What is the treatment for facial burns resulting from smoking on oxygen?

From the Guidelines

The treatment for facial burns resulting from smoking on oxygen requires immediate medical attention, and the most critical step is to stop the oxygen supply and remove the patient from the source. For minor burns, cool the area with room temperature water for about 10-20 minutes, then gently clean with mild soap and water. Apply an antibiotic ointment like bacitracin or silver sulfadiazine and cover with a non-stick dressing. Pain management typically includes acetaminophen or ibuprofen for mild pain, or prescription medications for more severe cases. For moderate to severe burns, hospitalization may be necessary, potentially involving specialized wound care, IV fluids, stronger pain management, and possibly skin grafting. Prevention is crucial - patients using oxygen therapy should never smoke, as oxygen makes materials more flammable and can cause rapid, severe burns, as highlighted in the British Thoracic Society guidelines for home oxygen use in adults 1.

Some key considerations in the management of facial burns from smoking on oxygen include:

• Ensuring the patient's safety by removing them from the source of the fire and stopping the oxygen supply
• Providing appropriate wound care, including cooling, cleaning, and dressing the burn
• Managing pain effectively, using medications such as acetaminophen or ibuprofen for mild pain, or prescription medications for more severe cases
• Considering hospitalization for moderate to severe burns, where specialized care can be provided
• Educating patients on the dangers of smoking while using oxygen, as emphasized in the British Thoracic Society guidelines 1, which can help prevent such incidents.

It's also important to note that the use of oil-based emollients and petroleum jelly can support combustion in the presence of oxygen, and patients should be advised to use only water-based products on their hands and face or inside the nose while using oxygen 1. Additionally, the local fire service should be made aware of patients who are using oxygen at home, especially those who continue to smoke, to carry out a home safety assessment 1.

In terms of specific treatment, there is limited evidence to support the use of hyperbaric oxygen therapy (HBOT) for burn wound healing, as noted in the management of severe thermal burns in the acute phase in adults and children 1. However, HBOT may be considered for patients with suspected or proven carbon monoxide poisoning secondary to smoke inhalation, as recommended by the European Committee of Hyperbaric Medicine 1.

Overall, the management of facial burns resulting from smoking on oxygen requires a comprehensive approach, including immediate medical attention, appropriate wound care, pain management, and prevention of further incidents.

From the FDA Drug Label

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 for facial burns resulting from smoking on oxygen involves:

• Cleansing and debridement of the burn wounds
• Application of silver sulfadiazine cream, USP 1% under sterile conditions
• Covering the burn areas with the cream at all times
• Applying the cream once to twice daily to a thickness of approximately one sixteenth of an inch
• Reapplying the cream immediately after hydrotherapy 2

From the Research

Treatment of Facial Burns from Smoking on Oxygen

The treatment of facial burns resulting from smoking on oxygen involves various approaches, including topical interventions and surgical procedures.

• Topical antimicrobial agents, such as silver sulfadiazine, may be used to promote wound healing and prevent infection 3.
• Non-antimicrobial agents, like Moist Exposed Burn Ointment (MEBO), may also be effective in treating facial burns 4.
• Skin substitutes, such as bioengineered skin substitutes, may be used to reduce time to partial wound healing and improve scar quality 4.
• Surgical procedures, like split-thickness skin grafting, may be necessary in some cases to repair damaged tissue 5.

Management of Facial Burns

The management of facial burns from smoking on oxygen requires a comprehensive approach, including:

• Wound care and dressing to promote healing and prevent infection 4.
• Pain management to reduce discomfort and promote patient comfort 4.
• Scar management to improve aesthetic and functional outcomes 3.
• Education and counseling to prevent future incidents, including smoking cessation programs 6.

Prevention of Facial Burns

Prevention of facial burns from smoking on oxygen is crucial, and can be achieved through:

• Patient education on the risks of smoking while on oxygen therapy 5, 6.
• Smoking cessation counseling and treatment to reduce the risk of burn injuries 6.
• Proper use and maintenance of oxygen therapy equipment to minimize the risk of ignition 7, 5.