From the Guidelines
For a patient with healed 25% second and third-degree burns being discharged home, I would advise comprehensive burn care management, including applying skin emollients to keep the healed skin moisturized and prevent dryness and cracking, as this is crucial for preventing complications and promoting quality of life. The patient should understand that the healed burn areas may remain erythematous (red) and itchy for months as part of normal healing 1. They should apply pressure garments continuously during the day and remove them at night to prevent hypertrophic scarring. Key aspects of care include:
- Applying skin emollients regularly to maintain skin hydration and prevent fissuring
- Using pressure garments as directed to minimize scarring
- Performing sterile dressing changes if skin fissuring occurs and reporting promptly to their doctor, as this could indicate complications requiring medical attention
- Protecting healed burn areas from sun exposure using sunscreen and clothing
- Attending all follow-up appointments for monitoring
- Performing prescribed physical therapy exercises to maintain mobility
- Watching for signs of infection such as increased pain, redness, warmth, or discharge. This comprehensive approach helps optimize long-term healing outcomes and prevents complications like contractures and hypertrophic scarring, ultimately improving morbidity, mortality, and quality of life 1.
From the Research
Burn Wound Care After Discharge
The patient with 25% 2nd and 3rd degree burn is ready for discharge after improvement in condition and healing of burn wounds. The following advice can be given to the patient:
- The burned area may be erythematous and itchy 2, 3
- Apply skin emollient to relieve itchiness and keep the skin moisturized 2, 3
- If skin fissuring occurs, do sterile dressing and report to the doctor 4, 5
Pressure Garment Therapy
- Apply pressure garment all day and take it off at night to prevent hypertrophic scarring 6