What is the treatment for superficial partial-thickness (second-degree) burns in a clinical setting?

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Last updated: May 23, 2025View editorial policy

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From the Guidelines

To treat a superficial partial thickness burn in clinic, first clean the wound gently with mild soap and water or saline solution, then apply a topical antimicrobial agent and cover with a non-adherent dressing. The most recent and highest quality study 1 suggests that cooling of burns with running water is an established and beneficial intervention with little risk of harm. For pain management, it is reasonable to give over-the-counter pain medications for pain from thermal burns, such as acetaminophen or ibuprofen 1. Some key points to consider when treating superficial partial thickness burns include:

  • Cleaning the wound gently with mild soap and water or saline solution to prevent infection
  • Applying a topical antimicrobial agent such as silver sulfadiazine 1% cream, bacitracin, or mupirocin to prevent infection
  • Covering the burn with a non-adherent dressing like Xeroform, Adaptic, or petroleum-impregnated gauze, followed by a layer of sterile gauze and secure with rolled gauze or medical tape
  • Changing dressings daily or every other day depending on drainage
  • Elevating the burned area if possible to reduce swelling
  • Instructing patients to return if they notice increasing pain, redness extending beyond the burn area, purulent drainage, fever, or if the burn doesn't show improvement within 3-5 days, as recommended by the American Heart Association and American Red Cross guidelines for first aid 1. It's also important to note that petrolatum, honey, or aloe vera may be applied to open burn wounds after cooling, as they have been shown to improve healing time in patients with partial-thickness burns 1. Superficial partial thickness burns typically heal within 7-14 days without scarring if properly cared for, and proper wound care facilitates the natural healing process by allowing regeneration of skin cells from surviving epithelial elements in hair follicles and sweat glands.

From the FDA Drug Label

Reduction in bacterial growth after application of topical antibacterial agents has been reported to permit spontaneous healing of deep partial-thickness burns by preventing conversion of the partial thickness to full thickness by sepsis. The FDA drug label does not answer the question about treating superficial partial thickness burns. The information provided is about deep partial-thickness burns 2.

From the Research

Treatment of Superficial Partial Thickness Burns

To treat superficial partial thickness burns in a clinic, the following methods can be considered:

  • The use of collagen sheet dressings has been shown to be effective in promoting wound healing and reducing pain 3, 4.
  • Collagen dressings can maintain a moist environment, act as a bacterial barrier, and allow for free exchange of gases, making them an ideal choice for superficial partial thickness burns 3.
  • Silver sulfadiazine (SSD) dressings can also be used, but they may be associated with poorer healing outcomes compared to biosynthetic dressings, silver-containing dressings, and silicon-coated dressings 5.
  • Hydrogel dressings may also be considered, as they have been shown to promote faster healing compared to usual care 5.

Dressing Change and Wound Care

  • Collagen dressings may require minimal or no dressing changes, reducing the need for frequent wound care and promoting faster healing 3, 4.
  • Conventional dressings, such as paraffin gauze and SSD, may require more frequent dressing changes, which can traumatize newly epithelialized surfaces and delay healing 3.
  • It is essential to consider the patient's comfort and ease of application and removal when selecting a dressing 5.

Patient Education and Follow-up Care

  • Patient education is crucial in preventing complications and promoting proper wound care 6, 7.
  • Follow-up care is essential to assess patients for infection, healing, and ability to provide proper wound care 6, 7.
  • Early surgical referral can often help prevent or lessen scarring and contractures 7.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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