From the Guidelines
Treatment for a partial thickness burn to the palmar surface of the hand involves immediate cooling with cool running water for 10-20 minutes, followed by covering the burn with a nonadherent bandage or clean cloth to protect the wound and reduce pain, as recommended by the 2024 American Heart Association and American Red Cross guidelines for first aid 1. The initial step in managing a partial thickness burn to the palmar surface of the hand is to cool the burn with cool running water for 10-20 minutes to stop the burning process and reduce pain, which is supported by a meta-analysis of observational data showing a decrease in the need for subsequent care in patients with thermal burns who receive immediate active cooling with clean running water 1. After cooling, the burn should be covered with a nonadherent bandage or clean cloth to protect the wound and reduce pain, while avoiding heat entrapment until the burn can be assessed by a healthcare professional 1. For pain management, it is reasonable to give over-the-counter pain medications such as acetaminophen or ibuprofen as needed 1. Key considerations in the treatment of partial thickness burns to the palmar surface of the hand include:
- Elevating the hand above heart level to reduce swelling
- Avoiding breaking blisters as they serve as natural barriers against infection
- Seeking immediate medical attention if the burn covers more than 3% of body surface area, shows signs of infection, or affects hand function
- Maintaining flexibility and functionality of the palmar surface during healing to prevent contractures and scarring that could limit hand movement.
From the Research
Treatment for Partial Thickness Burn to the Palmar Surface of the Hand
- The treatment for partial thickness burns to the palmar surface of the hand involves the use of topical antimicrobial agents and dressings to promote wound healing and prevent infection 2, 3, 4, 5.
- Silver sulfadiazine (SSD) has been a standard therapy for the conservative treatment of burn wounds, but recent studies have shown that newer dressings may have superior healing properties and be more comfortable for patients 2, 3, 4.
- A study comparing SSD with Centiderm, a topical treatment containing Centella asiatica, found that Centiderm showed better objective and subjective signs, re-epithelialization, and complete healing times, with no infection reported in the Centiderm group 3.
- Another study found that the use of SSD for partial thickness scald burns in children was associated with delayed healing and increased requirement for compression garments for scar therapy, leading the authors to recommend the use of biosynthetic dressings or topical antimicrobial ointments instead 4.
- The addition of hyaluronic acid to SSD has been shown to reduce healing time and accelerate the reduction of local edema, and may be a useful alternative for the treatment of partial thickness burns 5.
- When assessing hand burns, including those to the palmar surface, a rule of thumb for categorization and mapping of proportional surface area involvement can be useful for facilitating comparison and guiding treatment 6.