What is the treatment plan for a 2-year-old with a second-degree burn to the palm of the hand?

From the Guidelines

The treatment plan for a 2-year-old with a second-degree burn to the palm of the hand involves immediate cooling of 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 Care

• Cool the burn with cool running water for 10-15 minutes to reduce pain and prevent further injury, as suggested by the guidelines 1.
• Gently clean the area with mild soap and water, being careful not to break any blisters.

Wound Care

• After cooling, it may be reasonable to apply petrolatum, petrolatum-based antibiotic ointment, honey, or aloe vera and a clean nonadherent dressing to open burn wounds, as stated in the guidelines 1.
• Loosely cover a burn that has intact skin or an intact blister with a clean cloth or nonadherent dry dressing, as recommended by the guidelines 1.

Pain Management

• It is reasonable to give over-the-counter pain medications for pain from thermal burns, such as acetaminophen or ibuprofen, as suggested by the guidelines 1.

Follow-up Care

• Follow-up with a healthcare provider within 24-48 hours is essential to monitor the burn's healing progress and watch for signs of infection.
• Keep the hand elevated when possible to reduce swelling and promote healing.
• Change the dressing daily or when soiled to prevent infection and promote a clean environment for healing.
• Watch for signs of infection including increased redness, swelling, warmth, pus, or fever, and seek medical attention if any of these symptoms occur.

From the FDA Drug Label

DOSAGE AND ADMINISTRATION 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 burn areas should be covered with silver sulfadiazine cream, USP 1% at all times The cream should be applied once to twice daily to a thickness of approximately one sixteenth of an inch.

The treatment plan for a 2-year-old with a second-degree burn to the palm of the hand includes:

• Control of shock and pain
• Cleansing and debridement of the burn wound
• Application of silver sulfadiazine cream, USP 1% under sterile conditions
• Covering the burn area with silver sulfadiazine cream, USP 1% at all times
• Applying the cream once to twice daily to a thickness of approximately one sixteenth of an inch
• Reapplying the cream after hydrotherapy or whenever necessary 2

From the Research

Treatment Plan for a 2-year-old with a Second-Degree Burn to the Palm of the Hand

• The treatment plan for a 2-year-old with a second-degree burn to the palm of the hand may involve the use of topical antimicrobial agents or advanced occlusive dressings 3.
• Silver sulfadiazine has been widely used for the treatment of burns, and studies have shown it to be effective in promoting wound healing and preventing infection 4, 5, 6.
• However, some studies have reported that silver sulfadiazine can cause pain and discomfort, and additional nursing interventions may be needed to manage these symptoms 4.
• Alternative treatments, such as topical antibiotic ointments or Aloe Vera gel, may also be effective in promoting wound healing and reducing scarring 3, 7.
• A study comparing the effectiveness of hyaluronic acid plus silver sulfadiazine versus silver sulfadiazine alone found that the combination treatment resulted in faster re-epithelialization and shorter healing time 5.
• Another study found that Aloe Vera gel was more effective than 1% silver sulfadiazine cream in promoting wound epithelialization, pain relief, and cost-effectiveness 7.

Considerations for Treatment

• The choice of treatment should be based on the severity and depth of the burn, as well as the patient's overall health and medical history.
• It is essential to follow proper wound care and dressing techniques to promote healing and prevent infection.
• Pain management should also be a priority, and additional interventions may be needed to manage discomfort and promote patient comfort.
• The treatment plan should be individualized to meet the unique needs of the patient, and regular follow-up appointments should be scheduled to monitor progress and adjust the treatment plan as needed.