Thermal burns (or burns from a high temperature source – as opposed to electrical or chemical burns) are fairly common, and we all have a story of touching something a lot hotter than we expected.
But when a burn is significantly painful, or the contact time was longer, the immediate management and assessment is important to prevent further injury and help the healing process begin immediately.
If you suffer a burn – the first thing to do after getting away from the source of heat, is to place the burn under cool running water. A cold tap turned on will run at around 15 degrees, and this is perfect. Have the wound under this for at least 20 minutes.
It is important to NEVER APPLY ICE TO A BURN.
Although it may seem like it makes things better, ice can constrict blood flow to a burn after the thermal injury has already disturbed the blood supply. In some cases this can cause even more damage to the skin.
Simple analgesia like paracetamol and anti-inflammatories can be very helpful.
Sometimes you may need a stronger analgesic in the short term.
Cold water initially works as an excellent analgesic. As does covering the wound with an appropriate dressing.
Gone are the days of letting a wound dry up. We’ve found that this can increase the chance of infection, delays wound healing (not only the time to heal, but the type of healing), and causes significantly more pain.
Once a wound is deemed to be partial thickness or superficial thickness, it can be dressed with a non stick, absorptive dressing that will soak up all the ooze.
This wound needs to be reviewed in 24-48 hours for two reasons. Firstly, to change the soaked dressing, and secondly to assess the full damage of the burn.
If the burn is still deemed partial thickness, then a less absorptive dressing can be applied.
While silver dressings are popular for burns – they don’t need to be used unless there are signs of infection. In fact silver impregnated dressings, or silver sulfasalazine cream can significantly delay an otherwise healing burn.
No one seems to agree on what to do here. Large blisters at the time of the burn can be removed by a doctor to fully assess the burn underneath, while smaller blisters <6mm tend to remain without growing or spontaneously rupturing.
If there looks like infected material in a blister, it should be removed and the roof (dead epithelium) removed with it.
Superficial burns take about 7 days to heal, and often leave no trace.
Superficial dermal burns take about 7-14 days, and have a small risk of a hypertrophic scar, and sometimes a colour mismatch with surrounding skin.
Deep dermal burns often take over 21 days to heal and have a high risk (up to 80% risk) of hypertrophic scarring.
Full thickness burns – which go through all layers of the skin, and are often painless, do not heal spontaneously and need medical review.
Any burn that appears particularly severe or large should be reviewed in a hospital setting. However if any of the following apply – call an ambulance
Green Square Health provides a range of services to fulfil the needs of our community.
Please find more information on the pages below about our services and tips on how to stay healthy.