high-risk of developing complications

These burns typically require referral to a specialised burn treatment center.

Moderate

Moderate burns are defined as:

• Age 10-50yrs: partial thickness burns involving 15-25% of total body surface area
• Age <10 or >50: partial thickness burns involving 10-20% of total body surface area
• Full thickness burns involving 2-10% of total body surface area

Persons suffering these burns often need to be hospitalised for burn care.

Minor

Minor burns are:

• Age 10-50yrs: partial thickness burns <15% of total body surface area
• Age <10 or >50: partial thickness burns involving <10% of total body surface area
• Full thickness burns <2% of total body surface area, without associated injuries

These burns usually do not require hospitalization.

By surface area

Burns can also be assessed in terms of total body surface area (TBSA), which is the percentage affected by partial thickness or full thickness burns. First degree (erythema only, no blisters) burns are not included in this estimation. The rule of nines is used as a quick and useful way to estimate the affected TBSA. More accurate estimation can be made using Lund & Browder charts, which take into account the different proportions of body parts in adults and children.^[19] The size of a person's hand print (palm and fingers) is approximately 0.8% of their TBSA, but for quick estimates, medical personnel round this to 1%, slightly overestimating the size of the affected area.^[20]

Burns of 10% in children or 15% in adults (or greater) are potentially life threatening injuries (because of the risk of hypovolaemic shock) and should have formal fluid resuscitation and monitoring in a burns unit. Burns units will use surface area to predict severity and mortality, using a methodology such as the Baux score.

Management

The resuscitation and stabilization phase begins with the reassessment of the injured person's airway, breathing and circulatory state. Appropriate interventions should be initiated to stabilize these. This may involve targeted (using specific resuscitation formula to guide fluid administration) fluid resuscitation and, if inhalation injury is suspected, intubation and ventilation. Once the injured person is stabilized, attention is turned to the care of the burn wound itself. Until then, it is advisable to cover the burn wound with a clean and dry sheet or dressing (such as cling film).

Early cooling reduces burn depth and pain, but care must be taken as uncontrolled cooling can result in hypothermia.^[21]

Intravenous fluids

Children with >10% total body surface area burns, and adults with >15% total body surface area burns need formal fluid resuscitation and monitoring (blood pressure, pulse rate, temperature and urine output).^[22] Once the burning process has been stopped, the injured person should be volume resuscitated according to the Parkland formula. This formula calculates the amount of Ringer's lactate required to be administered over the first 24 hours post-burn.

Parkland formula: 4mL x (percentage of total body-surface-area sustaining non-superficial burns) x (person's weight in kgs).

Half of this total volume should be administered over the first eight hours, with the remainder given over the following 16 hours. It is important to note that this time frame is calculated from the time at which the burn is sustained, and not the time at which fluid resuscitation is begun. Children also require the addition of maintenance fluid volume. Such injuries can disturb a person's osmotic balance.^[23] Inhalation injuries in conjunction with thermal burns initially require up to 40–50% more fluid.

The formula is a guide only and infusions must be tailored to the urine output and central venous pressure. Inadequate fluid resuscitation may cause renal failure and death, but over-resuscitation also causes morbidity.

Wound care

Second degree heat burn, approx 1cm across centre, 6 days after burn.

Debridement cleaning and then dressings are important aspects of wound care. The wound should then be regularly re-evaluated until it is healed.^[3] In the management of first and second degree burns little quality evidence exists to determine which type of dressing should be used.^[24] Silver sulfadiazine (Flamazine) is not recommended as it potentially prolongs healing time^[24] while biosynthetic dressings may speed healing.^[25]

Antibiotics

Intravenous antibiotics may improve survival in those with large and severe burns. However due to the poor quality of the evidence, routine use is not currently recommended.^[26]

Analgesics

A number of different options are used for pain management. These include simple analgesics (such as ibuprofen and acetaminophen) and narcotics. A local anesthetic may help in managing pain of minor first-degree and second-degree burns.^[27]

Surgery

Wounds requiring surgical closure with skin grafts or flaps should be dealt with as early as possible.^[3] Circumferential burns of digits, limbs or the chest may need urgent surgical release of the burnt skin (escharotomy) to prevent problems with distal circulation or ventilation.^[3]

Alternative treatments

Hyperbaric oxygenation may be useful in adjunct to traditional treatments to speed up healing time; however, more research is needed to confirm or deny this.^[28] Honey has been used since ancient times to aid wound healing and may be beneficial in first and second degree burns, but may cause infection.^[29]

There are a number of methods to reduce procedural pain and anxiety for people with burns include the use of virtual reality therapy, relaxation techniques, sensory focusing, distraction, and education.^[30].

Complications

Infection is a major complication of burns. Infection is linked to impaired resistance from disruption of the skin's mechanical integrity and generalized immune suppression. The skin barrier is replaced by eschar. This moist, protein rich avascular environment encourages microbial growth. Migration of immune cells is hampered, and there is a release of intermediaries that impede the immune response. Eschar also restricts distribution of systemically administered antibiotics because of its avascularity.

Risk factors of burn wound infection include:

• Burn > 30% TBSA
• Full-thickness burn
• Extremes in age (very young, very old)
• Preexisting disease e.g. diabetes
• Virulence and antibiotic resistance of colonizing organism
• Failed skin graft
• Improper initial burn wound care
• Prolonged open burn wound

Burn wounds are prone to tetanus. A tetanus booster shot is required if individual has not been immunized within the last 5 years.

Circumferential burns of extremities may compromise circulation. Elevation of limb may help to prevent dependent edema. An Escharotomy may be required.

Acute Tubular Necrosis of the kidneys can be caused by myoglobin and hemoglobin released from damaged muscles and red blood cells. This is common in electrical burns or crush injuries where adequate fluid resuscitation has not been achieved.

Prognosis

The outcome of any injury or disease depends on three things: the nature of the injury, the nature of the injured or ill person and the treatment available. In terms of injury factors in burns, the prognosis depends primarily on total body surface area percentage burn and the age of the person. The presence of smoke inhalation injury, other significant injuries such as long bone fractures, and serious co-morbidities (heart disease, diabetes, psychiatric illness, suicidal intent etc.) will also adversely influence prognosis. Advances in resuscitation, surgical management, intensive care, control of infection, control of the hyper-metabolic response and rehabilitation have resulted in dramatic improvements in burn mortality and morbidity in the last 60 years. The modified Baux score determines the futility point for major burn injury. The Baux score is determined by adding the size of the burn (% TBSA) to the age of the patient. In most burn units a score of 140 or greater is a non-survivable injury, and comfort care should be offered. In children all burn injuries less than 100% TBSA should be considered a survivable injury.

Following a burn injury a children can suffer significant psychological trauma in both the short- and long-term. A major concern of a survivor of any traumatic injury is post-traumatic stress disorder (PTSD). Another significant concern for children is coping with a disturbance in body image.^[31]

Epidemiology

Disability-adjusted life years for fires per 100,000 inhabitants in 2004.^[32]

no data   < 50   50-100   100-150   150-200   200-250   250-300

300-350   350-400   400-450   450-500   500-600   > 600

As of 2004, 11 million burn requiring medical care occurred worldwide.^[33] About 90% of burns occur in the developing world and 70% of these are in children. Survival of injuries greater than 40% total body surface area is rare in the developing world.^[34]

United States

An estimated 500,000 burn injuries receive medical treatment yearly in the United States.^[7] The 2009 National Burn Repository reports the most common cause of burns as direct fire/flame (43%) followed by scalds (30%). Scald injuries were the predominant cause in children under the age of 5. Burns sustained at home accounted for 65.5% of all burn injuries in the United States that year, and had a mortality rate of 4% overall. This mortality rate was directly associated with advancing age, burn size, the presence of inhalational injury and the female sex.^[6] It is estimated that approximately 75% of deaths from burns and fires in the United States occur either at the scene of the incident or enroute to medical facilities. Demographically, people sustaining burns in the United States tended to be male (70%) and to have suffered their injuries in a residential setting (43%).^[6] The highest incidence of burns occurs in the 18-35yr old age group, while the highest incidence of scalds occurs in children 1-5yrs old and adults over 65.

Other

In India about 700,000 people a year are admitted to hospital, though very few are looked after in specialist burn units.^[35]

References

1. ^ MedlinePlus. "Burns". http://www.nlm.nih.gov/medlineplus/burns.html. Retrieved 2010-09-22. 
2. ^ WebMD (January 7, 2009). "Burns-Topic Overview". firstaid&emergencies. http://firstaid.webmd.com/tc/burns-topic-overview. Retrieved 2010-09-22. 
3. ^ ^{a b c d} Total Burn Care, 3rd Edition, Edited by David Herndon, Saunders, 2007.
4. ^ Total Burn Care 3rd Edition. Editied David Herndon. Chapter 1 [1] Accessed January 8, 2010
5. ^ Sevitt S (May 1979). "A review of the complications of burns, their origin and importance for illness and death". J Trauma 19 (5): 358–69. doi:10.1097/00005373-197905000-00010. PMID 448773. 
6. ^ ^{a b c d} "American Burn Association". http://www.ameriburn.org/resources_factsheet.php. 
7. ^ ^{a b} Ron Walls MD; John J. Ratey MD; Robert I. Simon MD (2009). Rosen's Emergency Medicine: Expert Consult Premium Edition - Enhanced Online Features and Print (Rosen's Emergency Medicine: Concepts & Clinical Practice (2v.)). St. Louis: Mosby. ISBN 0-323-05472-2. 
8. ^ Chemical Burn Causes emedicine Health Accessed February 24, 2008
9. ^ Chemical Burn Causes eMedicine Accessed February 24, 2008
10. ^ Hydrofluoric Acid Burns emedicine Accessed February 24, 2008
11. ^ Mechanism of Electrical Injury Chicago Electrical Trauma Research Institute Accessed April 27, 2010
12. ^ Electrical Burns: First Aid Mayo Clinic Accessed February 24, 2008
13. ^ Wright RK, Davis JH: The investigation of electrical deaths: A report of 220 fatalities. J Forensic Sci 25:514, 1980
14. ^ Mosby’s Medical, Nursing and Allied Health Dictionary, Fourth Edition, Mosby-Year Book Inc., 1994, p. 1395
15. ^ Scald and Burn Care, Public Education City of Rochester Hills Accessed February 24, 2008
16. ^ Allasio D, Fischer H (May 2005). "Immersion scald burns and the ability of young children to climb into a bathtub". Pediatrics 115 (5): 1419–21. doi:10.1542/peds.2004-1550. PMID 15867058. 
17. ^ Ashley G. Smart: "Kinetic Experiments Shed Light on Protein-folding Thermodynamics", Physics Today August 2011
18. ^ http://www.burnsurgery.com/Modules/BurnWound%201/sect_IV.htm SECTION IV: INITIAL WOUND MANAGEMENT
19. ^ Ames WA (1999). "Management of the Major Burn". Update in Anaesthesia (Nuffield Department of Anaesthesia, Oxford, UK) (10). http://www.nda.ox.ac.uk/wfsa/html/u10/u1010_01.htm. Retrieved 2010-01-22. 
20. ^ Perry RJ, Moore CA, Morgan BD, Plummer DL (May 1996). "Determining the approximate area of a burn: an inconsistency investigated and re-evaluated". BMJ 312 (7042): 1338. PMC 2350999. PMID 8646048. http://www.bmj.com/content/312/7042/1338.full. 
21. ^ Tintinalli, Judith E. (2010). Emergency Medicine: A Comprehensive Study Guide (Emergency Medicine (Tintinalli)). New York: McGraw-Hill Companies. ISBN 0-07-148480-9. 
22. ^ Herndon, David N. (2007). "Chapter 9 Total Burn Care". Total Burn Care. Philadelphia: Saunders. pp. 880. ISBN 1-4160-3274-6. 
23. ^ Lee JA (December 1981). "Sydney Ringer (1834-1910) and Alexis Hartmann (1898-1964)" (PDF). Anaesthesia 36 (12): 1115–21. doi:10.1111/j.1365-2044.1981.tb08698.x. PMID 7034584. http://www.dr-green.co.uk/PDFs/Ringer%20and%20Hartmann.pdf. 
24. ^ ^{a b} Wasiak J, Cleland H, Campbell F (2008). Wasiak, Jason. ed. "Dressings for superficial and partial thickness burns". Cochrane Database Syst Rev (4): CD002106. doi:10.1002/14651858.CD002106.pub3. PMID 18843629. 
25. ^ Hubley P (July 2009). "Review: evidence on dressings for superficial burns is of poor quality". Evid Based Nurs 12 (3): 78. doi:10.1136/ebn.12.3.78. PMID 19553415. 
26. ^ Avni T, Levcovich A, Ad-El DD, Leibovici L, Paul M (2010). "Prophylactic antibiotics for burns patients: systematic review and meta-analysis". BMJ 340: c241. doi:10.1136/bmj.c241. PMC 2822136. PMID 20156911. //www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=2822136. 
27. ^ Minor Burns quickcare.org Accessed February 25, 2008
28. ^ Villanueva E, Bennett MH, Wasiak J, Lehm JP (2004). Wasiak, Jason. ed. "Hyperbaric oxygen therapy for thermal burns". Cochrane Database Syst Rev (3): CD004727. doi:10.1002/14651858.CD004727.pub2. PMID 15266540. 
29. ^ Jull AB, Rodgers A, Walker N (2008). "Honey as a topical treatment for wounds". Cochrane Database Syst Rev (4): CD005083. doi:10.1002/14651858.CD005083.pub2. PMID 18843679. 
30. ^ Blount, R.L., Zempsky, W.T., Jaaniste, T., Evans, S., Cohen, L.L., Devine, K.A., & Zeltzer, L.K. (2011). Management of pediatric pain and distress due to medical procedures. In Roberts, M.C. & Steele, R.G. (Eds.) Handbook of Pediatric Psychology (171-184). New York, NY: Guilford Press.
31. ^ Tarnowski, K.J. & Brown, R.T. (2011). Pediatric burns. In Roberts, M.C. & Steele, R.G. (Eds.) Handbook of Pediatric Psychology (114-129). New York, NY: Guilford Press.
32. ^ "WHO Disease and injury country estimates". World Health Organization. 2009. http://www.who.int/healthinfo/global_burden_disease/estimates_country/en/index.html. Retrieved Nov. 11, 2009. 
33. ^ Peck, MD (2011 Nov). "Epidemiology of burns throughout the world. Part I: Distribution and risk factors.". Burns : journal of the International Society for Burn Injuries 37 (7): 1087-100. PMID 21802856. 
34. ^ Potokar T, Chamania S, Ali S. International network for training, education and research in burns. Indian J Plast Surg 2007;40:107
35. ^ Bhattacharya S. Principles and Practice of Burn Care. Indian J Plast Surg 2009;42:282-3

Further reading

• Herndon, David (2007). Total Burn Care. Saunders. ISBN 978-1-4160-3274-8. 

External links

Wikimedia Commons has media related to: burns

• Burn at the Open Directory Project
• NHS Choices - Burns and Scalds
• British Burn Association
• American Burn Association
• Japanese Burn Cases
• European Burn Association
• The UK National Burn Care Government Review
• Cochrane Injuries Group, systematic reviews on the prevention, treatment and rehabilitation of traumatic injury

v t e General wounds and injuries (T08-T35, 870-949) General Wound/ trauma Blunt trauma/ superficial/closed Abrasion (Avulsion) Blister (Blood blister • Coma blister • Delayed blister • Edema blister • Fracture blister • Friction blister • Sucking blister) Bruise/Hematoma/Ecchymosis (Battle's sign, Raccoon eyes, Black eye, Subungual hematoma, Cullen's sign, Grey Turner's sign, Retroperitoneal hemorrhage) Animal bite: Insect bite · Spider bite Penetrating trauma/open Animal bite: Snakebite · Lizard bite Ballistic trauma Foreign body In alimentary tract (Bezoar) Other Burn/Corrosion/Chemical burn · Frostbite · Traumatic amputation By region Hand injury · Head injury · Chest trauma · Abdominal trauma M: INT, SF, LCT anat/phys/devp noco(i/b/d/q/u/r/p/m/k/v/f)/cong/tumr(n/e/d), sysi/epon proc, drug (D2/3/4/5/8/11)

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Dansk (Danish)
1.
v. tr. - brænde, fortære
v. intr. - brænde, fortæres
n. - brandsår, forbrænding

idioms:

• burn down    nedbrænde, brænde ned
• burn in    afprøve ny hardware, brænde (stencil)
• burn off    forbrænde, brænde af
• burn one's boats    brænde sine broer
• burn one's bridges    brænde sine broer
• burn one's fingers    brænde fingrene
• burn out    brænde ud, udbrænde
• burn the candle at both ends    brænde sit lys i begge ender
• burn the midnight oil    arbejde til sent på natten, være oppe til langt ud på natten
• burn to the ground    brænde ned til grunden
• burn up    brænde op, brænde af, afbrænde
• have money to burn    have penge som græs, have penge at brænde af

2.
n. - løftekran

Nederlands (Dutch)
branden, verbranden, aanbranden, blakeren, schroeien, pijn doen, gloeien, op de brandstapel doodmaken, invreten, geëmotioneerd zijn, verlangen, sjezen, bloed onder de nagels vandaan halen, brandwond, ontbranding van (raket) motor, het wegbranden van vegetatie, schoongebrande plek in bos etc., saffie

Français (French)
1.
v. tr. - brûler, incendier, mettre le feu à, faire brûler, (Culin) laisser brûler, laisser attacher, (fig) se brûler, fondre (l'argent), brûler/ronger (par l'acide), brûler (la peau), (US) escroquer
v. intr. - brûler, être allumé, prendre au fond (le lait, la sauce), être brûlé vif, (fig) brûler de, ronger, se graver, (Aérosp) brûler
n. - (Méd) brûlure, (Aérosp) combustion, ruisseau

idioms:

• burn down    brûler complètement, être réduit en cendres, baisser (feu), incendier
• burn in    (Comput) tester (nouveau logiciel), (Phot) exposer à la lumière (mise en relief des détails)
• burn off    décaper (au chalumeau), s'évaporer (de l'alcool), (Méd) cautériser (une verrue), (Ind) faire brûler, (fig) dépenser (de l'énergie)
• burn one's boats    brûler ses vaisseaux, être trop tard
• burn one's bridges    brûler ses vaisseaux, être trop tard
• burn one's fingers    (fig) se brûler les doigts
• burn oneself out    s'user (à force de travail)
• burn out    s'éteindre, griller, sauter, laisser brûler jusqu'au bout (une bougie), forcer à sortir (en mettant le feu) (troupes ennemies, etc)
• burn someone out    forcer à sortir qn (en mettant le feu)
• burn someone up    (US) foutre qn en rogne (fam)
• burn something into    ronger (qch), (fig) graver (qch)
• burn something out    s'éteindre, griller, sauter, (Aut) brûler (la garniture des freins), (Élec) court-circuiter
• burn the candle at both ends    brûler la chandelle par les deux bouts
• burn the midnight oil    lire ou travailler tard
• burn to the ground    brûler complètement
• burn up    brûler (entièrement), consumer, griller, flétrir, foutre (qn) en pétard (fam), s'emporter, se consumer, être brûlant (de fièvre)
• go for the burn    conduire très vite
• have money to burn    avoir de l'argent à brûler

2.
n. - (Écosse) ruisseau

Deutsch (German)
1.
v. - brennen, verbrennen, anbrennen, glühen, ätzen, verfeuern, neuen Hardware testen
n. - Brandwunde, Brandfleck/-loch

idioms:

• burn down    abbrennen, herunterbrennen, niederbrennen
• burn in    neue Hardware testen
• burn off    verbrauchen, verbrennen
• burn one's boats    alle Brücken hinter sich abbrechen
• burn one's bridges    alle Brücken hinter sich abbrechen
• burn one's fingers    sich die Finger verbrennen
• burn oneself out    sich kaputtmachen
• burn out    ausbrennen, herunterbrennen, durchbrennen
• burn someone out    ausbrennen, herunterbrennen, durchbrennen
• burn someone up    verbrennen, abbrennen, herunterbrennen, ausbrennen, niederbrennen
• burn something into    einbrennen
• burn something out    ausbrennen, ausgehen
• burn the candle at both ends    (ugs.) sich zuviel aufladen
• burn the midnight oil    bis spät in die Nacht arbeiten
• burn to the ground    abbrennen, niederbrennen
• burn up    verbrennen, abbrennen, herunterbrennen, ausbrennen, niederbrennen
• go for the burn    (Spo) (inf) sich total verausgeben
• have money to burn    Geld wie Heu haben

2.
n. - (Schottland) Bach

Ελληνική (Greek)
v. - καίω, κατακαίω, φλέγομαι, κάθομαι στην ηλεκτρική καρέκλα
n. - έγκαυμα, κάψιμο, καύση, τσούξιμο

idioms:

• burn down    κατακαίω
• burn in    κάνω προκαταρκτικό τεστ διαρκείας σε Η/Υ, καίω το φώσφορο οθόνης Η/Υ
• burn off    κατακαίω, αφαιρώ με καύση
• burn one's boats    κόβω τις γέφυρες, αποκλείω κάθε περίπτωση υπαναχώρησης
• burn one's bridges    κόβω τις γέφυρες, αποκλείω κάθε περίπτωση υπαναχώρησης
• burn one's fingers    (καθομ.) την παθαίνω (από απειρία ή επιπολαιότητα), βρίσκω το μπελά μου
• burn out    (για φωτιά) σβήνω από έλλειψη καύσιμης ύλης, καίγομαι λόγω υπερθέρμανσης, παθαίνω υπερκόπωση λόγω στρες, είμαι καμένο χαρτί
• burn the candle at both ends    (καθομ.) ζω με υπερένταση
• burn the midnight oil    (καθομ.) διαβάζω ή εργάζομαι μέχρι πολύ αργά τη νύχτα
• burn to the ground    κατακαίω
• burn up    κατακαίω, κορώνω, εξαγριώνομαι
• have money to burn    (καθομ.) έχω λεφτά για πέταμα

Italiano (Italian)
bruciare, ardere, incenerire, corrodere, cremare, bruciatura, ustione

idioms:

• burn down    incenerirsi, dare alle fiamme
• burn off    bruciare
• burn one's bridges/boats    bruciarsi i ponti alle spalle
• burn out    ridurre in cenere
• burn the candle at both ends    occuparsi di troppe cose
• burn the midnight oil    lavorare fino alle ore piccole
• burn to the ground    ridurre in cenere, bruciare
• burn up    bruciare
• have money to burn    esser straricco

Português (Portuguese)
v. - queimar, estar em chamas, arder
n. - queimadura (f), local (m) queimado

idioms:

• burn down    destruir por incêndio
• burn off    remover algo pela ação do fogo
• burn one's bridges/boats    não ter volta, romper com o passado
• burn one's fingers    ser punido por realizar algo tolo
• burn out    estressar-se
• burn the candle at both ends    trabalhar muito
• burn the midnight oil    trabalhar ou estudar até tarde da noite
• burn to the ground    completamente destruído pelo incêndio
• burn up    avivar o fogo, queimar completamente
• have money to burn    ter muito dinheiro

Русский (Russian)
сжигать, жечь, гореть, сгорать, пылать, ожог

idioms:

• burn down    сгореть
• burn off    испариться, сжечь
• burn one's bridges/boats    сжечь за собою мосты
• burn one's fingers    обжечь пальцы
• burn out    догореть, перегореть, сгореть (на работе)
• burn the candle at both ends    работать день и ночь
• burn the midnight oil    работать всю ночь напролет
• burn to the ground    сгореть дотла
• burn up    загореться, разгорячиться
• have money to burn    денег куры не клюют, богатейший

Español (Spanish)
1.
v. tr. - arder, escocer, corroer, carcomer, calcinar, fundir, quemar, abrasar
v. intr. - quemarse, estar ardiendo, socarrarse, pegarse, estar encendido
n. - quemadura, marca

idioms:

• burn down    incendiar, reducirse a cenizas, ser destruido por el fuego, incendiarse
• burn in    técnica de fotografiado, probar nuevas partes de ordenador
• burn off    consumir
• burn one's boats    quemar las naves
• burn one's bridges    quemar las naves
• burn one's fingers    quemarse los dedos
• burn oneself out    esforzarse en exceso
• burn out    extinguirse, quemar, reducirse a cenizas, ser destruido por el fuego, fundirse
• burn someone out    extinguirse, quemar, reducirse a cenizas, ser destruido por el fuego, fundirse, exhaustar a alguien
• burn someone up    consumir completamente, abrasar, enojar mucho a alguien
• burn something into    marcar a fuego
• burn something out    extinguirse, quemar, reducirse a cenizas, ser destruido por el fuego, fundirse, incendiar completamente (edificio, auto, etc.) hasta que solo queda el armazón
• burn the candle at both ends    vivir de prisa
• burn the midnight oil    quemarse las pestañas
• burn to the ground    incendiar completamente
• burn up    consumir completamente, abrasar
• go for the burn    exigirse al máximo en ejercicios físicos
• have money to burn    tener mucho más de lo necesario

2.
n. - arroyo, riachuelo

Svenska (Swedish)
v. - bränna, förbränna, sveda, brinna
n. - förbränning, brännskada

中文（简体）(Chinese (Simplified))
1. 烧毁, 烧坏, 烧伤, 烧焦, 发热, 燃烧, 发光, 着火, 灼伤, 灼痛感, 烙印

idioms:

• burn down    烧毁
• burn in    烙上
• burn off    烧掉, 蒸发
• burn one's boats    破釜沉舟
• burn one's bridges    破釜沉舟
• burn one's fingers    由于管闲事而受损害
• burn out    不再热衷, 失去兴趣, 热情
• burn the candle at both ends    过分耗费
• burn the midnight oil    开夜车
• burn to the ground    全部焚毁
• burn up    烧起来, 发怒, 烧掉
• have money to burn    有用不完的钱

2. 小溪, 毒品交易中收钱而不给货, 卖假毒品给人

中文（繁體）(Chinese (Traditional))
1.
n. - 小溪, 毒品交易中收錢而不給貨, 賣假毒品給人

2.
v. tr. - 燒毀, 燒壞, 燒傷, 燒焦
v. intr. - 發熱, 燃燒, 發光, 著火
n. - 燒傷, 灼傷, 灼痛感, 烙印

idioms:

• burn down    燒毀
• burn in    烙上
• burn off    燒掉, 蒸發
• burn one's boats    破釜沈舟
• burn one's bridges    破釜沉舟
• burn one's fingers    由於管閒事而受損害
• burn out    不再熱衷, 失去興趣, 熱情
• burn the candle at both ends    過分耗費
• burn the midnight oil    開夜車
• burn to the ground    全部焚毀
• burn up    燒起來, 發怒, 燒掉
• have money to burn    有用不完的錢

한국어 (Korean)
1.
v. tr. - ~을 불태우다, 감명을 주다, 마구 쓰다
v. intr. - 타오르다, 더워지다, 부식하다
n. - 타버린 곳, 화상, 분사

idioms:

• burn down    죄다 태워버리다
• burn in    ~을 부식하다, 새겨지다, 인화하다
• burn off    ~을 불태워 버리다
• burn one's boats    배수의 진을 치다
• burn one's bridges    배수진을 치다
• burn one's fingers    손가락을 데다
• burn out    다 타버리다, 정력을 다 써버리다
• burn the candle at both ends    돈을 심하게 낭비하다
• burn the midnight oil    밤늦게까지 공부를 하다
• burn to the ground    전소하다
• burn up    다 태워버리다, 노하다, 열광케 하다
• have money to burn    주체 못할 만큼 돈이 많이 있다

2.
n. - 시내

日本語 (Japanese)
v. - 燃える, 焼ける, 焦げる, 日焼けする, ともる, 輝く, やけどする, 燃え上がる, かっとなる, ほてる, 焼き付ける
n. - 火傷, 日焼け, 噴射, 焼け跡

idioms:

• burn a hole into one's pocket    金がすぐ出ていってしまう
• burn down    全焼させる, 全焼する, 勢いが衰える
• burn off    焼き払う
• burn one's bridges/boats    背水の陣を敷く
• burn one's fingers    手を焼く
• burn out    焼き尽くす, 燃え尽きる
• burn the candle at both ends    精力を使い果たす
• burn the midnight oil    深夜まで勉強する
• burn to the ground    全焼する
• burn up    ぱっと燃え上がる, 燃やし尽くす, 燃え尽きる

العربيه (Arabic)
‏(فعل) يحترق أو يحرق (الاسم) حرق‏

עברית (Hebrew)
v. tr. - ‮שרף, חרך, צרב, נהג במהירות (מדוברת), הרגיז (מדוברת)‬
v. intr. - ‮נשרף, בער, נהג במהירות (מדוברת), הוצא להורג בכיסא החשמלי (מדוברת), השתזף‬
n. - ‮בעירה, כוויה, חלקה שפונתה באמצעות שרפה, ביעור צמחיה, מירוץ מכוניות (מדוברת), סיגריה (מדוברת)‬
n. - ‮נחל קטן, פלג, פלגלג‬

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