From the Guidelines
For a patient with healed 25% 2nd and 3rd degree burns being discharged home, the best advice is to apply skin emollients regularly. Applying moisturizing emollients is essential for burn recovery as it prevents skin dryness, cracking, and fissuring, which are common complications after burn healing 1. The newly healed skin lacks normal oil glands and has compromised barrier function, making it prone to dryness and breakdown. Patients should apply emollients 3-4 times daily, especially after bathing when the skin is still slightly damp to lock in moisture. Petroleum-based products or specialized burn recovery moisturizers are particularly effective. This simple intervention helps maintain skin integrity, reduces itching, prevents contractures, and promotes optimal healing outcomes.
Some key points to consider when advising the patient include:
- Applying emollients regularly to prevent skin dryness and cracking
- Using petroleum-based products or specialized burn recovery moisturizers for optimal results
- Applying emollients 3-4 times daily, especially after bathing
- Monitoring for complications, such as skin fissuring, and reporting to the doctor if necessary
- Considering the use of pressure garments for some patients, particularly for preventing hypertrophic scarring, although this may not be applicable for all patients 2.
It is also important to note that the patient's burned area may be erythematous and itchy, but this can be managed with regular emollient application and monitoring. While observation is important, providing the patient with proactive advice on how to manage their skin can help prevent further complications and promote optimal healing outcomes.
From the Research
Burn Scar Management
- The patient should be informed that the burned area may be erythematous and itchy after healing, and this can be managed with moisturizers and other scar management techniques 3.
- Applying pressure garments all day and taking them off at night may be beneficial in preventing hypertrophic scarring, but the evidence is very uncertain and it may not be applicable for all patients 4, 5.
- Skin fissuring can be prevented with proper wound care and moisturizing, and if it occurs, sterile dressing and reporting to the doctor can help prevent further complications 6, 7.
- Applying skin emollients is a crucial step in preventing further consequences such as dryness, itchiness, and skin breakdown, and it is recommended as a first-line treatment for burn scar management 3.
Pressure Garment Therapy
- Pressure garment therapy is commonly used to prevent hypertrophic scarring after burn injury, but the evidence on its effectiveness is very uncertain 4.
- The therapy may hinder scar contraction and improve skin biomechanics, but more research is needed to determine its optimal use and effectiveness 5.
Wound Care and Dressing
- Burn wound care requires a multidirectional approach, including surgical activities, pharmacological approaches, and dressing types 6.
- Various dressings, including moisturizers, are used to promote wound healing and prevent complications, but more research is needed to determine the optimal dressing type and treatment approach 6, 3.