From the Guidelines
The most effective treatment for burns is to cool the area with cool running water for 10-15 minutes, then cover with a nonadherent bandage or clean cloth, as recommended by the 2024 American Heart Association and American Red Cross guidelines for first aid 1. When it comes to treating burns, the priority is to reduce the risk of infection and promote healing.
- For minor burns, cooling the area with cool running water for 10-15 minutes is essential, as it helps to reduce the temperature of the skin and minimize damage 1.
- After cooling, applying an antibiotic ointment like bacitracin or petroleum jelly and covering with a sterile non-stick bandage can help to prevent infection and promote healing.
- For moderate to severe burns, it is crucial to seek medical attention immediately, as these burns can lead to serious complications, including infection and scarring.
- In terms of wound care, keeping the wound clean and properly dressed is vital to prevent infection and promote tissue regeneration, as highlighted in the 2016 UK guidelines for the management of Stevens-Johnson syndrome/toxic epidermal necrolysis in adults 1.
- The use of topical antibiotics, such as silver sulfadiazine, is not recommended, as it can increase the risk of burn wound infection and prolong hospital stay, according to a review of 36 RCTs 1.
- Systemic antibiotic prophylaxis may be beneficial in reducing mortality and infection rates in burn patients, particularly in high-risk patients, as suggested by the 2023 WSES guidelines on the management of trauma in elderly and frail patients 1.
- Ultimately, the key to effective burn treatment is to prioritize proper wound care, including cooling, cleaning, and dressing the wound, and seeking medical attention if necessary, to minimize the risk of infection and promote healing.
From the FDA Drug Label
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 cream should be applied once to twice daily to a thickness of approximately one sixteenth of an inch.
The recommended treatment for burns includes:
- Cleansing and debridement of the burn wounds
- Application of silver sulfadiazine cream, USP 1% under sterile conditions
- Covering the burn areas with the cream at all times
- Reapplying the cream once to twice daily to a thickness of approximately one sixteenth of an inch
- Continuing treatment until satisfactory healing has occurred or until the burn site is ready for grafting 2
From the Research
Burn Treatment Overview
- The primary goal of burn treatment is to prevent infection and promote wound healing 3, 4, 5, 6.
- Topical antimicrobial agents are commonly used to minimize bacterial growth and prevent infection in burn wounds 3, 7, 4, 5, 6.
Recommended Topical Antimicrobial Agents
- Silver sulfadiazine (SSD) is a frequently used topical prophylactic agent due to its broad-spectrum antimicrobial activity and relatively low cost 3, 7.
- Cerium nitrate (CN) may be added to SSD to enhance its antimicrobial properties and improve patient outcomes 7.
- Mafenide acetate is an alternative agent with superior eschar-penetrating characteristics, but its use is limited due to potential systemic toxicity 3.
- Other agents, such as nitrofurazone and chlorhexidine preparations, may be used in specific clinical situations 3.
Treatment Considerations
- The choice of topical antimicrobial agent depends on the depth and severity of the burn, as well as the patient's individual needs and medical history 4, 5, 6.
- Early excision and grafting of burn wounds can decrease the importance of topical antimicrobial care, but these agents are still essential in preventing infection and promoting wound healing 5, 6.
- Ongoing research is needed to develop more effective topical antimicrobial agents and improve treatment outcomes for patients with complicated burn wounds 6.