From the Guidelines
The initial treatment for second-degree burns involves cooling the burn with cool running water for about 10-15 minutes to stop the burning process and reduce pain, as recommended by the 2024 American Heart Association and American Red Cross guidelines for first aid 1.
Initial Treatment
- Cool the burn with cool running water for 10-15 minutes to reduce pain and stop the burning process.
- After cooling, gently clean the area with mild soap and water.
- Apply an antibiotic ointment such as bacitracin or petroleum jelly to keep the wound moist and prevent infection.
Wound Care
- Cover the burn with a sterile, non-stick bandage or gauze secured with medical tape.
- Change the dressing daily or whenever it becomes wet or soiled.
Pain Management
- Use over-the-counter medications like acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) as directed for pain management, as suggested by the 2024 American Heart Association and American Red Cross guidelines for first aid 1.
Important Considerations
- Avoid applying ice, butter, or home remedies directly to burns as these can cause further damage.
- Second-degree burns involve damage to both the outer layer (epidermis) and part of the underlying layer (dermis) of skin, causing blistering, redness, and pain.
- If the burn is larger than 3 inches in diameter, on the face, hands, feet, genitals, or major joints, or if there are signs of infection (increasing pain, redness, swelling, oozing), seek medical attention immediately, as recommended by the 2024 American Heart Association and American Red Cross guidelines for first aid 1.
From the FDA Drug Label
Silver sulfadiazine cream, USP 1% is a topical antimicrobial drug indicated as an adjunct for the prevention and treatment of wound sepsis in patients with second and third degree burns. Prompt institution of appropriate regimens for care of the burned patient is of prime importance and includes the control of shock and pain. The burn wounds are then cleansed and debrided; silver sulfadiazine cream, USP 1% is then applied under sterile conditions.
The initial treatment for second-degree burns involves:
- Control of shock and pain
- Cleansing and debridement of the burn wounds
- Application of silver sulfadiazine cream, USP 1% under sterile conditions, to a thickness of approximately one sixteenth of an inch, once to twice daily 2, 2.
From the Research
Initial Treatment for Second-Degree Burns
The initial treatment for second-degree burns involves several key steps:
- Stopping the burn process 3
- Evaluating the burn depth and percentage of total body surface area involved to determine the need for referral to a burn center 3
- Providing pre-hospital first aid, which may include cooling the burn with cool or lukewarm water, removing clothing and jewelry, and covering the burn with a non-stick dressing 4
- Considering advanced dressings to protect the wound and promote a moist environment for superficial partial-thickness burns 3
Topical Treatments
Various topical treatments have been studied for second-degree burns, including:
- Silver sulfadiazine, which is a common topical treatment but may delay healing 5, 6
- Sucralfate, which has been shown to accelerate burn wound healing in comparison to silver sulfadiazine 5
- Nitrofurazone, which has been compared to povidone-iodine and silver sulfadiazine in the treatment of second-degree burns, with results indicating superior healing and less pain in some cases 6
- Povidone-iodine, which has been shown to have equivalent results to nitrofurazone in some cases, but may cause more pain in patients with more serious burns 6
Special Considerations
Special attention should be given to factors such as the burn site, patient age, and burn area when treating second-degree burns 7 Patients with diabetes mellitus are at increased risk of complications and infection, and early referral to a burn center should be considered 3