From the Guidelines
For a patient with a superficial partial thickness burn, it is recommended to refer them to a burn specialist, as they have the expertise to evaluate and treat burns of varying severity, especially if the burn involves sensitive areas or is larger in size. According to the 2024 American Heart Association and American Red Cross guidelines for first aid 1, patients with second- or third-degree burns involving the face, hands, feet, and genitals, and those involving >10% body surface area (5% in children), should be treated in a specialized burn center.
Key Considerations
- Burn specialists can provide specialized wound care, potential skin grafting, or management of complications, which is crucial for minimizing scarring and preserving function.
- Primary care physicians can manage minor superficial partial thickness burns that are limited in size, but specialist care is recommended for larger or more complex burns.
- The American Burn Association recommends that patients with burns involving sensitive areas or large surface areas be treated in a specialized burn center, highlighting the importance of specialist care in these cases 1.
Treatment and Management
- Over-the-counter analgesics such as acetaminophen or NSAIDs can be used for burn pain, as they are well tolerated and generally recommended 1.
- Topical treatments like petrolatum, honey, and aloe have been shown to improve healing time in patients with partial-thickness burns, including unroofed blisters 1.
- It is essential to remove jewelry before the onset of swelling to prevent constriction and vascular ischemia, as burned tissue swells 1.
From the Research
Burn Treatment and Referral
- For patients with superficial partial thickness burns, the initial treatment is directed at promoting healing and protecting the wound with advanced dressings to maintain a moist environment 2.
- Deep partial-thickness burns require immediate referral to a burn surgeon for possible early tangential excision 2.
- Full-thickness burns involve the entire dermal layer, and patients with these burns should automatically be referred to a burn center 2.
Specialist Referral
- Patients with superficial partial thickness burns may not necessarily require referral to a specialist, but rather treatment with advanced dressings and monitoring for complications 2.
- However, patients with deeper burns or larger surface area involvement may require referral to a burn center or a specialist, such as a burn surgeon or a plastic surgeon 2.
Treatment Options
- Various dressings are available for the treatment of superficial and partial thickness burns, including silver sulphadiazine, biosynthetic dressings, silver-containing dressings, and hydrogel dressings 3.
- Silver sulphadiazine has been consistently associated with poorer healing outcomes than other dressings, while hydrogel dressings have been shown to promote faster healing 3.
- The choice of dressing should be based on its effects on healing, as well as ease of application and removal, dressing change requirements, cost, and patient comfort 3.