## Deep Partial-Thickness (2nd Degree) Burns: Feature Analysis ### Correct Answer: Painless due to complete nerve destruction **Key Point:** Deep partial-thickness burns are PAINFUL, not painless. The pain is often severe because nerve endings in the superficial dermis are stimulated, while deeper nerve endings may be damaged but not completely destroyed. ### Characteristics of Deep Partial-Thickness Burns | Feature | Deep Partial-Thickness (2°) | |---------|-----------------------------| | **Depth** | Extends into reticular dermis; basal layer may be damaged | | **Appearance** | Red, blistered, weeping surface; may appear mottled | | **Sensation** | PAINFUL — nerve endings stimulated, not destroyed | | **Healing** | Slow (3–8 weeks); heals with scarring and contracture | | **Fluid loss** | Significant; blisters contain plasma | | **Epithelialization** | From wound margins and hair follicles; may require grafting | **High-Yield:** The presence of pain in deep partial-thickness burns distinguishes them from full-thickness burns, where the area is characteristically painless ("leathery and insensate"). ### Why Other Options Are Correct 1. **Blistering is present** — Fluid accumulates between the epidermis and dermis, forming fluid-filled blisters. ✓ 2. **Healing with scarring and contracture** — Destruction of dermal collagen and slow re-epithelialization lead to hypertrophic scarring and contractures. ✓ 3. **Dermis partially preserved** — The basal layer and deeper dermis may retain viable fibroblasts and appendages (hair follicles, sweat glands), allowing slow healing. ✓ **Clinical Pearl:** The distinction between deep partial-thickness and full-thickness burns is critical for prognosis and management. Pain presence favors partial-thickness; pain absence suggests full-thickness involvement. [cite:Park 26e Ch 23]
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