From the Guidelines
The treatment for a second-degree burn involves immediate cooling of the burn with cool (not cold) running water for 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. The goal of treatment is to promote healing, prevent infection, and minimize scarring. After cooling, gently clean the area with mild soap and water, then apply an antibiotic ointment like bacitracin or petroleum jelly to keep the wound moist and prevent infection. Some key points to consider in the treatment of second-degree burns include:
- Covering the burn with a sterile, non-stick bandage or gauze secured with medical tape, changing the dressing daily 1.
- Using over-the-counter medications such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) for pain management, as they are well tolerated and generally recommended for burn pain 1.
- Keeping the burn elevated when possible to reduce swelling.
- Not popping blisters as they protect against infection.
- Seeking medical attention if the burn is larger than 3 inches in diameter, affects the face, hands, feet, genitals, or major joints, or shows signs of infection such as increased pain, redness, swelling, or pus. It's also important to note that second-degree burns damage both the outer layer (epidermis) and part of the underlying layer (dermis) of skin, causing blistering, redness, and pain. According to the 2024 American Heart Association and American Red Cross guidelines for first aid, burns involving the face, hands, feet, and genitals may require surgical intervention to prevent permanent disability, and those with a large surface area can lead to significant fluid loss and multisystem organ failure 1. Therefore, it's crucial to seek medical attention immediately if there's any concern about the severity of the burn or if there are signs of infection.
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 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 treatment for a 2nd degree burn includes:
- Cleansing and debridement of the burn wound
- Application of silver sulfadiazine cream, USP 1% under sterile conditions
- The cream should be applied once to twice daily to a thickness of approximately one sixteenth of an inch
- Treatment with silver sulfadiazine cream, USP 1% should be continued until satisfactory healing has occurred or until the burn site is ready for grafting 2, 2
From the Research
Treatment for 2nd Degree Burns
The treatment for 2nd degree burns involves various approaches, including:
- Prehospital first aid
- Nonsurgical treatment
- Surgical treatment
- Infection treatment 3 Some key considerations in the treatment of 2nd degree burns include:
- Burn site
- Patient age
- Burn area 3
Topical Treatment
Topical treatment is an important aspect of burn wound care, with the goal of promoting healing and preventing infection. Ideal topical antiseptics should have a broad antimicrobial spectrum, be able to penetrate necrotic tissue, and have minimal side effects 4. Some common topical treatments for 2nd degree burns include:
- Topical antiseptics
- Surgical dressing products
- Artificial skins 4
- Biobrane, which has been shown to be superior to topical treatment with 1% silver sulfadiazine in pediatric patients 5
- Topical antibiotic ointments, which have been shown to enhance reepithelialization and reduce scar depth and contraction compared to silver-based foam dressings 6
Advanced Wound Care
Advanced wound care techniques, such as the use of collagen hydrogel/scaffold and probiotic microorganisms, may also be beneficial in promoting burn wound healing 7. These approaches can help to modulate inflammation, increase wound healing and epithelialization, and improve biomechanical performance of the wound area 7.
Key Findings
Some key findings from the studies include:
- Biobrane is superior to topical treatment with 1% silver sulfadiazine in pediatric patients 5
- Topical antibiotic ointments can enhance reepithelialization and reduce scar depth and contraction compared to silver-based foam dressings 6
- The use of collagen hydrogel/scaffold and probiotic microorganisms can improve burn wound healing 7