From the Research
The correct answer is C. Every burned patient must receive tetanus vaccination. This statement is false because not every burned patient requires tetanus vaccination. Tetanus prophylaxis in burn patients follows the same guidelines as for other wounds. Patients with burns who have received a tetanus booster within the last 5 years and have a clean wound do not need another dose. For patients with tetanus-prone wounds or those who haven't had a booster within 5-10 years, tetanus prophylaxis is recommended 1.
Regarding the other options:
- Low temperature burns with prolonged contact can indeed cause significant tissue damage due to cumulative thermal injury (option A is true).
- Burns typically present with intact epithelium and erythema in first-degree burns (option B is true).
- Facial burns should be referred to a burn unit due to potential airway complications, functional concerns, and cosmetic outcomes (option D is true). Burns from electrical wires are particularly concerning as they can cause deep tissue damage that may not be immediately apparent on the surface, with the zone of stasis (the area of potentially salvageable tissue surrounding the burn) being affected by proper initial management. The use of topical antimicrobial agents, such as silver-containing dressings, can help prevent infection and promote wound healing 2.
It's worth noting that the management of burn wounds has evolved over time, with a focus on early excision and grafting, as well as the use of topical antimicrobial agents to prevent infection 3, 4. However, the principles of tetanus prophylaxis remain the same, and not all burned patients require vaccination.