6th degree burns, also known as full thickness burns, are the most severe type of burn injury. They penetrate through all layers of the skin and underlying tissues, damaging nerves, blood vessels, muscles, and even bones. 6th degree burns often result in devastating outcomes, and survival is extremely difficult. However, with prompt and proper emergency care followed by intensive medical treatment, survival is possible in some cases.
What are 6th degree burns?
Burns are classified into different degrees depending on their severity:
| Burn Degree | Depth of Skin Damage |
|---|---|
| 1st degree burns | Damage only to the outer layer of skin (epidermis) |
| 2nd degree burns | Damage extends into deeper layer of skin (dermis) |
| 3rd degree burns | Damage to entire thickness of skin, including epidermis and dermis |
| 4th degree burns | Damage extending into underlying tissues (fat, muscle, bone) |
| 5th degree burns | Damage through full thickness of skin and underlying tissues |
| 6th degree burns | Damage penetrating deeper tissues to bone and bone marrow |
6th degree burns are the most extensive, with damage going through the full thickness of skin and tissues down to the bone. They destroy nerves, blood vessels, and muscle, leaving the burned area completely insensate and unable to regenerate on its own. 6th degree burns often lead to severe complications like infection, loss of function, amputations, sepsis, and death.
What causes 6th degree burns?
Some potential causes of 6th degree burns include:
- Prolonged direct contact with flames, molten metal, or superheated steam
- High voltage electrical burns that penetrate deeply through tissues
- Explosions or blast injuries that severely damage underlying structures
- Chemical burns from strong acids or bases that eat away skin and tissues
6th degree burns can result from industrial accidents, fires, electrical injuries, or military combat. They may also be seen in victims of torture exposed to extreme heat or chemicals. The depth and extent of tissue damage depends on factors like temperature, duration of exposure, and concentration of chemicals. Even a few seconds of contact with extreme heat can cause disastrous 6th degree burns.
How are 6th degree burns diagnosed?
Doctors diagnose the degree of burns by examining the skin and evaluating the depth of tissue damage. Signs that help identify 6th degree burns include:
- Full thickness destruction of the skin, appearing white, brown or black with charring
- No sensation in the burned area due to nerve damage
- Firm, leathery feel on palpation of the damaged tissue
- Exposure of underlying fat, muscle, or bone
- Non-blanching discoloration with tissue coagulation
Imaging tests like CT scans or MRIs may be done to evaluate the extent of injury to deeper structures like muscles and bones. Doctors calculate the total body surface area (TBSA) burned to determine treatment needs and prognosis. 6th degree burns covering more than 50% TBSA usually result in fatal complications.
What is the prognosis for 6th degree burn victims?
The prognosis largely depends on the total body surface area burned, location of the burns, age and health status of the patient, cause of injury, and timeliness of medical care. Small 6th degree burns on the extremities may allow survival with proper treatment. But 6th degree burns over 50% TBSA are often fatal.
Some factors that influence prognosis include:
- Extensive burns >50% TBSA have a grave prognosis
- Burns involving the torso, head, neck, hands, or genitals cause higher mortality
- Elderly, pediatric, and immune-compromised patients have higher risk of complications
- Electrical and chemical burns carry worse prognosis than fire or scald burns
- Pre-existing medical conditions increase mortality risk
- Delay in first aid and medical treatment increases morbidity and mortality
Despite aggressive treatment, 6th degree burn patients have a high risk of multiple organ failure, sepsis, respiratory failure and death. However, the will to survive can sometimes help patients pull through extensive burns. Supportive care and rehabilitation are crucial for positive outcomes.
Can 6th degree burns be survived? What does it take?
Survival from devastating 6th degree burns is challenging but possible in some cases with prompt first aid, specialized trauma care, and long-term rehabilitative treatment. Some key factors for survival include:
- Immediate cooling of the burned area with water to minimize damage
- Quick medical attention and transport to a specialized burn care unit
- Fluid resuscitation and medications during the initial shock phase
- Critical care to prevent respiratory failure, kidney failure and sepsis
- Early surgical debridement and skin grafts
- Antibiotics and measures to prevent infections
- Long term rehabilitation including physical and occupational therapy
- Psychological counseling and support systems
With intensive care and dedicated efforts of the medical team and patient’s inner drive, survival is possible even with burns impacting over 50% of the body surface area. However, the patient has to be strong-willed and motivated to endure the long, painful and laborious journey of healing and recovery.
Case studies of 6th degree burn survivors
Some real-life cases of people surviving devastating 6th degree burns help illustrate that the human body and spirit can sometimes defy the odds.
Lai Thi Dao – Vietnam, 2003
67-year-old grandmother Lai Thi Dao survived 6th degree burns over 60% of her body from a tragic motorbike accident in Vietnam in 2003. She endured over 20 reconstructive surgeries and skin grafts to gradually recover over 7 years, defying doctors’ expectations. She attributes her will to live and maternal love for her injured granddaughter as crucial factors that helped her survive.
Chris Cates – California, 2016
In 2016, college student Chris Cates suffered 6th degree electrical burns to over 65% of his body after coming in contact with 12,000 volts power line while working. Doctors gave him just 1% chance of survival. But after a double leg amputation, over 15 major surgeries, extensive skin grafts and 2 months in coma, Chris survived and recovered with intensive rehab.
Madison Desch – California, 2020
In 2020, pilot Madison Desch miraculously survived after suffering 6th degree burns to over 70% of her body from a fiery plane crash. She endured months of special treatment including artificial skin grafts, cryotherapy, laser surgery and physical therapy to regain function. Her tremendous grit and optimism despite the pain helped her pull through and recover.
Treatment and recovery for 6th degree burn survivors
The treatment for 6th degree burns focuses on preventing complications, preserving remaining tissues, regaining function through skin grafts and rehabilitation.
Initial emergency management
At the site of injury, quick cooling of burns and care to ensure airway, breathing and circulation are vital. Emergency teams work to prevent shock, obtain IV access, provide oxygen, and transport the patient to a specialized burn center.
Initial hospital treatment
At hospital intensive measures focus on:
- Fluid resuscitation with IV fluids to stabilize circulation
- Medications like antibiotics, tetanus shots, and pain relief
- Hydrotherapy by bathing burns in antibiotic solutions
- Debridement of dead tissues to prevent infection
- Nutritional support through feeding tubes
Surgeries for 6th degree burns
Multiple reconstructive surgeries are needed, starting with debridement of irreversibly damaged tissues. Other procedures include:
- Skin grafts using the patient’s own unburned skin if available
- Flaps using healthy skin and tissue from other body parts
- Artificial skin substitutes when donor sites are inadequate
- Muscle and bone grafts to replace damaged areas
- Implants and external fixators to enable healing
- Amputation of unsalvageable limbs to control infection
Rehabilitation after 6th degree burns
After surviving the initial trauma, extensive rehab helps 6th degree burn patients regain function. Goals include:
- Improving range of motion and strength
- Reducing pain and discomfort
- Mastering daily living activities
- Walking and mobility training
- Adapting to changed body image and artificial limbs
- Vocational training and resources
Psychological counseling provides critical emotional support throughout the healing journey.
Prevention of 6th degree burns
While treatment is focused on recovery after burn injuries, prevention is key to avoiding such devastating trauma. Some tips to prevent 6th degree burns include:
- Follow strict safety precautions in workplaces prone to burn risks like industries and kitchens
- Ensure proper electrical wiring and guarding of power sources
- Keep flammable chemicals handled safely and segregated
- Never leave children unattended near heat sources
- Keep a fire extinguisher and first aid kit easily accessible
- Wear protective gear suited for the environment
- Learn basic first aid like STOP – Strip, Tepid water, Organize transport, Paramedic call
Public awareness campaigns regarding burn hazards and appropriate safety protocols can help reduce incidence of severe burns.
Conclusion
6th degree burns pose grave risks and high chances of mortality. But with early appropriate care, courage, grit and a multi-disciplinary medical effort focused on recovery, survival is possible in some cases of catastrophic full thickness burns. Advances in acute burn treatments and reconstructive surgery can help more patients defy the odds. However prevention remains the best solution, underscoring the need for safety consciousness regarding burn risks. Public awareness and preparedness, smart preventive strategies, and expert trauma management can save lives from disastrous 6th degree burns.
