Burns, Skin Lesions & Soft-Tissue Surgery
Assess burn severity and recognise skin or soft-tissue lesions that require specialist evaluation.
Quick revision ↓ Medical Dictionary
01Initial burn assessment
Stop further exposure safely and assess airway, breathing and circulation alongside associated trauma. An enclosed-space fire raises concern for inhalational injury even when external burns seem limited. Record timing, mechanism, burn depth and estimated surface area using an appropriate method. Prevent hypothermia during assessment and obtain early specialist advice when injury severity or airway risk warrants it.
02Depth, site and referral
Burn depth may evolve and requires reassessment. Deep burns, significant surface area, special sites such as hands or face, chemical or electrical mechanisms and important comorbidity influence referral. Electrical injury can cause damage beyond the visible skin mark. Specialist advice considers function and mechanism as well as size; a small but deep hand burn can have major consequences.
03Resuscitation and wound care
Major burns may require formal fluid resuscitation with frequent clinical and urine-output reassessment under a burn service protocol. Formula estimates are starting guides, not fixed prescriptions. Provide analgesia, appropriate wound protection and tetanus assessment. Avoid routine systemic antibiotics solely because a burn exists; suspected infection requires clinical evaluation and targeted treatment rather than assuming colonisation equals invasive disease.
04Suspicious skin lesions
An evolving pigmented lesion, nonhealing ulcer or growing skin nodule needs examination and an appropriate diagnostic pathway. Record location, change, symptoms and relevant risk factors; photographs may assist with consent. Biopsy strategy should preserve diagnostic value and future treatment options. Do not destroy a suspicious lesion without considering tissue diagnosis and the implications for staging or margins.
05Soft-tissue masses and recovery
An enlarging, deep or otherwise concerning soft-tissue mass needs assessment for a tumour pathway rather than casual unplanned excision. Imaging and biopsy planning should involve the appropriate team when sarcoma is suspected. After burns or reconstruction, recovery includes mobility, scar management, psychological support and function. A healed skin surface does not automatically mean full recovery of movement or confidence.
High-Yield Revision
- Burn mechanism and location matter as well as surface area.
- Fluid estimates require adjustment to monitored response.
- Plan tissue diagnosis before destructive treatment of a suspicious lesion.
Common Pitfalls
- Judging electrical injury solely by its skin mark.
- Unplanned excision of a concerning deep soft-tissue mass.
References & Further Reading
Read the relevant guideline sections alongside these original clinical teaching cases. Local pathways, available services and individual patient factors determine care.
Reference review: 27 September 2026. Consult current local protocols for prescribing, procedures and escalation.