From the Guidelines
The recommended management for a partial thickness burn involves cooling the burn with cool running water, gently cleaning the area, applying an antibiotic ointment, and covering the burn with a non-stick sterile dressing. This approach is supported by the 2024 American Heart Association and American Red Cross guidelines for first aid 1. The guidelines suggest that cooling of burns with running water is an established and beneficial intervention with little risk of harm, and that applying petrolatum, petrolatum-based antibiotic ointment, honey, or aloe vera and a clean nonadherent dressing to open burn wounds may be reasonable for small partial-thickness burns being managed at home 1.
Key steps in managing a partial thickness burn include:
- Cooling the burn with cool running water for about 10-20 minutes to stop the burning process and reduce pain
- Gently cleaning the area with mild soap and water, removing any debris without breaking blisters
- Applying an antibiotic ointment such as bacitracin, silver sulfadiazine (Silvadene), or mupirocin to prevent infection
- Covering the burn with a non-stick sterile dressing like Telfa or petroleum-impregnated gauze, and securing it with gauze wrap or medical tape
- Changing dressings daily or as directed by a healthcare provider
- Using acetaminophen (500-1000mg every 6 hours) or ibuprofen (400-600mg every 6-8 hours) as needed for pain management 1
- Keeping the burn elevated if possible to reduce swelling
It is essential to seek medical attention immediately for burns that are larger than 3 inches in diameter, involve the face, hands, feet, genitals, or major joints, or if there are signs of infection such as increasing pain, redness, swelling, or discharge 1. These recommendations aim to prevent infection, promote healing, and minimize scarring by maintaining a moist, clean healing environment while protecting the damaged tissue.
From the Research
Wound Management for Partial Thickness Burns
The management of partial thickness burns involves promoting healing and preventing infection. Several dressings are available, and the choice of dressing should be based on its effects on healing, ease of application and removal, dressing change requirements, cost, and patient comfort 2.
Dressing Options
- Silver sulfadiazine (SSD) is a commonly used topical agent for partial thickness burns, but it has been associated with poorer healing outcomes compared to biosynthetic dressings, silver-containing dressings, and silicon-coated dressings 2.
- Collagenase ointment is another option, but it has no antibacterial properties and is more expensive than SSD 3.
- Microbial cellulose dressing has shown promising results, with fewer dressing changes, less pain, and shorter hospital stays compared to SSD 4.
- Xenoderm, a biological dressing, has been shown to be more effective than SSD in terms of pain control, degree of wound infection, and length of hospital stay 5.
- Biosynthetic dressings have been associated with improved healing outcomes and are now preferred over SSD for pediatric partial-thickness scald burns 6.
Key Considerations
- The choice of dressing should be based on its effects on healing, ease of use, and patient comfort.
- SSD is not recommended as a first-line treatment due to its association with delayed healing and poorer outcomes.
- Microbial cellulose dressing and biosynthetic dressings are promising alternatives to SSD.
- Further research is needed to determine the most effective dressing for partial thickness burns, but current evidence suggests that SSD shouldn't be the first choice 2, 4, 5, 6.