Will a second (2nd) degree burn heal fully?

From the Guidelines

Second-degree burns can heal fully with proper care, as evidenced by the latest guidelines from the American Heart Association and American Red Cross 1. When considering the healing process of second-degree burns, it's essential to prioritize proper wound care and management to minimize the risk of complications and promote optimal recovery.

Key Considerations for Healing

• Second-degree burns typically heal within 2-3 weeks without scarring, though deeper burns may take longer and have a higher risk of scarring.
• The use of petrolatum, honey, or aloe has been shown to improve healing time in patients with partial-thickness burns, including unroofed blisters, compared with no dressing or various controls 1.
• Over-the-counter analgesics such as acetaminophen or NSAIDs are well tolerated and generally recommended for burn pain, as supported by a prospective study enrolling 61 patients with second- or third-degree burns 1.

Treatment Recommendations

1. Cool the burn with cool (not cold) running water for 10-20 minutes to reduce the risk of further tissue damage.
2. Apply an antibiotic ointment like bacitracin or silver sulfadiazine to prevent infection.
3. Cover with a sterile, non-stick bandage to protect the wound and promote a moist environment conducive to healing.
4. Change dressing daily and keep the area clean to prevent infection and promote optimal recovery.
5. Take over-the-counter pain relievers like ibuprofen or acetaminophen as needed to manage pain and discomfort. It's crucial to seek medical attention for large or deep burns, burns on sensitive areas, or if signs of infection develop, such as increased redness, swelling, or purulent discharge. Additionally, avoiding breaking blisters is recommended, as this increases the infection risk and can compromise the healing process.

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. The FDA drug label does not answer the question.

From the Research

Burn Healing Process

• Second-degree burns can be subdivided into two categories: superficial and deep partial-thickness burns 2
• Superficial partial-thickness burns extend into the dermis, may take up to three weeks to heal, and require advanced dressings to protect the wound and promote a moist environment 2
• Deep partial-thickness burns require immediate referral to a burn surgeon for possible early tangential excision 2

Treatment and Management

• The treatment of second-degree burns requires consideration of factors such as burn site, patient age, and burn area 3, 4, 5
• There is no unified standard or specification for the diagnosis, classification, surgical procedure, and infection diagnosis and grading of second-degree burn wounds, which poses challenges to clinical treatment plans 3, 4, 5
• Expert consensus and guidelines have been developed to provide recommendations on prehospital first aid, nonsurgical treatment, surgical treatment, and infection treatment for second-degree burns 3, 4, 5

Healing Outcome

• Second-degree burns can heal fully, but the healing process may take time and require proper treatment and management 2
• Long-term complications of partial-thickness burns include pruritus, hypertrophic scarring, and permanent hyperpigmentation 2
• Patient education and prevention strategies can help reduce the risk of complications and promote optimal healing outcomes 2