Occasionally, burns even deeper than a full thickness of skin occur, such as in an electrical burn, or when a part of the body is trapped in flame. These deep burns enter the muscle and bone and are also called "black" or "char" burns. If a fourth-degree burn involves more than a very small area of the body, the prognosis is very grave, since these deep burns can release toxic substances into the blood stream. If the burn involves a small area, it should be cut away down to healthy tissue; a charred large area on an arm or leg usually requires amputation.
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